DENTAL DEPARTMENT

The new purpose-built 3 surgery dental clinic with general x-ray facilities opened in June 2005. The building was funded by a legacy from Ella Boyce-Stamper, a UK dentist who worked in Ethiopia for many years and Lions International. Two fully equipped, refurbished dental surgeries were supplied by Dentaid UK. A third chair and dental unit from the US have recently been installed for training purposes, dental hygiene work and when we are busy with three clinicians working. The clinic is staffed by a UK dental surgeon, 2 Ugandan Public Health Dental Officers and 3 locally trained dental nurse assistants. Most routine dental services are available, including dental extractions, amalgam, light-cure composite and GIC restorations, ultra-sonic scaling and periodontal treatment, endodontics, prosthetics, minor oral surgery and x-ray services. Patient oral health education is aided by the use of dental educational videos in the waiting room. Cross infection control is adhered to with the use of Little Sister autoclaves in each surgery.

OUTREACH

A lot of work currently involves part of the dental team going out to rural and local primary schools where we are able to give appropriate oral health education and dental health screening for all children in the school. Often the dental message is put across through the children participating in a short drama. We carry with us a full mobile dental kit with reclining chair, several sets of extraction forceps, drill unit, light, ultra-sonic scaler and suction unit. Sterilisation is done in a pressure cooker on a gas bottle ring. The dental nurse assistants have been trained to do ART (atraumatic restorative technique). This is a painless restoration of small tooth cavities using hand-instruments, rather than a drill. Glass ionomer cement is used which bonds to the tooth cavity and has a cariostatic effect due to the release of fluoride. It is not unusual to find the dental chair and 2 or 3 other treatment stations set up in a class room; the children lying on tables for their treatment. We are working closely with Dentaid UK in currently running a pilot scheme to try out the efficacy of a prototype tooth-paste dispenser in primary schools. Dentaid is sponsoring all the dental treatment requirements in these 12 chosen schools through funding hopefully from primary schools and dental surgeries in the UK. In the future,

they plan to extend this sponsorship to many more schools by publicity through the Dept of Health “Bright Bites” learning tool for UK primary schools, which also gives the opportunity for schools to sponsor oral health programmes in schools in Uganda. Another way to get the oral health message across to the public and into the rural communities is through phone-in programmes on local radio, which creates a lot of interest and awareness. A tradition that has developed over the past 30 years in Uganda and other African countries is that of “false teeth” locally known as “ebiino” in this area. A baby in its first few months who presents with diarrhoea, vomiting and fever is diagnosed by the traditional healers as having “false teeth”. Treatment is by the healer removing the un-erupted deciduous, usually lower, canines with whatever implement is to hand and then giving herbs. Although babies very often survive through natural resilience and recover from the gastro-enteritis or malaria, this oral mutilation sometimes results in severe infection, bleeding and even death through septicaemia, anaemia or HIV. A later effect is the subsequent over-crowding of the permanent dentition in the canine region or damage to the developing tooth buds causing mal-formed or mal-placed canines. The Rugarama dental team also visits rural health centres, local communities and Child Development Centres for sponsored orphan children for screening, treatment and oral health education.

TRAINING

Training in dental health education is seen as an important side of the work at Rugarama; a number of such work-shops have been successfully run for primary schools’ health and science teachers. Several training courses in Basic Dental Care for rural health centre in-charges have also been run over the past few years. Patients in remote areas attend their nearest health centre and receive emergency dental treatment, usually tooth extraction, from a dentally untrained medical person. That’s if they are lucky; many attend the local tooth-puller, often with disastrous results. This course is run to help the clinical officers or registered nurses to diagnose and safely treat dental emergencies by good local anaesthetic and extraction technique, cross -infection control and what they should or should NOT attempt to do.

ELECTIVES

We can always give valuable experience and offer interesting studies for dental elective students in their final year at university and would welcome their input. If time allows, visits to the National Parks for game viewing, mountain gorilla trekking and volcano climbing is a must and for the more adventurous, rafting the grade 5 rapids on the River Nile near Jinja.

For more information contact:
Dr. Chris Barton, Dental Surgeon
Email: chris4polly@yahoo.co.uk

Also see Medical/Dental Electives information.