During the Middle Ages, when vocations were still not cleanly divided into branches, barbers took care of the most ordinary dental needs such as cleaning and whitening. Other extraordinary procedures like tooth extractions, where the gum was often mistakenly removed along with the tooth, were performed by more skilled men such as blacksmiths—their preferred tools of the trade being door keys or forceps. Dentistry, thus, as a profession, was largely unregulated until the twentieth century. The street dentists in modern India, however, mostly learned their skills from the Chinese,3 who came looking for work in India in the early 1900s. Many of them left China immediately after civil war broke out in the late 1920s and they were being forcefully drafted into the army. Religious India beckoned them, and one of the many communities that came via Bhutan and Tibet were the Hubei, from a province in central China, where most of the denizens were skilled in the art of dentistry, just as the Hakkas were known for their noodle-making skills. They passed on their expertise to fellow Indians, eager to carve a home among them, teaching them basic dentistry with amalgam fillings for a carious tooth, making dentures and using indigenous materials for the reconstruction of anterior teeth.
Amrit Singh’s grandfather learnt his skills in Aara Zilla, near Patna, from a young member of the Hubei community who had wandered away from his flock in the 1920s, struggling to find employment in a nation that was fighting for an independent identity.
‘See, that’s him,’ Amrit Singh says, pulling out a grainy black-and-white tintype photograph of a full-bodied young sardar on to a recycled biscuit jar. ‘Dadaji ne jawaani ke hisaab se kaam sikh liya [My grandfather learnt the trade to earn quickly as he was young],’ he tells me. ‘But there was no work in Bihar. The number of travellers and migrants dwindled with time. So he travelled with his family to Delhi and set up shop near Thandi Sadak in Chandini Chowk with the help of his friend,’ he says, scratching the rust off the tin photograph with his thumbnail.
‘I was born in Delhi,’ he smiles. ‘There was great respect for their work because doctors were few back then. They worked through the day, tending to migrants, labourers and their families. We visited people at their homes and often catered to refugees and families who had made their home in what was known as Ahmad Ka Mohalla,4 then an upmarket neighbourhood for migrants in Chandini Chowk. Areey yeh clinic wale dentist ab aye hain [Dentists in clinics have just recently come to the fore]. We have serviced the nation for a much longer time. Ask your grandfather, he will tell you . . . There were thousands of us—in Amarnath, Ahmedabad, Delhi,’ he says exuberantly.
Things started changing after Independence, when the Indian Constitution introduced regulations for dentistry practices, requiring dentists, dental mechanics and dental hygienists to be licensed compulsorily, thereby making street dentistry illegal. But dental street practitioners continued to thrive in the dark underbelly of the country.
The Dental Council of India, a statutory body that regulates the profession, says it has no current figures for the number of street dentists in the country, but they are estimated to be under a thousand in number, spread throughout the country.
‘Often, people place more trust in us than in doctors . . .’ Singh continues.
I must have looked surprised or unconvinced because he stops and explains what he means in the simplest of terms. ‘See, your teeth and mouth act like a mirror for the rest of the body. If your stomach is upset, your teeth will have more plaque. If you have acidity, the insides of your teeth will corrode,’ he reasons with me.
‘We know all this from our years of experience, and we inform our patients accordingly, if required. That’s why people trust us. The clinic-wallah dentists have machines for everything. Look at my dentures, I make everything by hand.’ He snorts again, proudly lifting a set from the display, tapping the teeth with his greasy, gold-ringed knuckles, to prove their strength. ‘I make fix, floating, bridge everything . . . If you want a cover for your teeth, I have them in chrome, gold, silver,’ he rattles off a list, counting on his fingers.
‘But don’t you wish you had those kinds of machines and that education?’
‘No,’ he says, his face falling. He pauses. For a moment Singh loses his sanguinity, but he checks himself. ‘Ohho, what is the point? Everyone has their speciality. I do this for poor people who cannot afford other dentists. I don’t take care of root canals, swollen gums or bleeding gums. Those the doctors do. I do dentures, tooth replacement, cleaning . . . All cheap and of good quality.’ He touches his index finger to his thumb to make an ‘okay’ sign. ‘My relations are very good. People come to me from villages all around Baroda, sometimes from Mumbai and Ahmedabad too.’
Singh gets his acrylic resin and porcelain for making dentures from ‘Dinesh Bhai who lives off Sayajiganj near the World Trade Centre in Baroda’. Although the wires may sometimes leave a metallic taste in the mouth, they work out to be most durable and cheap, he reveals. Holding a saddle-shaped mould made of chromium wires between his legs, he pours the resin. The occasional fly alights on his hands, the instruments and the patients. Still, there is an element of savoir faire about the archaic craft. The colour and size of the dentures depend on the patient’s mouth size, shape, skull size, age, sex, skin colour and hair colour. ‘You know all this from experience. A fair person can’t have very white teeth. They need that yellow tinge.’
‘I’ll tell you one more thing. You can make a person look younger by giving him longer teeth,’ he winks. ‘It’s a trick of the trade. Thirty years in the business will teach you this. My wife tells me that I’m like a thief, I never look anyone in the eye. I am always looking at their mouths instead—mentally rebuilding them.’ He laughs, snorting a few times in between, chattering incessantly as dentists do.
‘How many days do you take to finish a pair of dentures?’ I ask him.
‘The clinic-wallah dentist takes some ten days to make it, but we finish the job in a few hours,’ he says, chest puffing up a bit as he picks at an imaginary thread on his forearm.
Licensed dentists use wax to make a preliminary impression of the patient’s mouth and then make a diagnostic cast. Once an appropriate preliminary cast has been obtained, the final mould is made using gypsum, a stone-like product. This final shape is inspected, customized and approved before being used to manufacture the teeth.5
‘I make mine on a bhatti, or on a furnace, with acrylic resin in one straight go.’
‘Is there no need to test with samples before that?’
‘Humph!’ he grunts at me. ‘Now now, you have spoken like someone with deep pockets,’ he mocks. ‘There’s no need to make so many casts. Poor people can’t spare so much time, ji; they need everything fast and cheap.’
Singh continues, ‘Now, do you see this guy coming?’ He points to a small, feeble man crossing the road in a grey uniform. ‘He is Radhe, a peon at an office in Sayajiganj, and he has been losing a tooth every other month for the past year,’ Singh explains, opening his wooden box that contains teeth of all sizes, shapes and shades. His bridges—false teeth that are permanently fixed to the teeth on either side of the gap using a special cement—are unequally shaped, stocky and carefully painted to match each other.
Radhe squats on the stool before Singh, pulls a tattered book out of his wallet and starts reciting the Hanuman Chalisa, a devotional hymn addressed to Lord Hanuman—the god with the repository of incomparable strength—chewing his sloppy lips as he flips through the pages. ‘I have been brushing thrice a day now,’ he announces after finishing the hymn, hoping for some approval—‘You’re being very disciplined!’—but, instead, Singh says, ‘Oh, there’s no need to do that.’
It turns out Radhe hasn’t been able to afford dental care his whole life, and when one of his front teeth started rotting, a masonry worker pulled it out with a set of pliers. ‘It’s much better just to get it out of there. The space that the tooth leaves behind fills on its own anyway. Although, I smile less often these days,’ Radhe tells me, his nervous l
aughter dying in his throat as Singh randomly starts picking the ‘right tooth’ from the box.
‘But now I can’t eat much. I have a lower-paying job and my wife screams at me when she has to make separate meals for our four children and me. So I have to come to Singhji daantwale,’ he says, opening his mouth wider to reveal a few missing teeth, his pumpkin-shaped head and the gaps between his teeth making him look like a scarecrow being victimised by pesky birds. He nervously plays with the lace of his shoe, a toe peeking in and out of a hole, like a jittery animal. Teeth-wise, Singh has brought him back from hell, he claims. In the course of their two-year relationship, he has removed two of his lower incisors and a canine, cemented in place two posts and filled two cavities.
‘How long do these products last,’ I ask Singh, noticing a chip in the tooth that he is fixing for Radhe. ‘Easily five to eight years,’ he replies, smoothing the tooth with a file-like tool. ‘Indians have much better teeth because we eat hard substances all the time, unlike foreign people. A dentist from Scotland told me this when she visited me after hearing about “our kind” from a tourist.’ He laughs, putting aside his tools to show a postcard from her with a blue Queen Elizabeth stamp, dated March 2001. ‘It was nice meeting you,’ he reads out the card before carefully putting it back in his bag.
‘Tooth decline begins typically when fragments of food get stuck between the teeth,’ Singh explains while putting Radhe’s bridge in his mouth with his bare hands. Radhe is perspiring profusely; the sweat on his forehead soon starts trickling down to his throat. ‘This Radhe,’ he says, tugging at his bridge a little more forcefully than required, making Radhe jerk in pain, ‘refuses to stop eating kheni.’6 He gives the patient a cold stare. ‘The food rots and a cavity begins to blossom, reaching the pulp tissue and creating that insistent throbbing. The tooth turns brown and then I scoop out the cavity. But he comes to me after that. Now, you might assume he can crack open walnuts with his teeth. But no,’ Singh says as he inserts the bridge in Radhe’s mouth, squinting as the sun sets and disappears behind the domes of the university, leaving an orange-and-pink sky behind.
‘There is a lot more work left to be done on his teeth. But we’ll deal with it some other day.’
Because the teeth have to be positioned exactly on top of each other, the setting has to be perfect, so Singh puts the bridge in and then removes it to make some modifications. He twists and turns the teeth in their position, over and over again. ‘Theek hai? [Okay?]’ Singh asks the peon. Radhe makes a sound acknowledging him—‘Ae-oo’. There is no swig of whisky to relieve his pain; there is no biting of a bullet here.
The air is punctuated alternately with ‘Theek hai’ and ‘Ae-oo.’
After Radhe lunges back desperately, almost tumbling off his stool, Singh snaps, ‘What?’
‘Can we stop for two minutes?’ Radhe mumbles, his mouth filled with saliva. ‘It’s hurting.’
‘Who asked you to eat kheni then?’
‘Chalo, ek aur daant kal hoga [The next tooth we will fix tomorrow],’ Amar informs his patient after about fifteen minutes. Radhe barely stretches his bloody mouth to whimper, and then signals me to move so that he can use a sand-filled spittoon installed by the university. He gargles with the water he carries in a plastic bottle in his bag, spits again, this time on a fenced tree, and then hands over a wad of ten-rupee notes to Singh and wanders away down the road.
‘See, I charge very less.’ Singh touches the money to his head, thanking his god for his daily bread, before putting it in his shirt pocket. ‘About fifty to sixty rupees for a bridge. And hundred rupees for a tooth. So for an entire denture of twenty-eight teeth, that would be about 2800,’ he rattles off, like a hawker selling fish in the market.
‘But some patients give me 2000 rupees and some 2200, depending on what they can afford. This amount for a set of dentures is the least possible, these days. Even colleges set up by the trusts charge that much. In Pipariya, at Manubhai Dental College and even at Jalaram, they charge this much. But, of course, they are not as quick with their service,’ he says with the feline cynicism with which he eyes a ‘colleague’s’ handiwork.
‘Ten years ago, I used to see twelve or thirteen patients a day. Now we have just five or six complaining of feeling mildly uncomfortable, say, a cavity or a totally avulsed tooth. Ab roj toh choksi ka kaam nahi hota haina [It isn’t every day that I work on dentures, after all].’ He nods his head regretfully.
‘So I earn around 500 rupees,’ he says. ‘Dental clinics and hospitals are everywhere these days. It is becoming difficult with all the fancy advertising they do.’ Singh snorts, folding his legs beneath him, wriggling his toes to avoid a case of the pins and needles.
By now the sun has almost vanished and the domes of the university make a frieze of amber against an opal sky. The evening lamps have been switched on by the municipal corporation. Singh starts packing his things one by one, closing his tooth box, putting all the rusty pliers in, screwing the bottle caps on. Further down the pavement, a group of students in their lab coats gather under a peepul tree and buy cigarettes and mint gum from a tobacco shop. Singh’s neighbour, a fakir who sells semi-precious stones and tabizes brings us hot cups of chai. ‘Aaj jaldi chutti ho gayi inki [They got off early today],’ the fakir points out to Singh.
‘Haan, they start their holidays today,’ replies Singh, eyeing the students over the rim of his plastic cup.
‘Their fourth year will start in a month.’ he laughs and then turns to me. ‘When could I have ever found so much time to study? I have a family of six to feed,’ he says, shaking his head.
When he has no customers, Singh often engages in ‘timepass’ activities with the fakir and the watchman at one of the university gates.
‘Have they ever raised an objection to you practising here?’ I ask Singh. To other people, who, like Singh, work in the skulking shadows of the cities where their jobs are considered illegal, this could have been a repulsive question. But to him, I was being hysterical. ‘No,’ he guffaws, putting his cup of tea aside until his laughter subsides. ‘Why would you say that? I’m a pak-saaf person, haina, Syed?’ He turns to a fiercely nodding Syed.
‘These university people don’t care as long as we aren’t around on big days when national or international dignitaries are meant to arrive,’ he says, crushing the plastic cup before throwing it near the pavement.
Street dentists can be a source of embarrassment for a country trying to develop a world-class medical tourism industry,7 where an estimated 1,50,000 people travel to India for healthcare procedures every year. The Gujarat government, anxious to clear the pavements as part of a clean-up drive to attract more tourists to the state, is cracking down harder than most. The last decade has seen a surge in qualified dentists. Along with the crackdown, this is making it hard for these street practitioners to make a living. Mumbling under his breath, Singh gathers his things and takes our leave, stopping every now and then to buttonhole the chai wallah or a passing student for a quick conversation, until he disappears into the horizon.
Dr Yash R. Patel, an orthodontist based out of Baroda, has seen Singh and his late father all through his growing-up years in India. ‘They practise out in the open. It is definitely against the protocol of the dental fraternity in India,’ says Dr Patel. ‘The lack of hygiene, absence of post-procedure care, the multiple use of instruments and virtually no sterilization exposes the patients to infection. Also, they don’t really create a new set of dentures, they just fix the ones they have and adjust them around,’ he explains.
‘I understand their existence, given the fact that there were very few qualified dentists around till a decade ago. Even Paris had hundreds of unregistered street practitioners till a few years back,’ he observes. He is referring to a case where the police smashed a ring of twenty-three fake Syrian dentists8 operating out of cafes with battery-run drills. The ring served a mainly immigrant clientele. ‘Even within the Indian dental fraternity, there are so many bache
lor of dental surgery [BDS] doctors performing tooth implants, which is a legally punishable offence,’9 he says.
‘So why aren’t they taken under scrutiny,’ I ask him.
‘They do it in the shadows, at reduced prices, and it is hard to arrest them because this is India. There are few complaints, many beneficiaries and too many loopholes in the law.’
Even though there are more than 180 dental colleges in India that roll out about 13,000 dentists a year, there continues to be a shortage of competent professionals, creating an opportunity for proletarians and quacks. Street dentists, who mostly sit in the busy lanes of Baroda, Varanasi, Delhi and Amarnath, cater to a large section of our Indian society for whom dental care is not only imaginably expensive but, often, inaccessible too. The busy pilgrimage destinations of the Hindu community are the perfect places for street dentists to set up shop for quick treatments.
‘But there is no excuse any more,’ Dr Patel points out. ‘I understand that dental procedures can be expensive in private clinics and hospitals, but government hospitals like Shree R.C. Gandhi Public Dental Hospital provides basic dentures for as cheap as a thousand rupees!’ he exclaims.
On my second day in Baroda, I go back to Sayajiganj, walking along the pavement around the gigantic structure of Baroda University. It is still pretty early in the day. The night watchman is cleaning his teeth with a neem stick. A truck, laden with chairs, arrives at the gate and this is when I notice that the university looks a bit more dressed up than the day before. There is a banner at the entrance announcing: ‘Graduation Ceremony’. Posters of clubs and student unions have sprung up around the gate. I rest against the wall where Singh sits, hoping that the tea vendor arrives soon with my morning cuppa. Syed the fakir arrives with his paraphernalia before the others do. ‘Kaise ho [How are you]?’ he smiles, his forehead wrinkling beneath his skullcap.
The Lost Generation Page 9
