To explore and develop a model to maintain and build upon a dental clinic open for all in developing regions, with a primary focus on India

Table 1 Demographics of Indore

Variable	n (%)
Population
Total	2465827 (-)
Males	1289352 (53)
Females	1176475 (47)
Rural	735464 (29.7)
Males	379624 (15.3)
Females	355840 (14.4)
Urban	1730363 (70.3)
Males	909728 (36.9)
Females	820635 (33.4)
Age Distribution
< 10 yr	538943 (21.8)
10-20 yr	524116 (21.2)
20-30 yr	460948 (18.6)
30-50 yr	625071 (25.3)
> 50 yr	309070 (12.5)

Table 2 Questionnaire to determine health care status and needs

Age group	%
1 Percentage distribution of different age groups that have visited the dentist in the previous year
< 10 yr
10-20 yr
20-30 yr
30-50 yr
> 50 yr
2 Percentage distribution of different age groups needing dental treatment according to urgency of need
< 10 yr
10-20 yr
20-30 yr
30-50 yr
> 50 yr
3 Percentage distribution of children < 20 yr of age with the following diseases or dental ailments
Caries
Mobile teeth
Gums pyorrhea
Pulpal infection
Others
4 Percentage distribution of people between 20-50 yr of age with the following diseases or dental ailments
Caries
Mobile teeth
Gums pyorrhea
Pulpal infection
Others
5 Percentage distribution of people above 50 yr of age with the following diseases or dental ailments
Caries
Mobile teeth
Gums pyorrhea
Pulpal infection
Others
6 Percentage of different age groups who had all their teeth extracted
< 10 yr
10-20 yr
20-30 yr
30-50 yr
> 50 yr
7 Percentage of different age groups who had no teeth extracted
< 10 yr
10-20 yr
20-30 yr
30-50 yr
> 50 yr

Table 3 Percentage distribution by age of people visiting the dentist

Age group	%
< 10 yr	23
10-20 yr	31
20-30 yr	19
30-50 yr	16
> 50 yr	11

Table 4 Percentage distribution by age of people needing dental treatment according to urgency of need

Age group	%
< 10 yr	15
10-20 yr	24
20-30 yr	13
30-50 yr	19
> 50 yr	29

Table 5 Percentage distribution

Disease	%
Children < 20 yrs of age with the following diseases or dental ailments
Caries	61
Mobile teeth	20
Gums pyorrhea	4
Pulpal infection	12
Others	3
People between 20-50 yrs of age with the following diseases or dental ailments
Caries	34
Mobile teeth	25
Gums pyorrhea	18
Pulpal infection	23
Others	10
People above 50 yrs of age with the following diseases or dental ailments
Caries	24
Mobile teeth	59
Gums pyorrhea	3
Pulpal infection	12
Others	2

Table 6 Percentage of different age groups

Age group	%
Different age groups who had all their teeth extracted
< 10 yr	3
10-20 yr	4
20-30 yr	3
30-50 yr	7
> 50 yr	42
Different age groups who had no teeth extracted
< 10 yr	21
10-20 yr	33
20-30 yr	67
30-50 yr	8
> 50 yr	2

Table 7 Questionnaire to determine expense of a dental clinic

Expense	Cost
Start-up costs
Construction (or remodeling cost)
Dental equipment cost (including supplies and instruments)
Furniture
Record filling system
Phone / intercom system
Computer / data / billing
Operating Expenses
Dental assistant
Billing Clerk (or Secretary or Receptionist)
Clinical supplies
Office supplies
Equipment maintenance
Housekeeping
Laundry
Communications
Equipment reserve fund

Table 8 Result of dental clinic expenses survey

Expense	Cost
Start-up costs
Construction (or remodeling cost)	Rs. 1205000
Dental equipment cost (including supplies and instruments)	Rs. 924500
Furniture	Rs. 45900
Record filling system	Rs. 12500
Phone /intercom system	Rs. 9300
Computer/data/billing	Rs. 35200
Total start-up costs	Rs. 2232400
Operating expenses
Dentist	Rs. 750000
Dental assistant	Rs. 24000
Billing clerk (or secretary or receptionist)	Rs. 5000
Clinical supplies	Rs. 107900
Office supplies	Rs. 12500
Equipment maintenance	Rs. 21400
Housekeeping	Rs. 13600
Laundry	Rs. 26700
Communications	Rs. 24000
Equipment reserve fund	Rs. 10000
Total operating expenses	Rs. 995100
Total expenses	Rs. 3227500

Table 9 List of essential dental equipments and supplies

Operative Instruments	Handpieces	Other instruments	Operative supplies	Disposables	Infection control supplies	Standard oral surgery kit	Oral surgery instruments	Oral surgery supplies
Mouth Mirrors #5	High-Speed Handpiece	Dental Mirrors #5 for Exam Kits	Lidocaine 2% 1: 100000 epi/can	Tray Covers -Mauve lOOO/Box	Latex Exam Gloves, pick size	Surgical Handles, #3	150 Forceps	3-0 Silk Sutures, 18” Cutting, Needle C-6 12/Box
Mirror Handles	Low-Speed Handpiece	Mirror Handles for Exam Kits	3% Mepivicaine/can	2 x 2 gauze 8 ply 200/Pkg	Sterile Surgeons Gloves, pick size	#9 Molt Periosteal Elevator	151 Forceps	3-0 Chromic Gut Sutures, 27”, C-6 12IBox
23 Explorer/PSR	Ball-Bearing Contra Angle Assembly (Latch)	Explorer/PSR Periodontal Probes for Exam Kits	5% Marcaine 1:200000 epi/can	4 x 4 gauze 8 ply 200/Pkg	Utility Gloves, Large	Needle Holder, Crile-Wood 6 inch	17 Forceps	Biopsy Bottles
Scissors, Iris 41/2" Straight, Economy	Prophy Contra Angle Head Assembly	Cement Spatulas #24	27 gauge Long Needles/box	Dry-Gard Patient Bibs (rose) 500/Case	Face Masks, 50 per box	301 Elevator	23 Forceps	Dry Socket Paste, 1 oz
Cotton Pliers(s), College #317	Contra Angle Sheath	Aspirating Syringe CW Type	30 gauge Short Needles/box	Napkin Holder	Safety Glasses	34 Elevator	88R Forceps	Iodoform Gauze 1f4”× 5 yd
Spoon Excavator #38-39	Straight Attachment	Composite Instruments, Set of 3	Topical Anesthetic	Cotton Tip Applicators 6” non-sterile lOOO/Box	Disposable Cover Gowns, pick size	Minnesota Retractor	88L Forceps	Gelfoam
Amalgam Carrier Double Ended I	Spray and Clean Handpiece Lubricant	Rubber Dam Punch	Sharps Container	Cotton Pellets #2 2000/Box	Antiseptic Hand Soap,	Curette	#1 Forceps	#15 Blades 100/Box
Amalgam Plugger l/2 Black		Rubber Dam Clamps, Starter Kit	Accu Film II/box	Cotton Pellets #4 3000/Box	Cleaning Solution	Kelly Hemostats, Curved 51/2”	Cryer 30
Cleoid-Discoid 89/92			Amalgam -Regular Set/can	Cotton Rolls 2000/Box	Banicide Plus, 3.4% Glutaraldehyde, 1 Gallon	Mouth Mirror 1 Mouth Handle	Cryer 31
Cleoid-Discoid 3/6			Glass Ionomer Kit	Cotton Roll Dispenser	Disinfectant	Scissors Kelly 61/4”, Curved	Crane Pick
Hollenbach			IRM Caps 50/Pkg.	Plastic Cups, 1OOO/Case	Self Seal Sterilization Pouches 31/2”× 9”	Mouth Prop (adult) 2/Box	Periosteal Elevator #9 Molt
Interproximal Carver			Clear Matrix Strips/box	Cup Holder	Self Seal Sterilization Pouches 31/2”× 51/4”,	Suction Tips	Heidbrink #1 Root Tip Pick
Articulatiilg Paper Forceps			Sof-Lex Pop-On Kit #1980	Safe-Tips EZ 150/Pouch	Self Seal Sterilization Pouches 51/4”× 10”		Heidbrink #2 Root Tip Pick
Rubber Dam Frame			Finishing Strips Coarse/Medium 150/Box	High Speed Evacuation Tips SO/Bag	Self Seal Sterilization Pouches 71/2 × 13”,		Heidbrink #3 Root Tip Pick
Rubber Dam Clamp Forceps			Lightening Strips Medium 12/tube	Saliva Ejectors White Opaque 100/Bag	Chair Covers 48”× 56"		Tissue Forceps
Dycal Instrument			Polishing Paste/can	Dappen Dishes lOOO/Box	Air/Water Syringe Covers		Rongeurs
Tofflemire(s) 2 per kit, universal			Toillemire Matrix Bands #1, .0015 12/Pkg	Oral Evacuation Cleaner	Light Handle Covers		Bone File, 12 Howard
			Tofi1emire Matrix Bands #2 .0015 12/Pkg	Disposable Spatulas l00/Box	ALLRAP 1200 Sheets/Roll		Straight Hemostat, Crile 51/2”
			Dycal Ivory Shade/tube	Benda Brush 144/Box	Mouth wash, may want to order pump		Needle Holder, Crile-Wood
			Copalite 1/2oz/bottle	Disposable Mirrors 72/Box	Periogard 16 oz		Surgical Handle
			Vitrebond 3M/box	Disposable Traps Dental Unit 144/Box, pick size needed	Cure Sleeve, Steri Shield 5OO/Box		Dental Mirror for Post-Op Kit
				Disposable Traps Central Suction 8/Box, pick size needed	Tube Sleeve 2”		Mirror Handles for Post-Op Kit
				Paper Towels	X-ray sleeve 14” W × 13” D x 241/2” L		Iris Scissors for Post-Op Kit
					Biological Monitoring System Biological Indicators (25/box)		Cotton forceps for Post-Op Kit

Table 10 Questionnaire to determine revenue of a dental clinic

Source	Income
Patient care revenue - self pay
Patient care revenue - insurance
Patient care revenue - total
Donations and other sources
Individual donations
Corporate donations
Events

Table 11 Result of dental clinic revenue survey

Source	Income
Patient care revenue
Patient care revenue – self pay	Rs. 866050
Patient care revenue – insurance	Rs. 166450
Patient care revenue – total	Rs. 1032500
Donations and other sources
Individual donations	Rs. 9000
Corporate donations	Rs. 13000
Events	Rs. 6000
Donations – total	Rs. 28000
Total revenue (all sources)	Rs. 1060500

Table 12 Questionnaire to determine patient visits at a dental clinic

Variable	Value
Patient Visits
Total number of patient visits:
Well off patients1
Low income patients2
Patients with insurance
Per patient visit charge

¹Well off patients are way above the poverty line and have no money constraints on the cost of treatment; 2low income patients are either below the poverty line or belong to a middle class that cannot afford expensive treatment.

Table 13 Summary of patient visit survey

Variable	Value	%
Patient visits1
Total number of patient visits: 3550
Well off patients2	2610	74%
Low income patients3	940	26%
Patients with insurance	284	8%
Per visit patient charge	350	-

¹All visits are expressed per year;

²Well off patients are way above the poverty line and do not have any money constraints on the cost of treatment;

³Low income patients are either below the poverty line or belong to a middle class that cannot afford expensive treatment.

Table 14 Discounts to different income groups

Income group	Discount
Lower income	75%
Lower-middle income	50%
Middle income	12.50%
Higher-middle income	0%
Higher income	-75%