Oral Health Screening in a Remote Fijian Village

Objectives: The village of Wainawaqa on mainland Vitilevu is about two hours drive inland from Suva city. The objective of this outreach program was to give dental students a field experience in conducting oral screening in a rural community setting. Emergency dental extraction, simple restorations, scaling were carried out and factors affecting accessibility and utilization of oral health service were explored. Method: Oral assessment was carried out using the WHO Oral Health survey form (1997) with modifications to include questions on oral hygiene practice and accessibility barriers. Dental students were trained and calibrated to conduct the oral examination (n=310). Data was analyzed using Epi Info. Result: The average DMFT for the population screened was 9.7 teeth and 72% had DMFT >4. The most common CPI score was 2 (40.6%) and gingival recession was present in 46% of the community. Of all screened 95% needed some form of treatment. A total of 296 extractions, 225 restorations were carried out and 45 patients had scaling done. Majority of the adult screened (63%) had their last dental visit over the the last 12 months or more because of pain. Increase treatment cost at public dental clinics was the most common barrier to oral health service utilization. Other accessibility factors include geographical isolation, transportation problems and lack of perceived need. Conclusion: Dental caries, calculus and gingival recession are prevalent in the village of Wainawaqa. The data gathered presented over whelming evidence of treatment need and the challenge of addressing oral health accessibility and utilization factors in remote communities.