dental blitz the three week campaign of the aacap dental team at doomadgee- reed
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DENTAL BLITZ: THE THREE WEEK CAMPAIGN OF THE AACAP DENTAL TEAM
AT DOOMADGEE
AUSTRALIAN MILITARY MEDICAL ASSOCATIONJOINT HEALTH COMMAND SYMPOSIUM Oct 2010
BARRY REEDRoyal Australian Army Dental Corps
Australian Army ReserveOral & Maxillofacial Surgeon:
~ 1st Health Support Battalion Senior Specialist Oral & Maxillofacial
Surgeon~ John Hunter Hospital, Newcastle
Lecturer (part-time)School of Medicine
University of Newcastle, Australia
This lecture reflects my personal professional opinion
1st HSBC.O: LTCOL L Sinclair
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Army Aboriginal Community Assistance Program
(AACAP 14)DOOMADGEE Gulf of Carpentaria
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Doomadgee regionmid 2007
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Camp White Rock17th Construction Squadron
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Infrastructure construction, training & health promotion projects
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E DENTAL PROBLEM - DECAY
• Many thousands of fillings and
“the dental enemy” = decay
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resulting in pain and infection
• Periodontal disease was a further result of a lack of
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The dental problempprox. six decayed teeth per person in 500 persons (364 schoolchildren) hree to four week stay by Army dental am overnment dentist visits – 3 days every 3 onths, no dentures provided
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SOLUTIONS?tions:ND-AID SOLUTION? (fillings & extractions only a few weeks)NG TERM SOLUTIONS?:rease the SIZE of the team LENGTH of stay
- BOTH not practical -OR
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R reduce the scale of the problem by ducing the problem of decay in future
with preventive health measures:Targeted population strategies (two)Whole population strategy
dental campaign objective:
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First: establish CREDIBILITY with the ommunity to enable implementation of
these preventive health strategiesBy providing practical help:
**RELIEF OF PAIN**
**Dentures provided – Unique service -~ Importance of deploying dental technician o AACAP
dental campaign planning:
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Difficult teeth removal & specialist consultations ~ Oral & Maxillofacial Surgeon
Rapport with children ~ hygienist for oral health education at school
ablish CREDIBILITY with the community to enable implementation of these
preventive health strategies
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deployment communication: establish the port of permanent local health providers &
CommunityE-DEPLOYMENT communication with the visiting local ior govt dentist, school principal & hospital matron to
n approval for our planned preventive health strategies
olving the govt dentist to continue programs long term
port the govt dentist by providing practical training in cialised oral surgery at Mt Isa Base Hospital on last day
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fter arrival, communication with female ders and attending the local town council eeting to outline and obtain community
pproval for dental plans
ommunication: establish the support of permanent local health providers &
Community
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e ‘dental blitz’ teamJOR Catherine Prineasentist
na Rodway ~ hygienist
l Webster ~ technician
nor Gray ~ assistant
PT Barry Reed ~ oral maxillofacial surgeon
ier: one dentist tractions & fillings)
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Dental facilities: 1. Government dental clinic
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2. Dental laboratory for making dentures
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3. Dental hygiene &
oral surgery clinic
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First solution Targeted population strategy of a
CHOOL BASED fluoride toothpaste brush in” project
first phase of dental campaign:
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Effectiveness of fluoride othpaste school based programReduction in decay rate of up to 50 - 60%
“In fact, fluoride toothpastes may be more effective than fluoridated drinking water”from: Fluoride in Dentistry, 2nd edition, editors: O. Fejerskov, J. Ekstrand & B.Burt
mportantly, fluoride toothpastes have an significant ADDITIVE effect in decay reduction
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ablish teacher and schoolchild enthusiasm & pport by Colgate Oral Care donation of RIGHT SMILES, BRIGHT FUTURES” oral health ucation teacher kits for every school class
. preliminary school based oral hygiene education
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RAL B donation of 16 school bag packs as izes for classroom tooth drawing competitions
. preliminary school based oral hygiene education
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ractical education in solving the decay problem using fluoride
toothpaste once per week
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esources for school based oral hygiene education
olgate Oral Care donation of 300 othbrushes, 300 fluoride toothpaste tubes tooth models for BRUSH-IN PROJECT
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Donation of QLD Health Dept INDIGENOUS oral health & nutrition education flip charts
sources for school based oral hygiene education
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Small group learning
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“Disclosing” or showing the plaque problem with coloured disclosing solutions
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Tooth brushing models for instruction
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nvolving and tutoring the teaching staffPrinting and distribution of a USA University fluoride oothpaste weekly school class program supervised by eaching staff modified for the Australian situation
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Education in dentally healthy eating habits using indigenous nutrition flip charts
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Long term solutions going funding of project:MY Donation of 7,200 TOOTHBRUSHES & 1,100 UORIDE TOOTHPASTES ($9,000 donation)ure Aboriginal health funding grants and/or Qld vernment health funding
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More solutions• 2. WATER FLUORIDATION• Benefits both children and
ADULTS• Decay reduction of approx.
50% in both adult & child dentitions
• Decay reduction of up to 70% in adult teeth
• Root decay reduced by up to 40% in elderly
second phase of dental campaign:
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WATER FLUORIDATION APPROACH
aison – with state fluoridation oject officer ( for long term mmunity support)T water analysis - Armyrvey - community decay rateucation campaign – produce stomised fluoride fact sheets
eetings – with Community elders eaders (identify the “movers &
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ext targeted population strategy: ose at significant risk of MORBIDITY & EATH FROM DENTAL DISEASE rheumatic heart disease patients
Another targeted solutionthird phase of dental campaign:
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RHEUMATIC HEART DISEASEreated dental disease can be dly for rheumatic heart disease ents
ER 50 PERSONS –YOUNG & D – AT RISK (monthly bicillinctions)T OF A POPULATION OF PROX. 1500NTIFY BY HOSPITAL RECORDS D HELPFUL STAFFMMUNITY WORKERS PROVIDED ANSPORTUCATE & TREAT ATTENDEES
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urther training & support for Qld Govt visiting dentists to Doomadgee
providing practical training in specialised oral gery by visiting Mt Isa Base Hospital for the t day:
al surgery operations in the operating theatre h senior dental officer Dr Rachel Seadonorning)
ining in oral medicine/pathology and oral gery in the dental clinic for the three dental
fourth phase of dental campaign:
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e results of the AACAP ‘dental blitz’by the end of 2007
QUEENSLAND DEPT OF HEALTH planners & ngineers have visited Doomadgee community lders & leaders to PROGRESS WATER LUORIDATION PROJECT
T ISA based GOVT SENIOR DENTIST lanning to REPLICATE AACAP school based uoride toothpaste brush in project at ORNINGTON ISLAND COMMUNITY later in 007
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SCHOOL PRINCIPAL AT DAJARRA Birdsville track region) already instituted
fluoride toothpaste school program after earning of army dental program at
Doomadgee
Paediatric dentistry university professors at Sydney University requested AACAP dental program information to consider promoting similar CIVILIAN DENTAL PROGRAMS in remote communities in the Northern Territory
e results of the AACAP ‘dental blitz’by the end of 2007
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Long term results: by 2010ater fluoridation to commence next year for the oomadgee community
ueensland Govt dental clinic at Mt. Isa provides gular resupply of fluoride toothpastes and othbrushes to continue the Doomadgee school sed fluoride program
eaching other communities:ornington Island community continues their hool based fluoride toothpaste program
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est result ~ healthy, happy children
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Discussion CAP as a training exercise for dental teams for manitarian work on overseas deployments g. remote areas of Pacific island nations olomons
nviting remote area state govt civilian dentists he introductory ADF dental officer initial
urse for the clinical components of the course
Pushing the envelope” ~ dental disease in hanistan = pain and suffering
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ushing the envelope”: reduce pain and suffering
curity issue = no Aust Army dental clinic for local ilians possible
ale of the problem:
ere are only 3 dentists per 100,000 persons in ghanistan
e tooth decay rate is very high being 3.4 decayed teeth r child 3 to 4 years old and
decayed teeth per adult in 1991
scussion: Dental disease in Afghanistan
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ussion: Reducing dental disease in Afghanistansibilities:
othingdequate civilian capacity is not available, military forces fill the
(COIN Manual p.55)ep programs small. This makes them cheap, sustainable, low-key and tailored to local conditions” (COIN Manual p.300)
ain the local Afghan soldier medics in simple pain relief dentistry g their soldiers as patients in a clinic within the base trade training re. (overcomes the security issue)d a Dental “DMTF” rotation to train Afghan medics, ate simple instruments)
ese Army medics can then use acquired dental skills later in their an careers (“winning hearts and minds”)
ermanent preventive dental health solution using engineers:
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MEMORIES OF AACAP 14
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Sincere anks to the ental blitz’
am for their mateship, nthusiasm, ard work & cellent care
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Questions?
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Dental & maxillofacial task force (DMTF) deployment
r training local Afghan army medics, dental re for Australian soldiers and trauma care
ne dental team of four members:entist ~ three month rotational & maxillofacial surgeon ~ spring & summer ghting’ seasons ~ six week rotationental assistant/technician