Profession of Dental Surgery

Dr. Hilary COORAY

MODERN Dental Surgery as being practised today, has developed over hundreds of years of research based on various fields of science.

The common face of the Dental Surgeon as one who removes teeth is fast changing. Teeth are for ones entire life, is the paradigm shift undergone in modern Dental Surgery.

The present day Dental Surgeon is primarily concerned with health promotion and prevention. He would advise the community, social leaders and the patients on the importance of good health and therefore the value of good general hygiene and oral hygiene.

The key oral health messages, the use of fluoridated toothpaste, brushing after meals, and control of sugar intake are emphasized to patients at every visit.

In spite of these measures if some teeth are affected by dental caries or gum disease (periodontal disease) then the Dental Surgeon will do his best to save the teeth and not take the easy path of extracting them.

In the case of dental caries, the dental surgeon has the option of either simple restorations or doing root canal therapy using the modern equipment and pharmaceuticals available to them. If the teeth are badly broken down porcelain crowns and bridges will be done.

In more severe cases, dental implants may have to be done. This is a process whereby titanium implants are embedded into the jaw bone.

If teeth become loose due to periodontal disease (gum disease) many treatment options are available to strengthen them by procedures like deep scaling, periodontal surgery, splinting and bonding. Regeneration of alveolar bone and at times grafting of bone is done for these conditions.

The incidence of oral cancer in Sri Lanka is the highest of all cancers of the body. Early detection is of utmost importance for a good prognoses in treatment of oral carcinoma.

Oral Surgeons in the field of Oral and Maxillo Facial Surgery perform major surgery in Carcinoma, Tumours, Cysts and Correction of Deformities and Fractures of the Mandible and Mazilla.

Those who have an aptitude for research will be discovering new materials, drugs, equipments and new methods of treatment. In the modern consumeristic society the demand for dental treatment is shifting towards aesthetic dentistry.

Tooth whitening, crown and bridge work and dental implants are now developing into a greater focus of treatment.

Entry Requirements

Students are selected for the undergraduate course at the Faculty of Dental Sciences based on the advanced level examination. The selection process is done by the University Grants Commission taking into account the District Quota System.

The annual intake to the Faculty of Dental Sciences is seventy five (75). Though nearly 95,000 students become eligible for University Education only around 17,000 are admitted to the 13 Universities in Sri Lanka on the availability of seats for various disciplines of study.

The training programme consists of four years as a residential internal student of the Faculty of Dental Science of University of Peradeniya. In the first year the students learn basic sciences comprising of General Anatomy, Physiology, Bio Chemistry and Dental Anatomy.

In the second year they learn Pharmacology, General Pathology, Microbiology, General Medicine and General Surgery. The clinical dental training commences in the third year and goes on for the fourth year until they sit for the final exam.

They are trained in subjects such as Oral Medicine, Oral Surgery, Oral Pathology, Periodontology, Paedontics, Orthodontics Prosthetics, Restorative Dentistry and Community Dentistry.

Entry into Foreign Dental Faculties

Since every student who aspires to do Dental Surgery is unable to gain entrance to the Peradeniya Dental Faculty some take the other option of going abroad.

Many Dental Faculties in India, Pakistan, Russia, Bangladesh, Hong Kong and Nepal take students for their courses based on the Sri Lankan advanced level results.

There are many scholarships awarded to study Dental Surgery in foreign countries. Some students avail themselves of these and the others have to pay the course fee on their own as private students.

Once they qualify from the foreign dental schools these graduates need to register themselves with the Sri Lanka Medical Council and obtain the licences to practise.

This is done by passing the examination ERPDS (Examination for Registration to Practice Dental Surgery) conducted biannually by the Sri Lanka Medical Council.

Once a Foreign or Local Graduate is registered they have the option of joining the Department of Health, Private Sector Hospitals or start a General Dental Practice.

They could also join the Defence Services Medical Corps in the Army, Navy and Air Force and serve as Dental Surgeons and Specialists.

Post Graduate examinations

A specialist is a person who will advance his skills and knowledge on a particular discipline of Dental Surgery and provide a service to the public. The Specialist training programmes are conducted by the Post Graduate Institute of Medicine, University of Colombo through the Board of Study in Dental Surgery.

The Specialities so far established are, Oral and Maxillo Facial Surgery, Orthodontics, Restorative Dentistry and Community Dentistry. Many other go abroad to countries like United Kingdom and the United States to obtain their post graduate qualifications.

In addition there is a Diploma Course conducted for Diploma in Hospital Dental Practice. Course in Oral Pathology and General Dental practice are in the process of being organised.

Academic training leading to MPhil and PhD in various disciplines are done in the Faculty of Dental Sciences and the Faculties of Medicine. The Post Graduate Examination could be read by those Dental Surgeons in Government Service as well as those in the Private Sector.

Working Conditions of a Dental Surgeon

The working environment of a Dental Surgeon depends on the type of service that he chooses.

It will vary widely from serving in a city or rural village or in the Armed Services in conflict areas since they deal with human beings who are in need of their services as an one to one basis for their illness and suffering.

A Dental Surgeon who is a member of the healing team derives great satisfaction by alleviating pain and suffering of their fellow citizens.

Questions and answers

QUESTION: Refusal to submit Income Tax Returns

During the period 1999-2004 I was working for 2 Blue Chip companies in Sri Lanka and all taxes with regard to my monthly income was deducted from my salary and forwarded to the Inland Revenue Department by the respective employers.

I need to mention that I do not have any other source of income whatsoever and only own my house and no bank deposits also.

In 2001 I received a letter from the Inland Revenue Department requesting to declare my income for periods 1998/99, 1999/2000.

I was fully annoyed with this request as I clearly understood how disorganised the Inland Revenue is as they have sent the letters to the wrong people. I completely ignored this and after some time a warning letter came which I ignored as well.

Now situation has turned to be very serious as they have taken legal action against me according to a recent letter received. (Not court documents). Still I have ignored this as I feel that I need not pay a cent as taxes additionally as my dues are deducted from my salary and sent direct to the Inland Revenue.

Since 2005 I am working for a company in Dubai and out of the country.

Please advise me what action I should take regarding the irresponsible action by the Inland Revenue Department.

Also recently I saw on the Internet that the Deputy Minister of Finance is planning to open 500,000 more tax files in the coming years. One could assume that more than 50 per cent of the files to be opened could be similar to mine, without proper findings. This could be in the interest of the general public to know the exact position also would be a waste of public money.

SHYAMA PERERA, Dubai

email: Shyamap2000@yahoo.com 

Answer: Whether you are in receipt of taxable income or not you have to respond to the income declaration form/letter sent by the Department of Inland Revenue.

You could have submitted the returns stating your employment details and the ‘Paye’ tax reference.

Also you could have declared that you do not have any other income if it is the case as you have stated. Non submission of the tax return form sent to you is an offence and the department will proceed to take legal action after issuing warning notice.

It is stated that there are many who do not pay tax although they are liable to. Only way the department can determine this is from the return submitted.

In order to identify likely tax payers there are several factual criteria used by the Department.

To list a few persons receiving interest from bank deposits, receiving dividends from shares, electricity bills of over Rs. 10,000 per month, purchase of air ticket for foreign travel and several such information.

QUESTION: Setting up Dansala

During the past few years, some people of the area set up a Dansala for Vesak right along my front wall and by the side of my gate. This has been a big nuisance and we are helpless.

The dinner goes on late into the night for about three days. My invalid mother and the children cannot sleep. Furthermore the left over food is dumped on the pavement causing a terrible stench.

Presumably permission is given by the police for these Dansalas. Surely, should not the Police ensure that the affected residents have given their concurrence.

My family dread the Vesak which is due shortly. Can the OPA take this matter up with the IGP and ensure that residents are not harassed in this manner.

MANOHARAN, Colombo 6.

Answer: Although any erection or even a temporary shed is an offence, normally it is overlooked by all concerned since Vesak is a religious celebration and any dansal erected will be removed after Vesak.

If you consider the dansal erected along your wall is causing inconvenience to you. You can seek the assistance of the police in your area or amicably persuade them to move the dansala further away where it will not cause any serious inconvenience to anyone.

QUESTION: Issue of official passport

Passports are issued in the category of ordinary, official and diplomatic. As a member of a statutory body am I entitled to a official passport.

H. SIRISENA, Colombo.

Answer: Official passports are issued to officers of the executive grades and above in Government and statutory bodies who go abroad for official purposes. Their applications have to be recommended by the Heads of Departments and sent through the respective Secretary of the Ministry.

Others will be entitled only to an ordinary passport. For further details you may contact the Add. Director, Department of Immigration and Emigration on tele. 5329000.

QUESTION: Rectifying of pension anomalies

Let me first commend you for the great initiative taken by OPA to listen to the woes of the public. This is one instance where your organisation can be very effective. My question to you comes in the broad category of economics.

I am a government pensioner. My pension number is 616257. The number reminds me of the numbers given during the Nazi times. I sincerely hope that the result is not going to be the same fate that befell the Jews under Nazi Germany.

I retired from Government Service under the Pub. Admin. Circular No. 44/90. Under this circular I was entitled to receive 90 per cent of my last salary as pension. This was an incentive given at that time to get the maximum number to retire under this circular.

Now my question is why so far my pension has not been revised. I understand that in terms of Pensions Circular 06/2004, I should receive a pension revision with 50 per cent arrears paid on 1.1.2006 and the balance arrears on 1.1.2007. I have so far not received a single sum as arrears.

W. S. NANAYAKKARA, Colombo 5.

Answer: 1. Pensions of all government servants have been rectified taking into account the increases or revisions granted as if they have retired as at 01.01.97. Public Administration Circular No. 44/90 will no longer apply.

2. Regarding the 50 per cent arrears please contact the Divisional Secretary’s from where your pension is being paid.

QUESTION: Issue of Death Certificate

I applied to the Divisional Secretary, Thimbirigasyaya at Vajira Road, for a certified Death Certificate in respect of a death that occurred on 17th July 1983 at the Ward Place Nursing Home, Ward Place, Colombo 7 - which is opposite the Dental Institute. (My application No. A/2306 of 24.01.2006 refers).

After driving me from pillar to post, the Thimbirigasyaya office asked me to check with the Colombo Kachcheri in Dam Street, which I did. There too I drew a blank.

Please let me know the Divisional Secretary’s office to which I should make my application.

L. B. U. de SILVA, Battaramulla.

Answer: Are you sure that no death certificate has been issued as you cannot bury or cremate the remains without a death certificate. Perhaps you are trying to obtain a certified copy of the death certificate already issued.

You could obtain a certified copy by providing the details such as name and address of the person deceased along with the date and place, to the Divisional Secretary’s office at the Colombo Kachcheri, Dam Street where you had already visited.

Please contact the Additional District Registrar, Mrs. Ramya Barathi at this office. (Tele. 2472995). She as agreed to assist you.