Getting dental services to the rural 85 percent

For the past 30 years the organization of government dental services in Papua New Guinea has been modelled on the School Dental Service in New Zealand. Although the two most important mouth diseases occur in adults, children have been given priority. The dental work has been done by a workforce of less than 200 dental officers and dental therapists. Dental services are invisible to the mass of Papua New Guineans. Such organization of dental services has been disastrous for the oral health of the rural population. The need is urgent to integrate dental services within the mainstream health services, doing as much as possible at the aid posts, and referring on to health centres only what cannot be done at the local level. Both the present cadre of 2250 orderlies in aid posts plus the planned new 4750 community health workers by the year 2000 need to be trained in basic dental skills. The 2400 aid posts need to be equipped with a kit of basic dental materials and instruments, costing about K250 each. Training in basic dental care can be done in six weeks, and should take place within the province, under conditions as close as possible to real life. The benefits of providing a basic dental service at aid posts are obvious--the population coverage will be much higher, the range of diseases that are preventable or controllable will increase, and many of the deaths that now occur from cancer of the mouth will be prevented or delayed.