Rotary Club of Ballarat West Tonga Dental Health project; 2013 report

 

                                 

 

Our survey team consisted of A/Professor Matthew Hopcraft,(Head of the Department of Community Dentistry and Director of Clinical Studies at Melbourne University Dental School,  Dr Sisilia Fusi Fifita ( Principal Dental Officer of Tonga and coordinator of the Tonga schools MaliMali preventive dentistry program), Dr Ekke Martini(RC Ballarat)  and Dr David Goldsmith (RC Ballarat West and team leader). Recorders included dental nurse Camille Lewis (a PHF), Mrs.Isabel Martini (teacher) and Tongan dental staff Ms. Silia Latu, Ms. Matangisina Vaitaki, and Dr Na’ati Fakatava.

Regarding consistency, Dr Martini and Dr Goldsmith were also examiners in earlier Rotary dental survey teams conducted in 1998, 2003 and 2008 (and Dr Sililo Tomiki in 1986, 1998, 2003 and 2008)

The survey is particularly pertinent because of the progressive introduction of Preventive Dentistry measures into Tongan schools since ~2005; this survey will help to put a figure on the effectiveness or otherwise of the current preventive measures

A/Professor Matt Hopcraft is currently analysing the results and will prepare papers for publication following a peer review process. This may take a year or more

 

Incidentally, the survey work was also a lot of fun, especially when Camille chased the children around the playground with water pistols and Matt had them dancing!

Preliminary results show a reduction in caries in 12 year old children from 3.1 to 2.1 to 1.4 over the survey period but little or no change in the  6 year old children which remains fairly static.

This means the average 6 year old child has between 6 and 7 (out of 20) decayed teeth in on arrival at school.

This indicates the preventive measures in the schools are having a positive effect (as shown in the 12 year old stats.) but that children entering school at age 6 already have major oral health problems; i.e. preventive measures need to be targeted at pre-school age or before to have any impact on this group of children.

More research into the caries experience of pre-school children is needed

Also most of the tooth decay in 12 year old children is in the molar teeth (90%) so we recommend an extension of the fissure sealant program into the secondary schools system– this measure could reduce the DMFT score to lower that 1.0, even better than Australia

In conjunction with the survey a two day WHO Dental Caries seminar sponsored by the World Health Organisation was held at the Vaiola Hospital, Nuku’alofa.

 Presentations were given to the seminar by Prof. Hopcraft, Dr David Goldsmith and many of the Tongan dental staff.  Attendees included almost all of the Tongan dental staff including those from the outer islands, delegates from the Japanese Malimali program and representatives at high level from the Tonga department of Education

It was very pleasing to see that original research is being conducted on oral health in Tonga and most of this is being conducted to the same scientific WHO criteria we introduced into Tonga in our surveys since 1998. To our knowledge, no other Pacific Island nation is doing this amount of original research.

An interactive workshop followed the seminar with all parties actively participating and a comprehensive plan of action was formulated for the future

In a second week of the visit progress was made on initiating a Dental Twinning Program between the Tonga MOH dental department and the Rotary Club of Ballarat West.

It will be funded by AusAid

 If successful it is hoped to have the first envoy coming to Ballarat in November 2013

 

The Tonga dental department now has a very modern Japanese built dental clinic with 11 chairs,(including one for the Royal family!) a Prosthetics Lab., pathology lab. and an equipment repair workshop. There are also new rural dental clinics at Mu’a and Vaini built by the Chinese government and a third rural clinic at  NukuNuku has been renovated,. Also the Chinese have built a new clinic on Vava’u island. However all is not ideal with the robustness of some of this new Chinese and Japanese equipment. Dental engineer Sioeli Manu estimates a realistic lifespan of many major items such as chairs, X-Ray and handpieces of only 2-4 years and they have no spare parts or instruction manuals. Also nobody can translate technical terms for the equipment into the Tongan language either in Tonga or Japan – the words just do not exist!

 It was interesting to note that the dental chairs we installed way back in 2000 are still being used in the old dental clinic at weekends. They have not been thrown out as I expected. The upholstery is cracked and torn but they are all still in good working order and the staff actually prefer working with them. We took another seven of these same model chairs to Tonga in November 2011. They are stored and regularly serviced and are earmarked to replace the Asian chairs when they eventually break down. It is heartening to see that virtually all the dental equipment we have sent over the years has been lovingly cared for by Sioeli “Joe” Manu - the dental equipment technician PHF Peter Copp has trained). Joe is still the only such trained person in the whole of the South Pacific.  Joe has also set up a maintenance schedule for almost every single piece of dental equipment on every island in Tonga.

 

 I was most impressed.

 

 And also pleased to see he is now training an understudy!