It is said robust oral health is an element to right to life intricately linked with overall health and well-being. Achieving enhanced levels of oral health for humans require adopting a holistic health promotion strategy that addresses shared risk factors between systemic and oral diseases.” Article 7 of the Constitution mandates the state to “promote conditions that will enable the pursuit of GNH and provide free access to basic public health services.” While the government insists that there are no major impacts on healthcare services, the ground realities indicate otherwise. For example, Paro Hospital does not have any available appointments for teeth scaling until 2024 and this is not an isolation case.

The National Health Policy of Bhutan boasts that “despite its rugged terrain and limited resources, health indicators make Bhutan a model and pioneer for the promotion of primary healthcare.” Yet Bhutanese are finding it increasingly difficult to access basic health services and health professionals are indicating burn outs due to Australia rush with no sign of improvement as more and more experienced health professionals leave the nation.

As of March 2023, the World Health Organization (WHO) reported that “Oral diseases, while largely preventable, pose a significant health burden for many countries and affect people throughout their lifetime, causing pain, discomfort, disfigurement, and even death. It is estimated that oral diseases affect nearly 3.5 billion people.” WHO warns that “untreated dental caries (tooth decay) in permanent teeth are prevalent, and most low- and middle-income countries lack sufficient services to prevent and treat oral health conditions.” Bhutan is no exception.

Scaling of teeth is a non-surgical dental procedure aimed at removing plaque, calculus, debris, and stains from tooth root surfaces. Health experts emphasize that teeth scaling is essential for preventive dental care, as it helps prevent cavities, tooth decay, periodontal disease, staining, bad breath, and other oral issues. Regular scaling, combined with proper oral hygiene practices like brushing and flossing, plays a vital role in preventing tooth loss by averting plaque buildup that can harm tooth enamel.

Research demonstrates a significant link between lower socioeconomic status and a higher prevalence of oral diseases, affecting individuals across age groups and various income levels in high, middle, and low-income nations. Though dental issues are Non-Communicable Diseases (NCD) and there is constitutional guarantee of free health care, without timely accessibility of health care, these guarantees alone is not enough. There is must be accessibility and quality care.

The American Dental Association emphasizes the importance of proper home oral care to reduce the risk of dental. ADA studies found that while a person requires only about two hours per year at the dentist’s chamber for scaling compared to around 30 hours per year for brushing the teeth at home to do the same job.

Thus, the government must take immediate action to address public dental care issues. This entails a balanced approach, by increasing financial and human resources, along with cautious consideration of regulated privatization to lighten the public burden. Enhancing both public infrastructure and resources, while ensuring oversight of private alternatives, is vital for improving dental care accessibility for all citizens. These prudent yet decisive actions may meet constitutional mandates and maintain dental health in the face of current challenges. Failure to act will disproportionately affect the most disadvantaged groups, leading to more serious dental issues and increased national costs due to a lack of preventive measures.



Sonam Tshering

Lawyer, Thimphu


Disclaimer: The views expressed in this article are author’s own.