Introduction
Oral health is an essential part of overall health, especially for children who are easily susceptible to tooth decay. Providing oral healthcare to children through the school system has been shown to be very effective.

An oral healthcare project was initiated by the District Health Service and WHO, Jaffna, to provide sustainable, cost effective oral healthcare to children of Jaffna peninsula mainly through the schools.

Background
There are nine School Dental Therapists (SDT), working in the Jaffna district. They were the responsibility of Dr Balakumar, the Regional Dental Surgeon.
The SDTs worked with schoolchildren who were 12 years and below. Most of the SDTs had their dental clinics at the school premises itself.

Of the 413 schools functioning, 181 are schools with children in Grade 1.

Initially, the School Dental Therapists in the Jaffna district would receive training in Atraumatic Restorative Treatment (ART) method. This method of restoring carious teeth does not require an electric drill as caries is removed using hand instruments. Furthermore, this approach is easily portable hence can be used in field situations.

Training Programme


Dr. Sivarajah, WHO and Dr. Balakumar in discussion with the Dental Therapists

A two day training programme was conducted in Jaffna in the Regional Dental Surgeon, Dr Balakumar's Office and Ramanathan College School Dental Clinic, from the 13-14th of December 2010. Dr Jayanthi Ramanathan (CAPP), Dr Sivaraja (WHO Regional Coordinator) and Dr Balakumar met with the the SDTs.

The SDTs participated in a lively and open discussion. The SDTs were very eager to know, learn new methods and get involved in the project we presented. Tamil translated ART Manuals were also presented to the SDTs.

Dr Balakumar demonstrating ART Method


Dr. Balakumar supervising a Dental Therapist on ART method

The next day, on the 14th of December, Dr Balakumar organised a hands-on training of ART at the Ramanathan College School Dental Clinic in Jaffna. Each Therapist was able to perform ART under supervision, with several practical questions and discussions.

Next Phase of the Project

• Drs Sivaraja and Balakumar will invite the School Principals and Teachers to a meeting to introduce the programme and to get their cooperation and support for the success of this effort.
• SDTs will introduce supervised tooth brushing to primary school children in Jaffna district.
• SDTs will be provided with ART materials and instruments. They will perform ART method to children affected by caries, when indicated.
• Eventually, it is envisaged that the SDTs would also talk to parents, teachers and children about healthy diet- How one should incorporate healthy snacks and avoid sweets as frequent snacking.
• Dr. Balakumar plans to visit the SDTs in their School clinics periodically to check progress, encourage participants and discuss problems.
• At the end of one year, we plan to check on new caries and oral hygiene of the study and control children to assess the success of the Programme.

Schoolchildren waiting outside the School Dental Clinic

Further reading:

ART explanation
ART manual in Tamil