Dental
report for dental magazine!
In November
2013 I returned on a further mission to Pakistan to help fellow
human beings of a very different culture, religion living in a very disadvantaged
part of the world. I am very aware of the reports by Global dental health that
there have been a marked increase in caries experience amongst very young
children in a number of developing countries.
human beings of a very different culture, religion living in a very disadvantaged
part of the world. I am very aware of the reports by Global dental health that
there have been a marked increase in caries experience amongst very young
children in a number of developing countries.
The mission
was to build on previous visits aimed to put into place a dental health
education programme aimed at primary school children and a dental assessment
protocol follow up for those cleft lip and palate patients treated at the new Hospital
in Gurjrat Punjab.
education programme aimed at primary school children and a dental assessment
protocol follow up for those cleft lip and palate patients treated at the new Hospital
in Gurjrat Punjab.
Leaving Birmingham
with 39.5 kilos of luggage which consisted of donated hospital
equipment with no room for clothes...I arrived in Islamabad to be greeted warmly
by a customs official who plucked me from the horrendous queue awaiting passport
control to emerge in minutes to the early ( 7am) sunshine and chaos outside
Islamabad airport.
equipment with no room for clothes...I arrived in Islamabad to be greeted warmly
by a customs official who plucked me from the horrendous queue awaiting passport
control to emerge in minutes to the early ( 7am) sunshine and chaos outside
Islamabad airport.
My lift
arrived and went direct to Gurjrat.
In
partnership with the Director of Gurjrat Hospital, I again went round a number
of school assemblies and over the next few days addressed over 7000 children in
primary schools and examined the mouths of over 1500.
of school assemblies and over the next few days addressed over 7000 children in
primary schools and examined the mouths of over 1500.
I had
already transported a folding dental chair on my last visit and this was placed
on the stage where either myself or my colleague Aslam ( not a dentist but a real
enthusiast for improving oral hygiene ) looked at mouths did a very simple dmf
count and of course translated the messages for me into Urdu.
on the stage where either myself or my colleague Aslam ( not a dentist but a real
enthusiast for improving oral hygiene ) looked at mouths did a very simple dmf
count and of course translated the messages for me into Urdu.
My simple
message was brush with pea sized portion of a fluoride toothpaste in
priority last thing before going to bed and to reduce frequency of sugary snacks
and drinks. Using large models of teeth and giant brush this message was repeated also
to all the teachers who promised to remind the children of these messages on a
regular basis.
priority last thing before going to bed and to reduce frequency of sugary snacks
and drinks. Using large models of teeth and giant brush this message was repeated also
to all the teachers who promised to remind the children of these messages on a
regular basis.
I intend to
set up in class supervised tooth
cleaning sessions with repeat dmf
assessments to show up results.
assessments to show up results.
The average
dmf counts for these all under 9 year olds was 1.85, with 4% having
dmf counts of over 7. The feature of especially the mouths of children with over
7 dmfs was the classical appearance of baby bottle syndrome. This was quite a
feature in the UK when I first qualified in 1969 with use of sugared mini dinky
feeds to babies to ‘sooth’ them as they went to sleep. In Pakistan, the use of
dummies dipped in honey, sugar added to feeds ( only 50% are breast fed)
and even with breast fed babies, the baby is sometimes left on the breast as
they sleep.
dmf counts of over 7. The feature of especially the mouths of children with over
7 dmfs was the classical appearance of baby bottle syndrome. This was quite a
feature in the UK when I first qualified in 1969 with use of sugared mini dinky
feeds to babies to ‘sooth’ them as they went to sleep. In Pakistan, the use of
dummies dipped in honey, sugar added to feeds ( only 50% are breast fed)
and even with breast fed babies, the baby is sometimes left on the breast as
they sleep.
Standard of
OH was in many cases quite good, however a large number missed
brushing their lower incisors and posterior areas around the first molars.
First molars were decayed in all those with dmf level of over 7 which suggests
that those who were seriously ‘exposed’ to sugar as a baby , continued to
indulge in excess sugar . I was able to put into place a diet advice message
for those who act as midwives to give to the new mothers.
brushing their lower incisors and posterior areas around the first molars.
First molars were decayed in all those with dmf level of over 7 which suggests
that those who were seriously ‘exposed’ to sugar as a baby , continued to
indulge in excess sugar . I was able to put into place a diet advice message
for those who act as midwives to give to the new mothers.
I had 3
days of support from Colgate Pakistan who provided 1500 dental kits
to hand out to the children and a representative who also provided a dental
cartoon to show and gave further dental advice to the school assemblies.
to hand out to the children and a representative who also provided a dental
cartoon to show and gave further dental advice to the school assemblies.
One day was
billed as a national holiday but even then one school of over
1000 pupils opened up specially to hear my dental message.. a welcome
with the streets of the village decorated and lined with the children clapping
as we walked up to the school showering me with rose petals.. a traditional
welcome... now how many schools in UK would open up on a bank holiday
to do likewise?!
1000 pupils opened up specially to hear my dental message.. a welcome
with the streets of the village decorated and lined with the children clapping
as we walked up to the school showering me with rose petals.. a traditional
welcome... now how many schools in UK would open up on a bank holiday
to do likewise?!
A large
scout based school heard I was visiting and I was amazed that they all
600 lined up outside the school and welcomed me by making me an honorary
Pakistani scout... have to make sure my shoes are now always better polished!
600 lined up outside the school and welcomed me by making me an honorary
Pakistani scout... have to make sure my shoes are now always better polished!
I set up a
fully registered charity in 1993 called Oak Tree Trust as a Christian
based charity and helped set up another more Muslim based charity in 2003
Midlands International Aid trust and together we now do many missions as a
partnership. One of these is to provide free cataract operations which are
performed for free by a local eye surgeon and we provide the dressings and
eye drops ( £25 a case) So another eye camp on this visit resorted the sight
to another 95 otherwise blind young and old patients .
based charity and helped set up another more Muslim based charity in 2003
Midlands International Aid trust and together we now do many missions as a
partnership. One of these is to provide free cataract operations which are
performed for free by a local eye surgeon and we provide the dressings and
eye drops ( £25 a case) So another eye camp on this visit resorted the sight
to another 95 otherwise blind young and old patients .
The other
part of my mission was to set up a dental assessment programme
for the new and old cleft lip and palate patients treated at the free Bashir
Cleft hospital in Gurjrat . This hospital was initially funded by a grant from
the Japanese Embassy and various visiting cleft surgeons form around the
world have been coming here for some time , freely giving their time both
to provide operations and to train up local surgeons to International standards.
This time surgeons from Belfast. Hull, Bradford and Leeds had come over and
in this week provided around 90 operations on cleft patients. I did a more
detailed dental assessments on all these patients, giving oral hygiene and
diet advice to patients and their families, a gift of a Colgate dental care pack,
took study models where appropriate and made obturators for those adult
patients who could not benefit from cleft palate surgery.
for the new and old cleft lip and palate patients treated at the free Bashir
Cleft hospital in Gurjrat . This hospital was initially funded by a grant from
the Japanese Embassy and various visiting cleft surgeons form around the
world have been coming here for some time , freely giving their time both
to provide operations and to train up local surgeons to International standards.
This time surgeons from Belfast. Hull, Bradford and Leeds had come over and
in this week provided around 90 operations on cleft patients. I did a more
detailed dental assessments on all these patients, giving oral hygiene and
diet advice to patients and their families, a gift of a Colgate dental care pack,
took study models where appropriate and made obturators for those adult
patients who could not benefit from cleft palate surgery.
I used a detailed
record card showing charting ,decay, plaque levels and gave
more individual OH advice. The operations are now sponsored direct from
Smile Train, an International charity and I met the regional director for Asia
and Middle East and persuaded him that dental assessments are an essential
part of the longer term care of these patients and to achieve a long lasting
final result.
more individual OH advice. The operations are now sponsored direct from
Smile Train, an International charity and I met the regional director for Asia
and Middle East and persuaded him that dental assessments are an essential
part of the longer term care of these patients and to achieve a long lasting
final result.
Smile Train
have agreed to fund these follow up record taking.
A local
dentist Ayesha who came round with me during this week both at the
schools and at the cleft hospital will continue with these assessments. Some
will be done at the cleft hospital ( new cases) and previous cases will be
followed up via mobile phone calls to attend for more photos, models IOH
and diet advice and charting. What is also necessary will be taking some
dental x rays. These will be essential to be able to chart missing and position
of unerupted teeth. My next trip I wish to provide such a device preferably
a portable one with provision to take digital records and so store images on
computer. With models, photos, x rays and full charting , it will be possible
to make orthodontic treatment planning with advice maybe from the UK.
schools and at the cleft hospital will continue with these assessments. Some
will be done at the cleft hospital ( new cases) and previous cases will be
followed up via mobile phone calls to attend for more photos, models IOH
and diet advice and charting. What is also necessary will be taking some
dental x rays. These will be essential to be able to chart missing and position
of unerupted teeth. My next trip I wish to provide such a device preferably
a portable one with provision to take digital records and so store images on
computer. With models, photos, x rays and full charting , it will be possible
to make orthodontic treatment planning with advice maybe from the UK.
I brought
many letters from school children from Walsall and returned with
double numbers of replies.
double numbers of replies.
I am booked
to return on 11th February 2014 and I am hoping to either take
such a portable dental x ray with me plus a digital recorder. I already have
a virtually brand new vacuum little sister autoclave and a smaller more portable
autoclave ... looks like no room again for clothes!!
such a portable dental x ray with me plus a digital recorder. I already have
a virtually brand new vacuum little sister autoclave and a smaller more portable
autoclave ... looks like no room again for clothes!!
I will also
be taking the current mayor of Walsall with me , plus an even
larger pile of letters from children in Walsall in reply to the large pile I took
back with me from the trip last November.
larger pile of letters from children in Walsall in reply to the large pile I took
back with me from the trip last November.
The
dialogue between many thousands of children in Walsall with those in
schools in Pakistan will contribute to greater and more accurate understanding
of both communities and combat the very negative media reports shown currently .
schools in Pakistan will contribute to greater and more accurate understanding
of both communities and combat the very negative media reports shown currently .
I should
like to thank Colgate for the dental kits; Aslam from MIAT who came
with me and translated and helped with dental assessments, Ayesha the local
dentist, Dr Bashir who arranged the school visits and provided our free
accommodation and many who gave advice and support .
with me and translated and helped with dental assessments, Ayesha the local
dentist, Dr Bashir who arranged the school visits and provided our free
accommodation and many who gave advice and support .
