Education & Community

Oral Health Initiative: Bocas Del Toro, Panama

Assessment & Planning: The 2nd OHI trip was planned using the same structure as the Rosarito program, however the setting was very different. In addition to Ayuda and Rotary International, we partnered with the Floating Doctors who assisted with planning. This was the first time dental hygiene services were incorporated so there was a focus on prevention and education, rather than restoring and extracting teeth.

Initial assessment of the locations/villages revealed that we would not have access to electricity. Also, we would be traveling by small boat to get to the different locations to see the children, many of whom had never seen a dentist, owned a toothbrush or had any education about the cause of cavities or oral infections.

Since we flew, I had to account for luggage weight and costs. Also, 2 dentists accompanied us to perform extractions for those children who had an abscess. The program was planned for 4 days, each day in a different location based at a school. Again, I prepared a budget and recruited the DH volunteers, all of whom were part of the Rosarito, Mexico, outreach program. The assessment form was modified and photo consent information added.

Industry Partners: Premier Dental again donated a supply of fluoride varnish and Crest Oral-B (P&G) donated toothbrushes and toothpaste for this program.

Provided Services: 327 children received preventive care valued at $126,975. Services included:

• 327 Screenings, Fluoride and Oral Hygiene Instructions
• 190 Prophy’s (plaque removal)
• 137 Scaling (calculus & stain)
• 127 Sealants
• 27 extractions

Evaluation and Reflection: This program showed me how different one community can be from the other and the importance of planning to make sure the program is adapted for that community. One does not fit all.

Limitations and planning advice: We had to take small boats to the island villages and then hike to each location. The suitcases were heavy and not ideal to carry in the 100o heat. Making sure suitcases are all on wheels and easy to carry is crucial.

Children we saw were in school, which meant their parents were not always available. Consent for extraction (when needed) was often difficult to obtain. Sending consent forms to parents a week or more before the program starts would be ideal.

Time: I realized that time is almost always a limitation. These children deserve quality care and in these circumstances, it is often hard. We are trying to see all the children at school in one day, which is just not practical. The amount of decay and plaque was severe and each child needed more time than expected.

We had more adolescent patients than expected, consequently the next time I will bring more toothbrushes than needed so that we have enough supplies for all ages. (Better to have too much than not enough!)

Time was an issue. The clinic flow was disrupted due to splitting the team into two groups and the paperwork more extensive than needed. Also, the Consent Form did not include permission for using photos and will be added before my next program.

Advice for starting your own community oral health outreach program (in addition to the planning process shared)

• Stay determined and motivated because starting your own program takes a lot of time and effort. There are many aspects to developing a program and it can seem overwhelming.
• Networking is crucial so that you can meet people who have accomplished something similar – don’t be afraid to ask questions. There will be times that you feel you don’t know how to get something done but utilizing people in your networks can help you get the information you need.
• Expect the unexpected upon implementation. Striving for perfection is great but it can also be a downfall. That is what program evaluation is for – to identify limitations and improve the next time.