Rural dental program in Haiti

– A rural dental program located on La GonÂve, an island near the coast of Haiti is described along with demographic characteristics of the local population. The oral health of 61 adolescents and young adults seen during screening examinations was assessed. Caries free individuals made up 14.8% of the population. The mean DMFT for the group was 4.20. The OHIS score for the sample was 1.35; the PI score was 0.39. No significant association was found between DMFT, OHIS, PI and sex. One subject had a PI score 5.8 standard deviations from the mean score for the group and exhibited signs suggesting juvenile periodontitis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74982/1/j.1600-0528.1984.tb01446.x.pd

Inequalities in access to education and healthcare

The burden of disease is borne by those who suffer as patients but also by society at large, including health service providers. That burden is felt most severely in parts of the world where there is no infrastructure, or foreseeable prospects of any, to change the status quo without external support. Poverty, disease and inequality pervade all the activities of daily living in low-income regions and are inextricably linked. External interventions may not be the most appropriate way to impact on this positively in all circumstances, but targeted programmes to build social capital, within and by countries, are more likely to be sustainable. By these means, basic oral healthcare, underpinned by the primary healthcare approach, can be delivered to more equitably address needs and demands. Education is fundamental to building knowledge-based economies but is often lacking in such regions even at primary and secondary level. Provision of private education at tertiary level may also introduce its own inequities. Access to distance learning and community-based practice opens opportunities and is more likely to encourage graduates to work in similar areas. Recruitment of faculty from minority groups provides role models for students from similar backgrounds but all faculty staff must be involved in supporting and mentoring students from marginalized groups to ensure their retention. The developed world has to act responsibly in two crucial areas: first, not to exacerbate the shortage of skilled educators and healthcare workers in emerging economies by recruiting their staff; second, they must offer educational opportunities at an economic rate. Governments need to lead on developing initiatives to attract, support and retain a competent workforce. © 2008 Blackwell Munksgaard and The American Dental Education Association

Dental health of Aboriginal pre-school children in Brisbane, Australia

This investigation studied the dental health status of a group of 184 Australian Aboriginal children with a mean age of 4.4+/-0.8 years, who were attending pre-schools in metropolitan Brisbane, a non-fluoridated state capital city. The DDE (Developmental Defects of Enamel) Index was used to chart enamel hypoplasia and enamel opacities. WHO criteria was used to diagnose dental caries. The results showed that 98% of children had at least one tooth showing developmental enamel defects. Each child had a mean of 3.8+/-1.7 teeth affected by enamel hypoplasia and another 1.1+/-0.8 teeth affected by enamel opacity. Seventy-eight percent of the children had dental caries. The mean number of decayed, missing, filled teeth (dmft) per child was 3.8+/-3.7. The decayed component consituted 3.5 (95%) of the mean dmft, indicating a high unmet restorative need in this group. The mean dmfs (decayed, missing, filled, surfaces) was 5.9+/-7.3. Maxillary anterior labial decay of at least one tooth affected 43(23%) of the children. In this sub-group, the dmft and dmfs was 9.1+/-2.8 and 15.4+/-7.7 respectively. Oral debris was found in 98% of the children. It is hypothesized that the high levels of underlying developmental enamel defects, compounded by low fluoride exposure, poor oral hygiene and a diet high in refined sugars pose an important caries risk factor in this group of children