Midwestern University, with its 16 dental students and 5 faculty members, has been great. When we arrive at the clinic at 7:15 a.m., there are around 50 people waiting to see us. We have a short devotional, a prayer, and then it’s pedal to the metal until 4:00 p.m., when we try to finish up, or more realistically 5:00 p.m., when we actually finish the last patients.
After three days, we are working on around 35 dentures and partials that will be delivered by the end of the week, about 35 endo cases have been completed, probably 150 teeth removed, and we have done hundreds of restorations on dozens of patients, And we have another 7 days to see patients!
I am not looking forward to returning to our normal schedule, where I can only see a fraction of the patients who need treatment. But our oral surgeon is coming on Saturday, so that will help out tremendously.
We are lucky to have seen a number of pre-missionaries – Tongans who are turning in their papers, and need a dental exam and required treatment before they leave. Typically, in the past, they would just get their papers signed without following through on any of the treatment. Of course, then they would have problems out in the field. Now, we screen these patients and bang out multiple quadrants of restorative dentistry, root canals, extractions, and even crowns.
The crown patients are a bit problematic, though. Midwestern has a scanner. They prep the tooth for a crown, and take the measurements back to Phoenix. They fabricate the crown there, and return in 6 months to seat it. I hope they make nice temporaries!
Monday, as we were about to close for the day, I saw a 14 year old girl sitting quietly in the waiting room. I asked her if I could help her, and she said she had been given an appointment for 8 a.m. but no-one had called for her. She had been waiting all day long – for 9 hours. We got her in, did an exam, and then some treatment, and reappointed her for 8 a.m. yesterday, got her right in, and did some more treatment.
We have seen patients who have been waiting for flipper partials for 6 months – no front teeth. I pre-screened about 50 of them in the last few weeks, and we started seeing them on Monday, but ran out of impression material on Wednesday. We are getting some more when the second wave of students comes on Saturday, and I hope we will be able to see them all. If not, it’ll be another 6 months before they will have front teeth.
A patient yesterday had a difficult extraction and needed the socket to be packed with a product called “GelFoam” that helps to create a clot. I remembered seeing some GelFoam when I was organizing things in the clinic, and I located it,and brought it over to the chair. W read the label on the jar, and were shocked to learn that the expiration date was 1982. It had expired 35 years ago! However, it’s really only a cellulose sponge, and we reasoned, what can happen to cellulose, after all? So we used it. But we also put GelFoam on our wish list of things to bring to the clinic.
We also had a 13 year old with a severe infection and cellulitis. He had a bombed bicuspid that had only been in his mouth for two or three years. I looked in our medicine cabinet and reached for the jar of Amoxicillin. It was a 1,000 capsule jar, and it had about 11 capsules in it. We sent him to the hospital and are hoping that they will be able to treat him appropriately. However, they often just give their patients Panadol, which is just an analgesic.
There are no dental specialists in Tonga to bail us out if we get in over our heads. Luckily, we are equipped to deal with most of the issues that confront us, and the hospital in Nuku ‘alofa has a staff of 9 physicians – no specialists, though. If patients need specialty care for dental or medical needs, New Zealand is the closest option. I’ll be interested to see what the state of oral health is of the population living on the 35 outer islands, where there is no professional health care, at all.
Phil and Jan's Adventure in Tonga 