Oral healthcare in Pakistan has historically occupied a marginal position within the broader public health system. It has been dominated by insistent demands such as maternal health, infectious diseases and nutrition. The private sector has emerged as the dominant force shaping both dental education and service delivery across the country. Understanding its role is essential to appreciating the current structure and the persistent inequities of oral healthcare access in Pakistan.
Role of Private Sector in Dental Education
Dental education in Pakistan is overwhelmingly handled by private sector. Of the dozens of dental colleges registered with the Pakistan Medical and Dental Council (PM&DC), a significant majority operates as private institutions, either affiliated with public sector medical universities or functioning as constituent colleges of private medical universities. These institutions have expanded access to dental education considerably, absorbing thousands of students who would otherwise have no seats available in the limited public sector programs. Cities like Lahore, Karachi, Islamabad and Peshawar have seen a proliferation of private dental colleges over the past two decades.
This expansion, however, comes with mixed consequences. On one hand, private colleges have increased the overall output of dental graduates, helping to address severe shortage of dentists relative to its population. On the other hand, concerns persist regarding the quality and standardization of training, faculty shortages, inadequate clinical exposure and the financial burden placed on students through high tuition fees. This commercialization of dental education has also influenced career trajectories, with many graduates gravitating toward private practice in urban centers rather than underserved rural areas, exacerbating geographic disparities in access.
Role of Private Sector in Oral health Delivery
In terms of actual service delivery, the private sector is the primary provider of oral healthcare in Pakistan. Government dental facilities are largely concentrated in teaching hospitals attached to public medical colleges, and these are generally under-resourced, understaffed and limited to urban areas. As a result, the vast majority of dental care, including costly procedures like restorations, braces, dentures and implants, is delivered through private clinics, dental hospitals, and increasingly, corporate dental chains.
This reliance on private delivery has both positive and negative dimensions. Private clinics provide more modern equipment, shorter waiting times and greater responsiveness to patient needs compared to overstretched public facilities. Innovation in service delivery, including the adoption of digital dentistry, cosmetic procedures and specialized care, has largely been driven by private practitioners competing for market share in urban areas.
However, this private-dominated model raises serious equity concerns. Oral healthcare in the private sector operates largely as an out-of-pocket expense, with minimal insurance coverage or government subsidy. This renders dental care unaffordable for large segments of the population, particularly in rural and low-income urban areas. Preventive oral health services, which require less profit-driven infrastructure, are frequently neglected in favor of curative and cosmetic procedures that generate higher revenue. Consequently, oral health awareness and preventive practices remain poor among the general population, contributing to high rates of untreated dental caries, periodontal diseases and oral cancers.
A Balanced Model
The private sector dominance in oral healthcare system of Pakistan is unlikely to diminish given resource constraints on the public side. What is needed instead is a more structured partnership between public and private stakeholders. This could include public-private partnerships for rural outreach programs, regulatory reforms to standardize dental education quality, incentive structures encouraging private practitioners to serve underserved areas and greater investment in community-based oral health education campaigns that the private sector could help fund or implement through corporate social responsibility initiatives.
In Pakistan, though the private sector plays an indispensable role in oral healthcare system, yet without stronger regulatory oversight and public sector collaboration, this private-led model risks spreading inequities in access, leaving oral health as a privilege rather than a right for millions of Pakistanis.
The author is Dean, Bhitai Dental and Medical College, Mirpurkhas