Oral Health Care and Education
This project was initiated in 2001 under donation of dental supplies and instrument of private donor in New Zealand. With donation of dental supplies and instrument, KAD just started a very small dental activity by screening and extracting community and school children. In 2003, the project received financial support from Latter-Day Saint Charities and Australian Embassy to fund dental supplies, instrument, equipment and clinical building. In 2007, the project received the donations of dental surgery equipment from Dentaid in UK. The goal of the project is to reduce the rate of oral health problems and expenses on dental treatment and its objectives are to provide education on correct brushing technique and oral health care to the communities as well as primary school children and orphanages and provide the elderly, school children, the extremely poor people and orphans with good quality of dental services and improve mastication.

Dental Services | Oral Health Education

1.Dental Services
 Khmer Association for Development has established two dental clinics in Kandal province. One clinic is located in Kien Svay district and one another is located in Ta Khmao district. These two dental clinics have been equipped with dental supplies, instrument and equipments.

Two dental staff, a dental nurse, a dentist, a dental advisor and four other dental volunteers have been responsible for the project which covers the entire district comprising 12 communes and 46 villages in which a population of 147,563 inhabitants = 29,636 families lives but the patients come from both Kien Svay and other areas of Cambodia. The dental clinics provide dental services such as consultation, extraction, permanent and temporary filling, root canal treatment, scaling, apexectomy, crown bridge, complete denture and removable partial denture, jacket crown and radiography. Up to now, 4,500 dental patients have   received dental services.

For  self-sustaining,  dental patients are charged a very low cost for these dental services while children under 15 years old and the extremely poor people are exempted from payment.

Diagnostic cases of patients found acute and chronic pulpitis, acute and chronic periapical abscess, pericoronitis, pericoronal abscess, gingivitis, periodontitis, acute cellutitis, root- Stump, enamo-dentinal caries.

Dental survey has been done on 355 primary school students shown that 45% will require dental extraction, 25% will need dental  filling, 15%  will get root canal treatment and another 15% will be scaled. Dental pain made students attend school irregularly and difficult masticating.
The people in Cambodia seem not to pay attention or don’t know how to take care of their oral health. They go to dentist just when they have acute toothache. And sometimes, in order to stop dental pain, they use their own ways by inserting acid liquid, salt and other substances into caries, keeping tree leaves, bark liquid in their mouth, steaming the pain site with hot materials and picking caries with pointed needle. What they have done caused the serious problems. Some people went to unskilled private dental service providers. After getting services, their dental problems got more serious.

Infection Control Protocol
Equipment Sterilization:
Disinfection Protocol
Wipe dental chairs, glass tops and countertops with disinfectant after each patient. Wipe all mixing tools, light handles, curing light tips, hand pieces, saliva ejectors, supply containers, tubes, vials, composite syringes and other items used in a dental procedure with cotton spongs soaked with alcohol or GAH after each use and return to designated storage container scrub laboratory tools and instruments with soap and water, spray with alcohol or glutaraldehyde, dry and store after each patient

Entering Storage Containers
Instruments, burs, endo files, cotton squares, cotton balls, ect in storage containers will be removed using the forceps, cotton pliers, gauze or gloves.

Protection for Healthcare Provider
Doctor and dental assistant will wear gloves, protective eyewear, protective garments and masks when providing dental care or doing lab work Protective garment will not be worn in public places outside of the Pens pencils will be disinfected with alcohol or GAH after use Dental staff will use needle recapping devices, no personal items will be stored in dental surgeries.

Instrument Sterilization
Scrub instruments, burs and endo files with brush using soap and water, place instruments, burs, endo files, saliva ejectors and plastic instruments in glutaraldehyde solution and let soak for 30 minutes, rinse well with water, put metal instruments and plastic instruments in sterilizer, sterilize for 30 minutes under steam pressure, remove instruments with heat safe handles or tongs.
Immediately place instruments into appropriate containers for storage and cover. After rinsing, burs and endo files should placed in a disinfected area for drying and placed in their appropriate storage containers. Hand-pieces will be dry brushed and wiped with GAH or alcohol, cover tip with cotton until next use.

2.Oral Health Education
Apart from provision of dental services, KAD in cooperation with Cambodian Dental Association and primary school directors provided oral education and examination to primary schools and community children.

So far, 6,789 students have received oral education and other 5,389 were provided with oral examination. After oral examination, children with severe oral health problems were provided with treatment. 562 children have received dental treatment from KAD's clinic.

Objectives
- To develop a positive behavioral changes in Oral Health Self-Care.
- To learn the target group to understand the importance of their own oral health.
- To reduce the rate of oral health problems in the target site.
- To guide the target group to aware of badly prognosis in complicated dental problems and positive economic in saving the living-styles.
- The participants will be able to share their own understanding on DHE to the others, - school teachers to school children, parents to children etc…

Target Group

- School teachers for all schools in Kien Svay District, Kandal Province.
- Community Population, School Children and orphans in orphanages.

Strategies

  1. Prepare all Educating aids / supplies needed.
  2. Inform the above objectives to District Department of Education.
  3. Inform the above objectives and strategies 2 to the school which is the first priority ( all schools are to be orderly managed ).
  4. School teachers (participants) are to be invited to KAD office, Classroom, to attend The DHE class.
  5. Each DHE session will last for 60 minutes.
  6. The whole DHE period will consist of 3 (three) sessions and each session will be a 60 minutes each day.
  7. At the end of the DHE session, one tooth brush and one tooth paste will be awarded to each participant.

Activities

  1. Prepare all necessary teaching supplies needed prior to session hour.
  2. Note, checking the attendance sheet and do the introduction to the course out-line.
  3. Do a brain storming to the whole DHE class.
  4. Class is grouped to groups of four to work-out the core of the topic.
  5. Warm up and review topic taught prior to new topic teaching.
  6. Evaluate the results on post-DHE teaching.
  7. Regular observation in monitoring the process for positive behavioral changes in oral health self-care.
Expected Result
- Most cases in Dental Problems will be reduced.
- Positive behavioral changes in Oral Health  self- care will be developed.
- Appropriate principles in oral health self-care may be shared thought-out the communities.
- The community may be able to save its own account from being payment for dental problems and instead that would be turned to support its own living-styles toward a better economic issue.
- Educate the students to be aware of advantages of healthy teeth / gums and disadvantages of decayed teeth / swollen gums.
- To train on how the correct brushing technique is being made and when is a good time to do brushing.
- To screen children to identify the rate of oral health problems.
- To motivate the students to bring tooth brushes / cups to do brushing prior to either enter classrooms or National Anthem.
- To provide and promote Oral Health Monitoring ideas to school teachers in assisting to monitor the method the students do brushing and evaluate their oral health status.
- To motivate the fluoride solution mouth rinsing.