History and observation and common sense have shown that the more we can sustain a dental program and build trust with individuals (and the community), we have a greater chance to move beyond emergency care to restoring teeth and restoring dignity in the individual.

Many rural/remote communities have experienced episodic dental visits in the past, building an expectation that you only go to the “dentist” when you have toothache. This is also a symptom of limited resources and personnel.

Clinicians can provide effective preventive care to children and adults following the principles of minimal intervention, and the atraumatic treatment approach pioneered by Dr Graham Craig in remote New South Wales, Australia, in the 1980s. This approach was the foundation for the development of the Atraumatic Restorative Treatment (ART) program, part of the World Health Organisation’s Basic Package of Oral Care (BPOC).

We can be guided by evidence based approaches – for example fissure sealing in children, fluoride treatments where regularity of visits can be assured, and caries arrestment – and we can learn from experienced clinicians who have focussed their efforts on restoring dignity through sound clinical care.

Instruction on good oral hygiene, diet, habits are important.

However we must be aware of the limitations of our ability to change behaviours and social norms, no matter how often we explain the correct brushing technique to someone!!

Have a look here for some ideas on approaches to appropriate treatments in high risk communities, and here for more information and resources.

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what a difference a frame makes. 
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Fading eastern light over western NSW plains on re-entry to Sydney.  Tough visit to Nepal this time. Struggling economy, massive inflation, increasing suicide rates, fewer and fewer jobs. Small wonder the drain of young people coursing out of the country, mainly aged 18-30 years, continues to grow. On average 3-4000 per day.  Villages are emptying. Schools are closing due to falling numbers of students.  Families are breaking up, leaving the parents to grow into either a lonely retirement in Nepal or face moving to another country where they are with their kids and grandkids but without their daily neighbours and local community.  It’s great to see so many beautiful Nepalese working and helping in Australia and other countries, and seeking opportunities they can’t find in their home country but the social, structural and political fracturing back in Nepal is deepening. The next few years will be very interesting.  Namaste!!🙏🏽 🙏🏽
Golden. @floyd_thegolden