Photo: Oral and maxillofacial surgeon Simon Lou with one of Island of Smiles clients on Viti Levu.
Fiji is quickly becoming a toothless nation. The cost to fill a small cavity is five dollars, a class two restoration is eight dollars and large composites can cost upwards of 15 dollars.
For most Fijians, dental treatment is too expensive in comparison to their income. Those with small cavities would rather have teeth extracted as a cost saving measure. Fijian people will usually only turn up to the dentist when their pain has become unbearable, or a vestibular of facial swelling has developed.
Earlier this year seven Waikato Hospital dental colleagues swapped the modern facilities of a hospital in New Zealand for the challenges of a small village in rural Fiji.
It was the first mission for the Island Of Smiles Dental Charitable Trust, a voluntary group of dental health professionals who have worked in the Department of Oral Surgery, Maxillofacial, and Dental at Waikato Hospital. The team of past and present house surgeons, dentists and dental assistants have the common goal of improving oral health in deprived and remote regions of the Pacific.
This mission took them to the village of Daku on the island of Viti Levu, Fiji. In the village and its surrounding areas there is very poor oral hygiene in both adults and children, and as a result many are suffering from dental pain and infection, dental decay and gum disease. The remoteness of the village makes it very hard for local people to access emergency hospital dental treatment.
The team has just published their report with many photos taken by Waikato DHB clinical photographer Gus Stevens who accompanied them on the trip.
Here’s an extract from that report:
Day 7 – Impacted 38
It was estimated to be our biggest day at clinic and finished off intensely by having to treat the most challenging patient of the day. We had thought our clinic had ended but people kept dribbling in having gained the courage in knowing this was their last chance to be seen.
The positive feedback had made the rounds and therefore our last man had decided to face his tooth issue knowing that we would give him the best treatment we could in relief of pain.
Our man had presented to triage with a mesially impacted 38 which was decayed and causing pain. To treat this man we had to unpack all of the gear, in particular the surgical drill that was essential to remove this decayed wisdom tooth.
We had come to realise the use of the fans made by the locals were of utmost relief to working in the sweltering heat and Simon Lou and his patient received fanning treatment whilst performing the surgical procedure. A buccal mucoperiosteal flap was raised, buccal bone was removed and the tooth was sectioned (with surgical drill) resulting in the tooth being removed in bits.
The atmosphere was charged and relentlessly Simon drilled away in the heat with a curious audience at his side. A hushed silence accompanied him as he worked, the radio singing out a classic tune with a round of applause from the crowd that had gathered at the final piece of extracted tooth being laid on the surgical tray.
An impressive ending to a successful mission.
The Island of Smiles clinic was open for 4 days, during which time a total of 250 patients were assessed. 167 of these patients were treated immediately after assessment by means of extraction of decayed and infected teeth. Of the remaining 83 patients, 81 required restorative treatment and were referred to the local Nausori dental clinic. Only 2 patients were deemed dentally fit to the point of no treatment being required.
A total of 431 dental extractions were provided over the 4 day period; an average of 1.72 extractions per patient.
Island of Smiles team
Dentists Ryan Smit, Graham Jull, Margie Paterson, Sarah Twine; Oral and Maxillofacial surgeon Simon Lou; dental assistants June Crawford, Shonal Stevhen, Amanda Walker; clinical photographer Heather (Gus) Stevens; Fijian contact Seli Scutts.
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