First day

Wow, what a day! It has been non-stop. From getting up a little later than we should have, eating breakfast on the tuk-tuk to the hospital, having a guided tour of the hospital (and it is VERY different from anything I've seen in the west!). We expected to be shadowing the dentists at the dental clinic for the first week, before being allowed to do any treatment. But after watching the first patient, we were thrown into the deep end, and I ended up with 4 extractions on my first child. I was very fortunate that this child was cooperative and did not scream or cry, which seemed to be the general background music to the clinic throughout the day. Here, it is the norm for the parent to hold the child's hands and body down by pretty much lying on top of them, and an assistant to restrain the child's head. This is so the child cannot wriggle about ferociously (which is what they tend to do - and they are very strong!) and therefore needle sticks and other injuries can be prevented. I didn't see a single child who didn't need an extraction, there are a lot of rotten teeth over here.....and they don't take pre-op X-rays, which is different from BDH, who advocate an X-ray for every extraction! Their X-ray developing room is in the toilet!

The dental surgery

Treatment is very fast moving and the clinic sees a lot of kids in one day, there are four dental chairs altogether but only three were really in full time use. There are two dentists, Dr Naren and Bora. Bora has recently graduated and has been working at the hospital for one year, I was working with him today. We are supervised by a dentist at all times, and they nurse for us, which is really nice of them-they must enjoy teaching, and they are very good at it. He also asked me some questions he genuinely didn't know, for example if fluoride completely arrests caries or if the caries would recur, at first I thought he was testing  me but it turned out he actually didn't know. He was also concerned about using Duraphat which had expired and asked for our advice-they don't have a choice though, as the materials they use are donated so what they do have, they must make use of, if it would benefit the child. Obviously if it was something like LA, they would know not to use it if out of date, but fluoride varnish would probably just be less effective as opposed to harmful.

Infection control is a bit different too, they do have separate bins for clinical and domestic waste and sharps. But they sterilise and reuse their burs, only wipe down the hand pieces between patients, and use old clothes rags and disinfectant spray to wipe down the dental unit.

So after a long hot working day, we chilled in the pool for a bit with a piña colada, before going into town for dinner - I'm keen to try new foods so had some fresh spring rolls and a banana leaf salad (which tasted lovely - very fragrant!)

Quite tired now though, so off to bed for an early start tomorrow morning!