Training as an undergraduate dental student in the country’s capital for 4 years has provided me with an extensive outlook on the dental treatment needs of the British population. I have developed my clinical and communication skills whilst treating patients of varying age, ethnicity and socioeconomic background.
For my elective, I decided to explore a clinical environment different to London teaching hospitals, where I could use my current skills and knowledge to advantage those in desperate need of dental care. I believe Western Province in Papua New Guinea (PNG) is such an environment. As an active promoter of good oral hygiene, I aimed to improve the dental health of others while broadening my clinical experience.
For the 6 million PNG inhabitants, the word “dentist” is associated with an unknown magical practice. The need for dental care is substantial with only 32 registered dentists. Despite global advances in the prevention of dental caries, its incidence in PNG remains unacceptably high. I volunteered aboard the Youth With A Mission (YWAM) Medical Ship and was an integral part of a healthcare team dedicated to addressing the dental needs of individuals with limited, if any, access to dental care.
The main aims of the project were to:
- Identify the severity of dental caries in adults.
- Increase awareness and educate the population regarding dental caries.
- Improve oral hygiene techniques and promote oral health.
Since 2010, YWAM volunteers have delivered health services to 594 villages in PNG. An overview of the work of YWAM can be found on http://vimeo.com/78136948#.
My 2-week project involved oral health education, examination and treatment of adults from 6 different villages along the Bamu River in Western Province, PNG.
Adults were triaged on land and those experiencing pain and requesting treatment were brought onto the ship. Prior to treatment on the ship, I led educational sessions regarding dental caries and provided preventative dietary advice with the aid of village interpreters. Each participant received a toothbrush and toothpaste, and I demonstrated tooth-brushing technique at an individual level.
The severity of dental caries was identified using the DMFT caries index. During clinical examinations, I recorded the number of decayed (D), missing (M) and filled (F) teeth per individual and subsequently calculated mean DMFT scores per village.
This project was funded by the King's College London Elective Travel Awards and personal finances. The dental supplies were provided by YWAM Australia through many generous donations from their sponsors including Henry Schein and 1300SMILES. Individual volunteers also donated toothbrushes and toothpaste tubes.
Oral health is vital for overall wellbeing of individuals. Observing life-changing treatment for PNG inhabitants has highlighted the significant impact of properly administered non-operative and operative interventions on quality of life, as well as the importance of preventative care in patient management.
The exposure to a new demographic in PNG has improved my understanding of global differences in attitudes to oral health and access to dental care. The project has also reinforced my knowledge of dental public health, enabling me to practically apply epidemiological indices in PNG.
This experience has helped to not only broaden my outlook on dentistry, but also to better equip me to deal with situations out of my comfort zone. In addition, it has enabled me to further develop my communication and teamwork skills, thereby preparing me not only for final year at University and FT1, but also for future years in general practice.
Two major barriers to achieving oral health are poor access to dental care and lack of knowledge. This project addressed both these issues by providing dental treatment and oral health education in remote areas. The tutorials were very well received and despite the alien nature of the toothbrushes, the villagers seemed keen to learn from us.
The DMFT data collected confirm that dental caries, a preventable disease, continues to be a significant problem in PNG. The mean DMFT score for villages ranged from 5.6 to 7.8 with an overall average of 6.9. Decayed teeth accounted for over 50% of the total DMFT score in all villages, indicating that active disease continues to affect a substantial number of teeth in rural villagers. Due to widespread caries, dental treatment predominantly involved extraction of grossly carious teeth.
Therefore, less economically developed countries such as PNG remain desperately in need of oral health education and treatment.