Outreach Clinics

I can't believe it's only the second day! This morning we were both at the hospital clinic, I did a few fillings and the beginning of a root canal treatment to start with, and Jessye had all the extractions. I was then trying to help Bora decide what dose of diazepam should be used for oral sedation in children, as he had never used it before....so after introducing him to the bnf online, which said diazepam should not be used for Dental treatment on kids, we decided another drug should be used. I find it interesting that they are so confident using materials and drugs that they have never/rarely used. As the dentists here say: 'no choice' - they have to use what they've got to help the kids.

I had the most horrific experience with my next patient: a scared little four year old boy. He was whimpering as he got put in the chair, but I really felt like the bad guy in a horror movie when giving him local anaesthetic...he shrieked and screamed and balled his eyes out, thrashing his body about like he was in pain, but it was just because he didn't want the treatment. It was horrible. I almost cried. But the tooth just needed to come out as quickly as possible. And after it did, he was fine (although probably traumatised for life) A LOT of the children at the hospital are like that every day :-(

The afternoon was more pleasant, I went on outreach to a school about an hours drive away from the hospital. It was exactly what I had imagined a third world outreach programme to be like- the dental team (Dr Naren, two dental nurses and me) set up a clinic in a dark dingy classroom. We had one portable dental chair which Dr Naren and I used, and the nurses used a couple of school desks for their makeshift dental unit. (Dental nurses do everything the dentists do here.) There were no lights in the classroom, so a handheld torch provided our tiny glimmer of light. They do have enough clean instruments to use for each patient which was good to see!
School children who are in pain come to the outreach clinic, the nurse then quickly examines them and confirms which teeth need extracting, we then rattled through the patients (18 altogether today) within an hour. I feel much more confident with extractions from outreach alone. These kids are much more cooperative than at the hospital and don't cry so much, because they actually want the treatment, to get out of pain. In fact when the last patient was told to get up and leave because they were being uncooperative and not accepting an injection, they immediately lay back down and opened their mouth as they really wanted the teeth out.

They are then all given a toothbrush and toothpaste. The kids were all really sweet and liked having their photos taken....watch this space  for uploaded photos coming soon...