Dentistry focus: students fund oral health

Smiles & Hopes is a global initiative of the Global Child Dental Fund (GCDFund) and since 2009 has been working in Cambodia which is a developing country still recovering from the devastating acts of the Khmer Rouge, an extremist party responsible for the mass murder of almost two million of Cambodia's educated population in the 1970s.

Once the regime was over, only a handful of dentists remained to treat the millions of people in need of dental treatment.

In the months before our trip to south-east Asia we set up a donation page and aimed to raise as much money as possible. We wanted to use this money to contribute to improving the oral health of Cambodia's population.

Ektaa Abrol, Anna Lad and Ria Chande with some of the school children at lunch

Fortunately, we have been able to donate £1500 to the Global Child Dental Fund and their plan to distribute Duraphat fluoride varnish to orphanages in Cambodia, making a huge difference in the prevention of dental caries in the most disadvantaged children in the population (www.gcdfund.org).

The money was mainly raised by our family and friends along with sponsorship from Integrated Dental Holdings (IDH) and GlaxoSmithKline (GSK) towards our trip costs and HIV pep and rabies vaccinations.

Smiles & Hopes_Cambodia brings together all the dental NGOs, the two dental schools and the Ministry of Health to give basic hygiene and dental care to orphanages in Phnom Penh. The funding that was raised helped, in 2011, us to provide care for over 15 orphanages.

The GCDFund pay for staff in a central office in Phnom Penh to coordinate the orphan work and funding to a local NGO (One-2-One Charitable Trust) to liaise with all the other partners.

As part of our final year elective we were excited to become members of the Smiles & Hopes_Cambodia team and practice dentistry in a different extreme to that in the UK.

During our time there we would be reaching areas of Cambodia far from any dental services through the use of a mobile dental service.

After travelling for two weeks down the east coast of Vietnam, and a nine-hour bus journey to Phnom Penh, we were up and ready to get involved in the action!

A briefing on the upcoming week and a quick lesson in some useful Khmer words set us up for the weeks ahead. We then had some free time to visit the beautiful grand palace and an opportunity to pay our respects at the killing fields, where hundreds of innocent people were tortured and killed.
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On the way home we were able to visit a local slum where the One-2-One medical team were working, we handed out snacks to the children and observed the team performing check-ups and treating any urgent cases.

It was eye opening to see one of the areas of Cambodia most affected by poverty and how the team improvised in such a basic setting. Back to the guesthouse we went and an early night was in order before a 5am start to leave for Siem Reap.

Shock
Although Smiles & Hopes_Cambodia is focussed upon orphanages it also reaches out to children who live in prison with their parents. So we were on route, via a scenic six-hour bus journey, to the Siem Reap prison in North West Cambodia where we would be spending our first week. The initial shock of treating prisoners soon disappeared as we realised they were patients who required extensive care and were unable to access any dental treatment.

With over 1200 prisoners, prison guards and a number of children to treat; there was evidently a great need for the mobile dental service, and we quickly saw it was going to be busy week! The first job of the day was to set up all the dental chairs and equipment; four dental chairs were used for extractions and three other chairs enabled restorative work as well, one chair was used just for screening and instruments, materials and a sterilisation station were also set up within the area. We were paired with a final-year Cambodian dental student which made communicating with the patients much easier.

Working alongside Cambodian students was an experience in itself; not only was it fascinating to see new techniques but it gave us an insight into how other cultures live and work. Together we worked as a team to get the job in hand completed, focusing on relieving patients of dental pain.

Extractions
With no X-ray facilities, unbearable heat and a pace 10 times faster than at university we felt far from home but quickly got used to the new environment. The majority of work involved the extraction of teeth, restorations and root canal treatment on anterior teeth in a few cases. After treatment was complete patients' were given a toothbrush, appropriate medication from the pharmacist in our team and post-op instructions. At the end of the week the patients were given basic oral hygiene instructions in groups by one of the Khmer speaking members of our team.

After a week of hard work, we spent the weekend visiting the beautiful temples of Angkor Wat before heading back to Phnom Penh. During our second week we were situated in the poor province of Takeo, where we set up the dental service in a primary school. This trip was a first for the mobile dental unit, and a very worthwhile one as there were around 500 children aged four to fourteen to treat, some of whom had never seen a dentist before. Treatment involved fillings on permanent teeth, extractions of unrestorable decayed teeth and preventative measures such as fissure sealing permanent teeth and the application of Duraphat.

It was rewarding to see first-hand where the money we had raised was helping these children by preventing dental caries. As a team, we found the children to be so brave and resilient, despite many never having dental treatment before. Alongside us were a medical team, also from One-2-One, carrying out hygienic cleaning on the children such as removal of head lice and washing their hair.

By the end of the week we had treated all pupils, school teachers and a few Buddhist monks that had also come for treatment. It was an honour and pleasure to be able to help such lovely and welcoming people.

Like many others we can easily become complacent about our lifestyles, however visiting Cambodia made us realise how lucky we are to have access to the important things we need in the UK, such as dental and medical care. With so many patients to treat, we were fortunate enough to use the skills we have learnt over the past four years in dental school. On returning to the UK we continued to raise money for the invaluable work of One-2-One in Cambodia and were able to send them £750 to continue the work of Smiles & Hopes_Cambodia.

Working in such a challenging environment, whilst also helping patients who rely on charities, made it a truly valuable experience. We all came home having gained a great deal from the elective experience and hope to be able to do similar things again in the near future.