Challenges faced in dental care delivery amid financial crisis in Sri Lanka : an evidence-based analysis from the perspective of health professionals

Over the years, Sri Lanka achieved excellent scores in health indicators relative to the national expenditure on health. However, due to several challenging situations such as the 2019 Easter bombings, COVID-19 pandemic and economic crisis, there was a depletion of the GDP as well as rising inflation. This created a humanitarian crisis for all socioeconomic groups. Among them, the health sector was widely affected, including healthcare providers and healthcare recipients. The objective of this study was to elaborate on the challenges faced in dental care delivery by private general dental practitioners and the impact on dental education for undergraduate and postgraduate dental students during the economic crisis. A descriptive cross-sectional survey-based questionnaire (n = 28) was conducted and assessed among the dental surgeons of various districts in Sri Lanka. An interviewer-based questionnaire was carried out via telephone conversation by the principal investigator of dental surgeons for those who managed and owned the respective dental clinic. Data from the computed questionnaires were analyzed using the SPSS Statistical Software Package (SPSS, Version 21). Descriptive statistics were expressed as frequency distributions and percentages. Based on the results, a significant decrease was observed in the number of patients requesting restorative dental procedures including implant crowns (36.29%), implant over dentures (35.63%), crowns (39.03%), bridges (49.12%), amalgam restorations (47.38%), composite restorations (42.11%) and dentures (49.69%). In surgical dental treatment, the extractions and surgical removal of teeth were reduced by 2.11% and 43.71%, respectively. The availability of dental materials such as light care composite (LCC) bonding, silver amalgam, impression materials and surgical consumables was reduced in the post-economic crisis situation compared to the pre-economic crisis status. Furthermore, dental laboratory charges per item, fees per procedure, salaries to support staff, utility bills including electricity and water, payments to government bodies, travelling costs to the clinic (for the doctor) and other expenses have increased in the post-economic period.