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Indian Market for Dental Equipment
2172
The Journal of the American Dental Association
pros and cons of the various foods as they affect the problem are considered, and all of this is boiled down to the essentials. This chapter will be found very valuable not only to the dentist, but also to all of those who are in any way concerned with the rearing of children. In like manner, the various dietary problems in health and disease are taken up in this volume, and the whole constitutes itself a rich mine of val uable information. The publishers and authors are to be congratulated on the suc cess of this volume.
1920, and T h e J o u r n a l for April, 1921, where appear papers by Dr. Monson and J . Leon Williams, respectively. If Dr. Helmer has correctly portrayed the theory advanced in the editorial in question, I can but say that it is absolutely wrong. My paper on “ Balanced Occlusion” gives the reasons for this statement. C. W. B e n s o n , 1216 Medical Arts Bldg., • Duluth, Minn.
CORRESPONDENCE
Considering its population, India is an extremely poor market for dental equip ment and dental supplies of all kinds. Ow ing to the fact that its population of 360,000,000 has an extremely low average money income, estimated at not over $45 per annum, approximately 80 per cent of which is spent on essential food and cloth ing, there is little remaining for medical services of any description, and the great majority of the population, following their ancient custom, depend on treatment at the hands of the village physician in the case of dental troubles or any other physical ailment. It is among the Europeans, Anglo-In dians, Parsees and westernized Indians that the potential clientele for the dentist is found, and it is estimated that the total population from which a modern dentist using up-to-date equipment and supplies may hope to draw his practice does not ex ceed 1,000,000 persons. It is only in the large cities that high grade dental service is available, and there are not more than a dozen qualified dental surgeons in either Calcutta, with a population of 1,500,000, or Bombay, with a population of 1,250,000. Estimates place the total number of den tists in India at not over 2,000 and the same estimates indicate that only about 15 per cent of these possess qualifications as D.D.S. (American), L.D.S. or R.C.S. (Eng lish) or D.E.D.P. (French). Of these quali fied dentists, about fifty are American and British, the remaining being principally In dians, both foreign and Indian trained, and a few Japanese. One of the criticisms fre
“ S p h e r ic a l O c c l u s io n ”
To the Editor: In further replying to Dr. Helmer, I must be brief, wishing to conserve valuable space. The sequence of reasoning during right lateral movement in the experimental stage, employing the articulating instrument shown in my illus trations, was about as follows: I. The tri angle remains constant to the lower cast. (Fig. 2.) II. Point “B ” moved, while point “A” did not. (Fig. 5.) III. Point “ B ” moved as point “ B” in Figure 7. IV. Con sidering point I, the mandible moves as in Figure 3, on an axis. We have thus far witnessed the displacement of a material structure, the triangle. The intercondylar dimension (a straight line) has described a surface of revolution, to merely state a fact to convey the thought of “motion.” After three different bite relations have thus been analyzed, we are through with the triangle. Then the pyramid comes into the picture. The pyramid cannot “sidetrack” what is already past. I have no argument as to the spherical pyramid’s faces being com prised of sectors. I have probably known that longer than Dr. Helmer, but I main tain that that fact in nowise “ sidetracks” the use of the triangle as a visible material evidence in the analysis. I could not very well begin with an imaginary form which cannot reveal the action. It had to be the triangle. As for Dr. Helmer’s implication of another theory of spherical occlusion, I may say that I cannot accept an editorial opinion based on such a title. I would re fer Dr. Helmer to T h e J o u r n a l for May,
IND IAN MARKET FOR DENTAL EQUIPM ENT
2173
Miscellany quently heard from the medical authori ties in India concerns the large number of unqualified persons practicing dentistry within the country, but this condition is difficult to remedy, as at present there is no legal requirement concerning qualifica tions for the practice of dentistry. It is said that the Calcutta Dental College and Hospital annually graduates about twentyfive qualified practitioners, but large num bers leave the college and commence the practice of dentistry long before their courses of training are completed. T h is, situation contributes to some ex tent to the disinclination of Indians in the low and medium income class to patronize dentists, as they distrust the unqualified men and cannot afford the prices charged by the European and highly qualified In dian dentists. The usual charge of Ameri can or British dentist is Rs.32/- per visit, irrespective of the type of work performed. Efforts are being made to bring into op eration an act to govern the practice of dentistry in India and the government has recently decided to establish a dental col lege in Lahore. European and other first class dentists have fairly well equipped operating rooms with modern instruments and appliances. These dentists as a rule use American and British made dental appliances, which are considered the best in quality, but in many instances items of German manufacture are in use among them, owing to the rela tively low prices at which they are avail able and the satisfactory service that they give. Unqualified and cheap dentists do not have adequate equipment, their outfit con sisting usually of a chair, a foot-operated machine and a few of the more necessary instruments. This equipment is usually of Japanese make or is second-hand German equipment purchased locally. SALES O UTLETS
Dental supply houses, particularly those considered to be reliable and progressive, are extremely few. Trade reports indicate that there are altogether not more than four or five houses of any importance in
the principal cities of Bombay and Cal cutta. These dental supply houses prepare periodical catalogs which are sent to lists of dentists throughout the country, selling at list. Besides direct sales, a great deal of equipment is disposed of through chemists and druggists throughout the country who carry small stocks of instruments and sup plies. Dental supply houses usually give discounts of 10 to 15 per cent to these re tail outlets on instruments, etc., and, on orders for chairs and larger equipment, their discount is as high as 25 per cent. These dental supply houses bid on govern ment tenders and sell direct to the various hospitals, dental schools, etc. Many of the American and British dentists place their orders direct with manufacturers abroad. IMPORTS
No customs statistics are available from which the annual value of imports of den tal supplies and equipment may be ob tained. Trade estimates by Calcutta dental supply houses place the total value of im ports at between Rs.600,000/- and Rs.750,000/- per annum. Estimates from the same sources indicate that the United Kingdom has most of this business, with Germany, United States and Japan following, in that order. Certain well known American lines are manufactured in England and exported from there to this country. It is reported locally that certain items supplied from Germany are manufactured there under American patents and supplied to the In dian market in order to meet price competi tion, which cannot be met with American made items. Export statistics of the United States indicate that the total value of den tal instruments, supplies and equipment ex ported to British India in 1933 amounted to less than $3,000. IMPORT d u t y
Dental and surgical instruments are as sessed under item 77 of the Indian Import Tariff at a standard rate of duty of 30 per cent ad valorem. A preferential rate of 20
2174
The Journal of the American D ental Association
per cent ad valorem is assessed on products from the United Kingdom. Surgical instruments imported by a pas senger as part of his personal baggage and in actual use by him in the practice of his profession are admitted duty free. PRICES AGAINST AMERICAN EQUIPMENT
While catalogs of the dental supply houses list numerous American items, par ticularly in instruments and supplies, it is said that little effort is made here by Amer ican manufacturers to push their products. This is said to be particularly true of larger items of equipment. The decidedly higher prices of American manufacturers make it extremely difficult for them to compete with the lower priced products of other countries without con siderable sales effort, and the present po tential market is too small to make feasible
the expenditure required for sales effort. An example of the great disparity in price is that of dental chairs. A well-known American chair sells in this market for Rs. 1,000/- to Rs. 1,500/-. The identical item manufactured in Germany sells for Rs.750/, while a duplicate of excellent pat tern and good workmanship made in J a pan retails for Rs.250/-. It is readily ad mitted by foreign and Indian dentists alike that they prefer American dental equip ment, but they cannot afford to pay the dif ference in price that obtains. This division has on file a copy of the Calcutta Dental Review, which has just begun publication and claims to be the only monthly magazine in the East devoted to dentistry and “ allied subjects.” The other dental journal in this area is the Indian Dental Journal, a quarterly.—Department of Commerce Bulletin.
A N N O U N C EM EN TS* C A L E N D A R O F M E E T IN G S
American Dental Association, Oakland, Calif. Chicago Dental Society Midwinter Clinic, February 17-20. Dental Protective Association of the United States, Chicago, 111., December 16. Five State Post Graduate Clinic (M ary land, Delaware, Virginia, West Virginia and North Carolina), Washington, D. C., March 8-11. Greater New York December Meeting, New York City, December 2-6. International Dental Congress, Vienna, August 2-9. Philadelphia County Dental Society (in combination with Pennsylvania State Den tal Society), Philadelphia, February 4-6. Southern Society of Orthodontists, Chat tanooga, Tenn., January 27-29. Society for the Advancement of General *Announcements must be received by the fifth day of the month in order to be published in the forthcoming issue of T h e J o u r n a l . Jour. A .D .A ., V ol. 22, D ecem b er, 1935
Anesthesia in Dentistry, New York City, third Monday in February, April, October and December. District of Columbia at George Wash ington University, Washington, D. C., sec ond and fourth Tuesdays in each month from October to June, inclusive. S T A T E S O C IE T IE S
February Minnesota, at St. Paul (25-27) Pennsylvania, at Philadelphia (4-6) April Alabama, at Birmingham (14-16) Connecticut, at Stamford (15-17) Kansas, at Salina (27-29) Louisiana, at Baton Rouge (26-28) Massachusetts, at Boston (28-May 1) Montana, at Butte (16-18) New Jersey, at Atlantic City (22-24) Wisconsin, at Milwaukee (21-23) May Illinois, at Peoria (12-14) Indiana, at Indianapolis (18-20) Maryland, at Baltimore (4-6)
The Journal of the American Dental Association
pros and cons of the various foods as they affect the problem are considered, and all of this is boiled down to the essentials. This chapter will be found very valuable not only to the dentist, but also to all of those who are in any way concerned with the rearing of children. In like manner, the various dietary problems in health and disease are taken up in this volume, and the whole constitutes itself a rich mine of val uable information. The publishers and authors are to be congratulated on the suc cess of this volume.
1920, and T h e J o u r n a l for April, 1921, where appear papers by Dr. Monson and J . Leon Williams, respectively. If Dr. Helmer has correctly portrayed the theory advanced in the editorial in question, I can but say that it is absolutely wrong. My paper on “ Balanced Occlusion” gives the reasons for this statement. C. W. B e n s o n , 1216 Medical Arts Bldg., • Duluth, Minn.
CORRESPONDENCE
Considering its population, India is an extremely poor market for dental equip ment and dental supplies of all kinds. Ow ing to the fact that its population of 360,000,000 has an extremely low average money income, estimated at not over $45 per annum, approximately 80 per cent of which is spent on essential food and cloth ing, there is little remaining for medical services of any description, and the great majority of the population, following their ancient custom, depend on treatment at the hands of the village physician in the case of dental troubles or any other physical ailment. It is among the Europeans, Anglo-In dians, Parsees and westernized Indians that the potential clientele for the dentist is found, and it is estimated that the total population from which a modern dentist using up-to-date equipment and supplies may hope to draw his practice does not ex ceed 1,000,000 persons. It is only in the large cities that high grade dental service is available, and there are not more than a dozen qualified dental surgeons in either Calcutta, with a population of 1,500,000, or Bombay, with a population of 1,250,000. Estimates place the total number of den tists in India at not over 2,000 and the same estimates indicate that only about 15 per cent of these possess qualifications as D.D.S. (American), L.D.S. or R.C.S. (Eng lish) or D.E.D.P. (French). Of these quali fied dentists, about fifty are American and British, the remaining being principally In dians, both foreign and Indian trained, and a few Japanese. One of the criticisms fre
“ S p h e r ic a l O c c l u s io n ”
To the Editor: In further replying to Dr. Helmer, I must be brief, wishing to conserve valuable space. The sequence of reasoning during right lateral movement in the experimental stage, employing the articulating instrument shown in my illus trations, was about as follows: I. The tri angle remains constant to the lower cast. (Fig. 2.) II. Point “B ” moved, while point “A” did not. (Fig. 5.) III. Point “ B ” moved as point “ B” in Figure 7. IV. Con sidering point I, the mandible moves as in Figure 3, on an axis. We have thus far witnessed the displacement of a material structure, the triangle. The intercondylar dimension (a straight line) has described a surface of revolution, to merely state a fact to convey the thought of “motion.” After three different bite relations have thus been analyzed, we are through with the triangle. Then the pyramid comes into the picture. The pyramid cannot “sidetrack” what is already past. I have no argument as to the spherical pyramid’s faces being com prised of sectors. I have probably known that longer than Dr. Helmer, but I main tain that that fact in nowise “ sidetracks” the use of the triangle as a visible material evidence in the analysis. I could not very well begin with an imaginary form which cannot reveal the action. It had to be the triangle. As for Dr. Helmer’s implication of another theory of spherical occlusion, I may say that I cannot accept an editorial opinion based on such a title. I would re fer Dr. Helmer to T h e J o u r n a l for May,
IND IAN MARKET FOR DENTAL EQUIPM ENT
2173
Miscellany quently heard from the medical authori ties in India concerns the large number of unqualified persons practicing dentistry within the country, but this condition is difficult to remedy, as at present there is no legal requirement concerning qualifica tions for the practice of dentistry. It is said that the Calcutta Dental College and Hospital annually graduates about twentyfive qualified practitioners, but large num bers leave the college and commence the practice of dentistry long before their courses of training are completed. T h is, situation contributes to some ex tent to the disinclination of Indians in the low and medium income class to patronize dentists, as they distrust the unqualified men and cannot afford the prices charged by the European and highly qualified In dian dentists. The usual charge of Ameri can or British dentist is Rs.32/- per visit, irrespective of the type of work performed. Efforts are being made to bring into op eration an act to govern the practice of dentistry in India and the government has recently decided to establish a dental col lege in Lahore. European and other first class dentists have fairly well equipped operating rooms with modern instruments and appliances. These dentists as a rule use American and British made dental appliances, which are considered the best in quality, but in many instances items of German manufacture are in use among them, owing to the rela tively low prices at which they are avail able and the satisfactory service that they give. Unqualified and cheap dentists do not have adequate equipment, their outfit con sisting usually of a chair, a foot-operated machine and a few of the more necessary instruments. This equipment is usually of Japanese make or is second-hand German equipment purchased locally. SALES O UTLETS
Dental supply houses, particularly those considered to be reliable and progressive, are extremely few. Trade reports indicate that there are altogether not more than four or five houses of any importance in
the principal cities of Bombay and Cal cutta. These dental supply houses prepare periodical catalogs which are sent to lists of dentists throughout the country, selling at list. Besides direct sales, a great deal of equipment is disposed of through chemists and druggists throughout the country who carry small stocks of instruments and sup plies. Dental supply houses usually give discounts of 10 to 15 per cent to these re tail outlets on instruments, etc., and, on orders for chairs and larger equipment, their discount is as high as 25 per cent. These dental supply houses bid on govern ment tenders and sell direct to the various hospitals, dental schools, etc. Many of the American and British dentists place their orders direct with manufacturers abroad. IMPORTS
No customs statistics are available from which the annual value of imports of den tal supplies and equipment may be ob tained. Trade estimates by Calcutta dental supply houses place the total value of im ports at between Rs.600,000/- and Rs.750,000/- per annum. Estimates from the same sources indicate that the United Kingdom has most of this business, with Germany, United States and Japan following, in that order. Certain well known American lines are manufactured in England and exported from there to this country. It is reported locally that certain items supplied from Germany are manufactured there under American patents and supplied to the In dian market in order to meet price competi tion, which cannot be met with American made items. Export statistics of the United States indicate that the total value of den tal instruments, supplies and equipment ex ported to British India in 1933 amounted to less than $3,000. IMPORT d u t y
Dental and surgical instruments are as sessed under item 77 of the Indian Import Tariff at a standard rate of duty of 30 per cent ad valorem. A preferential rate of 20
2174
The Journal of the American D ental Association
per cent ad valorem is assessed on products from the United Kingdom. Surgical instruments imported by a pas senger as part of his personal baggage and in actual use by him in the practice of his profession are admitted duty free. PRICES AGAINST AMERICAN EQUIPMENT
While catalogs of the dental supply houses list numerous American items, par ticularly in instruments and supplies, it is said that little effort is made here by Amer ican manufacturers to push their products. This is said to be particularly true of larger items of equipment. The decidedly higher prices of American manufacturers make it extremely difficult for them to compete with the lower priced products of other countries without con siderable sales effort, and the present po tential market is too small to make feasible
the expenditure required for sales effort. An example of the great disparity in price is that of dental chairs. A well-known American chair sells in this market for Rs. 1,000/- to Rs. 1,500/-. The identical item manufactured in Germany sells for Rs.750/, while a duplicate of excellent pat tern and good workmanship made in J a pan retails for Rs.250/-. It is readily ad mitted by foreign and Indian dentists alike that they prefer American dental equip ment, but they cannot afford to pay the dif ference in price that obtains. This division has on file a copy of the Calcutta Dental Review, which has just begun publication and claims to be the only monthly magazine in the East devoted to dentistry and “ allied subjects.” The other dental journal in this area is the Indian Dental Journal, a quarterly.—Department of Commerce Bulletin.
A N N O U N C EM EN TS* C A L E N D A R O F M E E T IN G S
American Dental Association, Oakland, Calif. Chicago Dental Society Midwinter Clinic, February 17-20. Dental Protective Association of the United States, Chicago, 111., December 16. Five State Post Graduate Clinic (M ary land, Delaware, Virginia, West Virginia and North Carolina), Washington, D. C., March 8-11. Greater New York December Meeting, New York City, December 2-6. International Dental Congress, Vienna, August 2-9. Philadelphia County Dental Society (in combination with Pennsylvania State Den tal Society), Philadelphia, February 4-6. Southern Society of Orthodontists, Chat tanooga, Tenn., January 27-29. Society for the Advancement of General *Announcements must be received by the fifth day of the month in order to be published in the forthcoming issue of T h e J o u r n a l . Jour. A .D .A ., V ol. 22, D ecem b er, 1935
Anesthesia in Dentistry, New York City, third Monday in February, April, October and December. District of Columbia at George Wash ington University, Washington, D. C., sec ond and fourth Tuesdays in each month from October to June, inclusive. S T A T E S O C IE T IE S
February Minnesota, at St. Paul (25-27) Pennsylvania, at Philadelphia (4-6) April Alabama, at Birmingham (14-16) Connecticut, at Stamford (15-17) Kansas, at Salina (27-29) Louisiana, at Baton Rouge (26-28) Massachusetts, at Boston (28-May 1) Montana, at Butte (16-18) New Jersey, at Atlantic City (22-24) Wisconsin, at Milwaukee (21-23) May Illinois, at Peoria (12-14) Indiana, at Indianapolis (18-20) Maryland, at Baltimore (4-6)