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

Army Aboriginal Community Assistance Program

(AACAP 14)DOOMADGEE Gulf of Carpentaria

Doomadgee regionmid 2007

Camp White Rock17th Construction Squadron

Infrastructure construction, training & health promotion projects

E DENTAL PROBLEM - DECAY

• Many thousands of fillings and

“the dental enemy” = decay

resulting in pain and infection

• Periodontal disease was a further result of a lack of

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

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

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:

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:

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

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

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

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)

Dental facilities: 1. Government dental clinic

2. Dental laboratory for making dentures

3. Dental hygiene &

oral surgery clinic

First solution Targeted population strategy of a

CHOOL BASED fluoride toothpaste brush in” project

first phase of dental campaign:

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

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

RAL B donation of 16 school bag packs as izes for classroom tooth drawing competitions

. preliminary school based oral hygiene education

ractical education in solving the decay problem using fluoride

toothpaste once per week

esources for school based oral hygiene education

olgate Oral Care donation of 300 othbrushes, 300 fluoride toothpaste tubes tooth models for BRUSH-IN PROJECT

Donation of QLD Health Dept INDIGENOUS oral health & nutrition education flip charts

sources for school based oral hygiene education

Small group learning

“Disclosing” or showing the plaque problem with coloured disclosing solutions

Tooth brushing models for instruction

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

Education in dentally healthy eating habits using indigenous nutrition flip charts

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

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:

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 &

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:

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

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:

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

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

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

est result ~ healthy, happy children

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

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

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:

MEMORIES OF AACAP 14

Sincere anks to the ental blitz’

am for their mateship, nthusiasm, ard work & cellent care

Questions?

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