“Health literacy has to improve across all the sections of the population,” Associate Professor Sajeev Koshy OAM, Times NOW & ICICI Bank NRI of the Year winner in Professional category across Asia-Pacific

Times NOW & ICICI Bank NRI of the Year winner in Professional category across Asia-Pacific winner, Dr Sajeev Koshy, is also the proud  recipient of ‘The Medal of the Order of Australia (OAM)’ on Australia Day Awards in 2016.  He is currently working as the Head of Specialist Unit- Endodontics , Prosthodontics and Periodontics at The Royal Dental Hospital of Melbourne and Dental Clinical Director for DPV Health.  Dr  Koshy who has been serving his profession with honesty, hardwork and full heart talks to Indus Age in an exclusive interview. Excerpts:

By Shashikanth  Narasimhiah

Congratulations doctor on your achievement and the recent award. We are all very proud of you. In layman’s terms what is the difference between Endodontistry and Dentistry?

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​Dentistry deals with all aspects of oral health including oral health promotion and interventions and is currently managed by dentists, oral health therapists, dental hygienists and dental prosthetists.  A new model of care where dental assistants with extended scope of practice is going to be trialed in the public dentistry service delivery.  Specialist Endodontists are  dentists who are additionally qualified and  trained in the Universities for a minimum of another 3 more years to deal with more complex cases of diagnosis and treatment. In simple terms endodontics is that branch of dentistry which deals with infection of the pulp in the tooth and nearby areas in the bone (root canal treatment) and managing dental traumatic injuries.

You have applied and practiced your chosen profession primarily both in India as well as in Australia. What can each country learn from the other in terms of public dental health service?
Dentistry is expensive all across the world . In India , patients approach the public dentists only when they have pain and mostly that will be extraction and also the public dentists are not  concentrated evenly across the states leading to disparity and poor out comes for the patients for conservative management of dental caries. In Australia , public dentistry service delivery is very structured and varies from state to state and there is a strict criteria for eligibility such as being a pensioner, low income earner with a health care card  holder, priority groups such as homelessness, mental health , pregnant women, preschoolers, refugees and asylum seekers etc . There is no right way of health service delivery. Each country has to understand the needs and wants of its needy population and then provide what is necessary for better outcomes.

 You have extended your valuable service to the disadvantaged, poor and down trodden world over without imposing a boundary. What inspired you to embark on such a noble mission?

As a young student , I used to do social service and was a student leader with a socialist thinking and coming from Kerala the issues of equity , equality and social justice was imbibed to me by my gurus and social reformers in Kerala. This had inspired me to move forward and be quite active in the social and community aspects in Kerala and has held various leadership positions as a student leader and for the dental profession. I started volunteering for Rotary International as a dental volunteer and has served the Vietnamese refugees in Hong Kong in the detention centres under UNHCR , Quechi Indians in Guatemal twice, Kikuyu tribes in Kenya and the orphans in Colima, Mexico. I also provide clinical advise to Smile High project managed by Australians in Nepal.

Could you provide an insider’s insight on how it would be economically feasible to extend expensive treatment such as yours free of cost to so many across the world? Could you tell us how your public services are funded whether there are any sponsors? 

Nothing comes free. It is upto the patient to self manage and adopt preventive strategies for oral health leading to better outcomes .  Universal Dental care is not a substitute. People should be conscious of their diet, less sugary food consumption, manage obesity, drink fluoridated tap water etc .This all contributes to healthy habits and life styles which will improve oral health outcomes. The Victorian government and Dental Health services is moving forward with a new model of integrated value based care where the outcomes / outputs should be related to costs. No government can keep on spending a heavy percentage of the budget for poor health comes. Australians and clinicians have to change the ways they manage healthcare in this decade for better outcomes in a cost effective manner.

Public dentistry is funded both by the State and Federal governments.

Could you elaborate on how the principle of “best practice” can be applied in your profession? How do you measure the success or otherwise of your service? What are some of the Key Performance Indicators? 

Success will be better outcomes with lesser costs and lesser interventions. Health literacy has to improve across all the sections of the population, impose sugar tax to reduce sugar consumptions, self management of oral health issues by proper regular brushing and flossing , low intake of carbohydates , more fresh vegetables and fruits, less sugary food and drinks, regular dental checkups . The success also will be with improved access to oral health care for the rural and regional areas. For this Tele-dentistry and technology can play a major part to support rural clinicians and patients with specialist advice.

What is your advice to the elderly in terms of preventive measures for dental health and hygiene?

Proper brushing and flossing, seek appropriate advice from oral health professionals.
What is the cause of bad breath especially among the elderly and how can that be controlled if not prevented? What measures do you suggest?

The cause of bad breath can be due to many reasons such as dryness of the mouth , systemic diseases etc and intake of multiple medications. The general dental practitioner will be the clinician to understand the causes and then manage it.

 In terms of public health service what are your future plans, goals and aspirations?

I work only for public dental service and with multiple leadership roles in the Royal Dental Hospital of Melbourne , DPV Health and Boort District Health, I will continue to do what I am doing and have a work life balance with my other commitments with the  Dental Board of Australia and the Victorian Clinical Council.

Apart from your profession what are some of your leisure activities and pastimes?
I enjoy travelling, nature and also I am a member of the Freemason fraternity.
In a lighter vein do you have a word of advise on why general public should not be scared to visit a dentist?

Gone are the days of painful dentistry and discuss with your oral health  clinician your fears and anxiety and that can be appropriately managed.