1. DENTAL BLITZ: THE THREE WEEK
CAMPAIGN OF THE AACAP DENTAL TEAM
AT DOOMADGEE
AUSTRALIAN MILITARY MEDICAL ASSOCATION
JOINT HEALTH COMMAND SYMPOSIUM Oct 2010
BARRY REED
Royal Australian Army Dental Corps
Australian Army Reserve
Oral & Maxillofacial Surgeon:
~ 1st Health Support Battalion
Senior Specialist Oral & Maxillofacial
Surgeon
~ John Hunter Hospital, Newcastle
Lecturer (part-time)
School of Medicine
University of Newcastle, Australia
This lecture reflects my personal professional opinion
1st HSB
C.O: LTCOL L Sinclair

2. Army Aboriginal Community
Assistance Program
(AACAP 14)
DOOMADGEE
Gulf of Carpentaria

3. Doomadgee region
mid 2007

5. Camp White Rock
17th Construction Squadron

7. Infrastructure construction, training &
health promotion projects

8. E DENTAL PROBLEM - DECAY
• Many thousands of fillings and
“the dental enemy” = decay

9. resulting in pain and infection
• Periodontal disease
was a further result
of a lack of

10. The dental problem
pprox. six decayed teeth per person in
500 persons (364 schoolchildren)
hree to four week stay by Army dental
am
overnment dentist visits – 3 days every 3
onths, no dentures provided

11. SOLUTIONS?
tions:
ND-AID SOLUTION? (fillings & extractions only
a few weeks)
NG TERM SOLUTIONS?:
rease the SIZE of the team
LENGTH of stay
- BOTH not practical -
OR

12. R reduce the scale of the problem by
ducing the problem of decay in future
with preventive health measures:
Targeted population strategies (two)
Whole population strategy
dental campaign objective:

13. First: establish CREDIBILITY with the
ommunity to enable implementation of
these preventive health strategies
By providing practical help:
**RELIEF OF PAIN**
**Dentures provided – Unique service -
~ Importance of deploying dental technician
o AACAP
dental campaign planning:

14. Difficult teeth removal & specialist
consultations
~ Oral & Maxillofacial Surgeon
Rapport with children
~ hygienist for oral health education at school
ablish CREDIBILITY with the community
to enable implementation of these
preventive health strategies

15. deployment communication: establish the
port of permanent local health providers &
Community
E-DEPLOYMENT communication with the visiting local
ior govt dentist, school principal & hospital matron to
n approval for our planned preventive health strategies
olving the govt dentist to continue programs long term
port the govt dentist by providing practical training in
cialised oral surgery at Mt Isa Base Hospital on last day

16. fter arrival, communication with female
ders and attending the local town council
eeting to outline and obtain community
pproval for dental plans
ommunication: establish the support of
permanent local health providers &
Community

17. e ‘dental blitz’ team
JOR Catherine Prineas
entist
na Rodway ~ hygienist
l Webster ~ technician
nor Gray ~ assistant
PT Barry Reed ~ oral
maxillofacial surgeon
ier: one dentist
tractions & fillings)

18. Dental facilities: 1. Government
dental clinic

19. 2. Dental laboratory for making
dentures

20. 3. Dental
hygiene &
oral surgery
clinic

21. First solution
Targeted population strategy of a
CHOOL BASED fluoride toothpaste
brush in” project
first phase of dental campaign:

22. Effectiveness of fluoride
othpaste school based program
Reduction in decay rate of up to 50 - 60%
“In fact, fluoride toothpastes may be more
effective than fluoridated drinking water”
from: Fluoride in Dentistry, 2nd edition,
editors: O. Fejerskov, J. Ekstrand & B.Burt
mportantly, fluoride toothpastes have an
significant ADDITIVE effect in decay reduction

23. ablish teacher and schoolchild enthusiasm &
pport by Colgate Oral Care donation of
RIGHT SMILES, BRIGHT FUTURES” oral health
ucation teacher kits for every school class
. preliminary school based oral hygiene
education

24. RAL B donation of 16 school bag packs as
izes for classroom tooth drawing competitions
. preliminary school based oral hygiene
education

25. ractical education in solving the
decay problem using fluoride
toothpaste once per week

26. esources for school based oral hygiene
education
olgate Oral Care donation of 300
othbrushes, 300 fluoride toothpaste tubes
tooth models for BRUSH-IN PROJECT

27. Donation of QLD Health Dept INDIGENOUS
oral health & nutrition education flip charts
sources for school based oral hygiene
education

28. Small group learning

29. “Disclosing” or showing the plaque problem
with coloured disclosing solutions

30. Tooth brushing models for instruction

31. nvolving and tutoring the teaching staff
Printing and distribution of a USA University fluoride
oothpaste weekly school class program supervised by
eaching staff modified for the Australian situation

32. Education in dentally healthy eating habits
using indigenous nutrition flip charts

33. Long term solutions
going funding of project:
MY Donation of 7,200 TOOTHBRUSHES & 1,100
UORIDE TOOTHPASTES ($9,000 donation)
ure Aboriginal health funding grants and/or Qld
vernment health funding

34. More solutions
• 2. WATER FLUORIDATION
• Benefits both children and
ADULTS
• Decay reduction of approx.
50% in both adult & child
dentitions
• Decay reduction of up to 70%
in adult teeth
• Root decay reduced by up to
40% in elderly
second phase of dental campaign:

35. WATER FLUORIDATION
APPROACH
aison – with state fluoridation
oject officer ( for long term
mmunity support)
T water analysis - Army
rvey - community decay rate
ucation campaign – produce
stomised fluoride fact sheets
eetings – with Community elders

36. ext targeted population strategy:
ose at significant risk of MORBIDITY &
EATH FROM DENTAL DISEASE
rheumatic heart disease patients
Another targeted solution
third phase of dental campaign:

37. RHEUMATIC HEART DISEASE
reated dental disease can be
dly for rheumatic heart disease
ents
ER 50 PERSONS –YOUNG &
D – AT RISK (monthly bicillin
ctions)
T OF A POPULATION OF
PROX. 1500
NTIFY BY HOSPITAL RECORDS
D HELPFUL STAFF
MMUNITY WORKERS PROVIDED
ANSPORT
UCATE & TREAT ATTENDEES

38. urther training & support for Qld Govt
visiting dentists to Doomadgee
providing practical training in specialised oral
gery by visiting Mt Isa Base Hospital for the
t day:
al surgery operations in the operating theatre
h senior dental officer Dr Rachel Seadon
orning)
ining in oral medicine/pathology and oral
fourth phase of dental campaign:

39. e results of the AACAP ‘dental blitz’
by the end of 2007
QUEENSLAND DEPT OF HEALTH planners &
ngineers have visited Doomadgee community
lders & leaders to PROGRESS WATER
LUORIDATION PROJECT
T ISA based GOVT SENIOR DENTIST
lanning to REPLICATE AACAP school based
uoride toothpaste brush in project at
ORNINGTON ISLAND COMMUNITY later in

40. SCHOOL PRINCIPAL AT DAJARRA
Birdsville track region) already instituted
fluoride toothpaste school program after
earning of army dental program at
Doomadgee
Paediatric dentistry university professors at
Sydney University requested AACAP dental
program information to consider promoting
similar CIVILIAN DENTAL PROGRAMS in
e results of the AACAP ‘dental blitz’
by the end of 2007

41. Long term results: by 2010
ater fluoridation to commence next year for the
oomadgee community
ueensland Govt dental clinic at Mt. Isa provides
gular resupply of fluoride toothpastes and
othbrushes to continue the Doomadgee school
sed fluoride program
eaching other communities:
ornington Island community continues their
hool based fluoride toothpaste program

42. est result ~ healthy, happy children

43. Discussion
CAP as a training exercise for dental teams for
manitarian work on overseas deployments
g. remote areas of Pacific island nations
olomons
nviting remote area state govt civilian dentists
he introductory ADF dental officer initial
urse for the clinical components of the course
Pushing the envelope” ~ dental disease in
hanistan = pain and suffering

44. ushing the envelope”: reduce pain and suffering
curity issue = no Aust Army dental clinic for local
ilians possible
ale of the problem:
ere are only 3 dentists per 100,000 persons in
ghanistan
e tooth decay rate is very high being 3.4 decayed teeth
r child 3 to 4 years old and
decayed teeth per adult in 1991
scussion: Dental disease in Afghanistan

45. ussion: Reducing dental disease in Afghanistan
sibilities:
othing
dequate civilian capacity is not available, military forces fill the
(COIN Manual p.55)
ep programs small. This makes them cheap, sustainable, low-key
and tailored to local conditions” (COIN Manual p.300)
ain the local Afghan soldier medics in simple pain relief dentistry
g their soldiers as patients in a clinic within the base trade training
re. (overcomes the security issue)
d a Dental “DMTF” rotation to train Afghan medics,
ate simple instruments)
ese Army medics can then use acquired dental skills later in their
an careers (“winning hearts and minds”)

46. MEMORIES OF AACAP 14

47. Sincere
anks to the
ental blitz’
am for their
mateship,
nthusiasm,
ard work &
cellent care

48. Questions?

50. Dental & maxillofacial task force
(DMTF) deployment
r training local Afghan army medics, dental
re for Australian soldiers and trauma care
ne dental team of four members:
entist ~ three month rotation
al & maxillofacial surgeon ~ spring & summer
ghting’ seasons ~ six week rotation
ental assistant/technician