PRESENTATION
1. Background
2. South Pacific Medical Team – MALIMALIPROJECT
3. Outcomes-HIGH SCHOOLS SURVEY RESULTS/DMFT INDEX
4. Interventions
5. Conclusion and Lessons

KING OF TONGAOFFICIAL OPENING OF NEW VAIOLA HOSPITAL DENTAL CLINIC BY KING TUPOU VI IN 2012

KING OF TONGA AT DENTAL VVIP CHAIR

DENTAL DEPT(11 CHAIRS)1. BACKGROUND

2NIUAS-1 DENTAL THERAPIST EACH (1% EACH)PROVIDED BY
GOVERNMENTHOSPITALS IN 5 MAIN
ISLANDS

VAVA’U-1 DENTIST AND 2 THERAPISTS (15%)

HAAPAI-1 Dentist, 1 THERAPIST (6%)

TONGATAPU-9 DENTISTS, 15 DENTAL THERAPISTS (73%)

EUA-1 DENTAL THERAPIST (5%)

1. BACKGROUNDTONGA HEALTH CARE SERVICES• Decentralized and Government Health Services are provided FREE OF
CHARGE to a population of 105, 323 (mini census 2011)

ORAL HEALTH SECTIONS• Conservative Treatment• Oral Surgery and Oral Pathology

ORAL PUBLIC HEALTH = MALIMALI PROGRAM-SMILE• Prosthodontics• Health Centre Outreach1. BACKGROUND• 1998-2000 SPMT first DMFT
– DMFT count 4.10(BOYS) AND 5.48 (GIRLS)• 2000 - Dental Caries selected to be among the health priorityissues, SPMT work in caries prevention was supported.
• AUSTRALIA ROTARY DENTAL TEAM survey in 1998 showed
DMFT count to be 3.1.

OBVIOUS DETERIORATION IN ORAL HEALTH IN TONGAN
CHILDRENSPMT-JAPAN 1ST DMFTSURVEY (2000)
GENDER(12yrs)

DMFT Person Rate

Mean DMFT

BOYS

89%

4.40-HIGH

GIRLS

91%

5.81-HIGH

2. SOUTH PACIFIC MEDICAL TEAM (SPMT)• Voluntary group of Japanese dentists and therapists• Main activity - planning and administration of a school-based
fluoride mouth-rinsing program known as The MALIMALIPROGRAM and Weekly visits to all primary schools- teaching
children about proper use of toothbrushes and fluoride toothpastes• November 2006 – Ministers of Health & Education signed theworking collaborations with SPMT and JICA– School based OralHealth Program• 2013-MALIMALI Part 2 commenced-August 2013-To ImproveTongan peoples’ life style by approaching from oral health and lifestyle modification-HIGH SCHOOL ORAL EXAMINATION STARTEDPRIMARY SCHOOLSMALIMALI PROGRAM

PRIMARY SCHOOLSMALIMALIPROGRAM

Fluoride mouth-rinsing
・ＮaＦ・0.2% (once/week)•Primary school
7～10 ml•Rinsing３０～６０ sec•Effect of prevention 40～60%

PRIMARY SHCHOOLSMALIMALI FLUORIDE
MOUTHRINSING

2000 AND 2007 TONGATAPU DMFT INDEX

2000(SPMT1stsurvey)

2007(SPMT 2ndsurvey)

Sex(12yrs)

Num

DMFT
Person
Rate

Mean
DMFT

Num

DMF
Person
Rate

Mean
DMFT

BOYS

4589%

4.40

4470%

1.84

GIRLS

2191%

5.81

2070%

2.10

TONGA OVERALL 2011 DMFT INDEX
12 years
oldF

M

num
num ofteeth

num ofDMF

DMF
DMF DMFnum ofperson numindex holder
teethrate

DMF
DMF
num of
DMF
indeperso
DMFholderxn rate

Tongata
58pu1583

157

2.74984%842258201

2.45565%

Vava'u20553

26

1.3945%28757

341.21554%

Ha'apai

410941250%

10265

18

1.8880%

Eua

8214

27

3.4675%11305

242.2982%

Total

902459214

2.46673%1333585277

2.18765%

3. THE QUESTION OF HOW WAS THE ORAL HEALTHCONDITION OF HIGH SCHOOL STUDENTS?---A WONDER!!
SO, IN 2014 WE STARTED DMFT SURVEY OF SOME HIGH SCHOOLSIN TONGATONGA-48 high schools with a total of over 16,5000 students-Churches sponsored majority of these schools and GOVTMalimali Project High Schools DMFT Survey-6 High Schools in Vava’u-5 High Schools in Haapai-3 High Schools in Eua-4 High Schools in Tongatapu

HIGHSCHOOLSVISIT
AT HIGH SCHOOLSWE DO-ORAL HEALTH TALKNCDS-OE AND DMFTINDEX-WEIGHT N HEIGHTMEASUREMENT-DISTRIBUTION OF
TOOTHBRUSHESAND TOOTHPASTES-APPNT GIVEN IF
NEEDED-QUESTIONNAIRSHIGH SCHOOLS ORAL HEALTH VISITORAL HEALTH TALKQUESTIONNAIRSORAL EXAMINATIONTUPOU COLLEGE ORAL
EXAMINATION FORM 1-3-5AT HIGH SCHOOLS WE DO-ORAL HEALTH TALK-NCDS-OE-WEIGHT N HEIGHT MEASUREMENT-DISTRIBUTION OF TOOTHBRUSHESAND TOOTHPASTES-APPNT GIVEN IF NEEDED-QUESTIONNAIRSORAL EXAMINATIONSAT HIGH SCHOOLSVISITING TONGA HIGHSCHOOLPLAQUEGINGIVITISHIGH SCHOOLORAL FEATURES

gingivitis

GINGIVITIS-BLEEDING ON BRUSHING3. HIGH

2015
DMFT INDEXQSC
FORM 195 STUDENTS
1.75

162 STUDENTS
1.29

30 (31%)QSC
FORM 325 STUDENTS
1.48

91 STUDENTS
1.85

14 (56%)QSC
FORM 523 STUDENTS
2.13

25 STUDENTS
2.92

TC
FORM 197 STUDENTS1.67 –123 STUDENTS
1.12

44 (45%)14 teeth-10 students
11.4%

TC
FORM 396 STUDENTS
2.12-

103 STUDENTS
1.87

40 (42%)14 teeth-10 students
9.7%

TC
FORM 5135 STUDENTS
2.36

74 STUDENTS
2.03

39 (29%)39 teeth-28 persons
52.7%

SCHOOLSA

B

No. of 1st molar
extraction

2014
DMFT-INDEXCARIES
FREE No.
%(2014)8 (35%)

3. VAVAU HIGH SCHOOL
No. ofStudents

FORM 1102

No.
Students
MISSING
TEETH

No.
Students
NEED
TX

No.
Students
NEED
FLG

No.
Students
NEED
RCT

GINGIVA

11/10211%

45/10244%

39/102
38%

3/102
3%

N-55-54% 8-8%
S-41-40%
OM-2-2%

21/61
34%

17/61
28%

8/61
13%

NO
RECORD

39/67
58%

36/67
54%

9/67
13%

N-38-57% 17-25%
S-27-40%
OM-2-3%

NEEDSCALING*9 molars
FORM 361

6/61
10%NO
RECORD*6 molars
FORM 567

23/67
34%*molars/anteriors

4. What shall be our INTERVENTIONS for TONGA-High

Schools level? What can be applied in High Schools?

MALIMALI ACTIVITIES SHOULD reach out to all High School in Tonga
and give oral health dialogue- REINFORCE the message of good andhealthy teeth /do DMFT examination in Form1-3 every year
Fluoride mouthrinse to be continued in form 1 to form 3
ENCOURAGE the need for students and families to practice
good hygiene for healthy mouths and healthy smiles at schools
and home
WHAT else CAN WE DO with High School Oral Health Prevention??
-cooperation of students/principals/teachers/MALIMALI TEAM
-oral health prevention program vs treatment-appointments

5. CONCLUSION/LESSONS• Our high schools results have shown us someevidence that oral health interventions should
be applied to high schools• Partnerships-involvement and support fromMalimali Team/MOH/MOET and High Schools
principals/teachers and students• Clear Strategy-promote good oral health andgood malimali for children in high schools

MALO ‘AUPITOTONGATAPU DENTAL STAFF