The Dental subprogram was incorporated into the School Continuity Program when it was discovered that many children did not eat or play in the centres because their mouth ached. Today, Dental treats about seventy children each day in consultation and has designed a program of prevention and promotion of oral health for the children of all the different camps.
THE SMILE SEARCHES
The Dental subprogram was merged a few years ago to the School Continuity Program when it was perceived that many of the children of the different centres did not play or eat because their mouth ached. The subprogram had to complement PSE dental clinic’s work during the whole school year with PSE students, but it should also meet the needs of children who came to the subprograms and who, because they are not PSE students, had never received dental treatment, many of them with mouths full of cavities and without any culture of oral hygiene: oral health is a pending issue in children who attend the School Continuity Program.
“It’s not enough to remove cavities,” says Rosana, the Dental coordinator. “The important thing is to learn how to take care of the mouth, to have hygiene and to understand what damages your teeth and what not.”
Therefore, this subprogram seeks not only to address and solve the most urgent problems, but also to educate children to have good hygiene and oral health: it is the only way to avoid major problems in the future in the kids’ health.
THE DENTAL TEAM
The Dental team is composed of five European volunteer dentists, a team of four Cambodian workers – driver, coordinator, monitor and technician – and seven Cambodian dentistry students who volunteer part-time and work on two lines of action: treatment and prevention.
“They have the threshold of pain very high, when they say that their mouth hurts, they hurt them a lot. And when we heal them, they do not blink. “
Each one of them is carried out in all subprograms. An impressive job, considering the number of children that exist among all the centres – more than three thousand – that makes it possible to reach all of them through perfect work planning and division of the dental team into two groups that rotate: one of them stays in the centre of PSE and the other one goes every morning to a subprogram located outside of PSE; this is the way in which the performance of their work doubles.
“Every morning we ask the children in each row who has pain, that is the fundamental criteria, to treat children who are having a bad time.”
In addition, the implication of each subprogram in the dental agenda is fundamental for everything to work. “We owe much to the coordinators of each subprogram, “ Rosana says, “without their collaboration whenever we go to a centre, none of this would be possible.
There are two types of treatment for children attending the School Continuity Program: on the one hand, children who have pain or visible urgent problems are treated, on the other hand tooth-seals are made for children who need it. Given the number of children attending each day to the subprograms and the inability to check the mouths of all, the dental team, coinciding with the moment when the monitors check the attendance, makes each morning a selection of the most urgent cases.
“Every morning we ask the children in each row who has pain,” says Rosana, “that is the fundamental criteria, to treat the children who are having a bad time,” she adds, “sometimes even before arriving to their line, children come asking us to see them because they have pain, they recognize us because we have painted a giant tooth on the shirts. ”
“It is fundamental that they acquire the habit of brushing, otherwise, we will not achieve anything.”
“They have the threshold of pain very high,” says Rosana, “when they say that their mouths hurt, they hurt them a lot. And when we heal them, they do not blink. ”
In addition to children with pain, other children with problems such as infections are also selected, detected with a simple check-up in the line. In total, about sixty children are selected daily to treat in clinic, who go in groups of four to the consultation carried by a Cambodian monitor. The work is perfectly organized: while two children are taken care of – there are two dental chairs – two others wait outside with the Cambodian monitor, who explains to them, with a story that they have prepared for this purpose, the misadventures of a great crocodile that did not care his teeth.
“There are many who believe that chicken is bad, because they have chicken bones among their teeth and they bother them, but instead they have never thought that too much sugar can spoil their teeth.”
In the case of visits to subprograms located outside the PSE centre, the selection follows the same process and the consultation is articulated through a Mobile Unit equipped with everything necessary to attend the children.
At the end of the day, about forty children in the PSE centre and another forty more in the centre to which the second team has attended will have gone through the consultation. “We also have the help of spontaneous ones,” the monitors laugh, “every day we have children who come just to reassure their friends or to hold the mirror while we take care of them, we are very good helped!”
When the children attended are students of PSE, a Cambodian worker incorporates the data of the consultation to the student’s file, so that the Dental team that remains throughout the year has knowledge of the treatment performed.
“The worst thing about this job is the fear children have. We are a bit of the bad guys. “
It is the second part of the content of the dental team program and is based on two activities:
The first of them consist of distributing daily and throughout the program toothbrushes and toothpaste to the boys and girls at the entrance of the showers. This work is done in all centres and all shifts. “It is fundamental that they acquire the habit of brushing,” says Rosana, “otherwise we will not have achieved anything.”
The second activity is to give workshops of prevention and promotion of oral health in which the objective is to explain to the children, first, the technique of brushing and its frequency and, secondly, the healthier eating habits so that children learn to identify which foods are harmful to their mouth and which are not. “There are many who believe that chicken is bad,” says Rosana, laughing, “because they have chicken bones between their teeth and they bother them, but instead they have never thought that too much sugar can spoil their teeth.”
“The best thing is when, after a few days of treatment, a child comes from behind and hugs you by surprise and when you turn he shows his healed teeth and smiles. Sometimes, even, they point you with a finger where the teeth you’ve healed are, and then the other, where the teeth they want you to look at today are. That moment gives meaning to all our work. “
The prevention sessions are usually given by the Cambodian members of the Dental team, in groups of twenty children, using large drawings that have been prepared for this purpose or giant dentures with which it is easy to explain how brushing should be, but in reality they are quite flexible – there are centres in which the session became a small and fun play, others where the session was incorporated into the program of activities of the day as one more activity, and there is even a kind of gymkana of letters which the dental team has invented to incorporate into the centres’ games, with good and bad foods, in which children compete to see which team is able to accumulate more good foods. The important thing is that the message reaches the children.
THE WORST AND THE BEST
“The worst thing about this job,” dentists say, “is the fear children have to us. We are a bit of the bad guys in the story. ”
“We cannot be soft,” says Rosana, “sometimes when a child cries because he is afraid, we reassure him, we calm him and let him go, hoping that the next day he will be more cooperative, but it’s a double-edged sword,” she says, laughing. because they tell their friends to cry, they explain them that, in that way we will let them go without doing anything to them. ”
When one goes through the consultation and observes for a while, you see children waiting outside, colouring or listening to the story of the crocodile that lost his teeth. Inside, a couple of kids are sitting on dentist’s chairs with fists a little tight, but enduring with an amazing dignity the bad time. When the treatment is over, the dentists applaud and pat them on the back and embrace them: there is no more mime in a consultation.
“The best thing is when, after a few days, a child comes from behind and hugs you by surprise and when you turn, he shows you his healed teeth and smiles,” says Rosana excitedly. “Sometimes even they point to you with the finger where the teeth that you have healed are, and then the other, where the teeth they want you to look at today are. That moment, gives meaning to all our work “.