Emergency dental care in the field

SHAJOY, Afghanistan -- Staff Sgt. Nestor Albalos uses an elevator to extract an Afghan man's tooth during a Village Dental Outreach visit here. The visit was hosted by the Zabul Provincial Reconstruction Team. Sergeant Albalos, PRT combat medic, assisted with the removal of teeth and sanitized tools during the visit. Sergeant Albalos, a native of Stockton, Calif., is deployed here from Travis Air Force Base, Calif. (U.S. Air Force photo/Master Sgt. Keith Brown)

Emergency dental care in the field

SHAJOY, Afghanistan -- Capt. (Dr.) Charles Craft, U.S. Public Health Service, watches as Afghan dentists examines an Afghan's teeth and a Village Dental Outreach visit. Dr. Craft provided the dentist and Zabul Provincial Reconstruction Team medics five-weeks of field dental care training. The course was launched here to enhance the skills of four area non-governmental organization dental professionals; providing them the ability to establish free field clinics with infection control standards in place to offer emergency extractions and routine cleanings. (U.S. Air Force photo/Master Sgt. Keith Brown)

Emergency dental care in the field

SHAJOY, Afghanistan -- An Afghan dentist, trained by the Zabul Provincial Reconstruction Team, examines an Afghan's teeth and a Village Dental Outreach visit. Although most Afghans lack basic dental hygiene products, their teeth remain relatively healthy due to limited sugar in their diets. When they do have problems many go untreated for years with the lack of basic dental care. The Zabul PRT uses the visits to address these problems, which normally consist of extracting the bad tooth.(U.S. Air Force photo/Master Sgt. Keith Brown)

Emergency dental care in the field

SHAJOY, Afghanistan -- Capt. (Dr.) James Arnold, Zabul Provincial Reconstruction Team, injects an Afghan patient with Novocain at a Village Dental Outreach visit. Although most Afghans lack basic dental hygiene products, their teeth remain relatively healthy due to limited sugar in their diets. When they do have problems many go untreated for years with the lack of basic dental care. The Zabul PRT uses the visits to address these problems, which normally consist of extracting the bad tooth. Dr. Arnold is a family practice doctor deployed to the PRT from Anderson Air Force Base, Guam.(U.S. Air Force photo/Master Sgt. Keith Brown)

Emergency dental care in the field

SHAJOY, Afghanistan -- Staff Sgt. Nestor Albalos prepares an infection control station to clean dental tools prior to a Village Dental Outreach visit here. The visit was hosted by the Zabul Provincial Reconstruction Team. Sergeant Albalos, PRT combat medic, assisted in the removal of teeth and sanitized tools during the visit. Sergeant Albalos, a native of Stockton, Calif., is deployed here from Travis Air Force Base, Calif. (U.S. Air Force photo/Master Sgt. Keith Brown)

Emergency dental care in the field

SHAJOY, Afghanistan -- Noorullah Agha, trained by the Zabul Provincial Reconstruction Team, examines an Afghan's teeth and a Village Dental Outreach visit. Although most Afghans lack basic dental hygiene products, their teeth remain relatively healthy due to limited sugar in their diets. When they do have problems many go untreated for years with the lack of basic dental care. The Zabul PRT uses the visits to address these problems, which normally consist of extracting the bad tooth. (U.S. Air Force photo/Master Sgt. Keith Brown)

Emergency dental care in the field

SHAJOY, Afghanistan -- (Left to right) Afghan interpreter John, Capt. (Dr.) James Arnold and Staff Sgt. Nestor Abalos, examine an Afghan man's teeth at a Village Dental Outreach hosted by the Zabul Provincial Reconstruction Team. Although most Afghans lack basic dental hygiene products, their teeth remain relatively healthy due to limited sugar in their diets. When they do have problems many go untreated for years with the lack of basic dental care. The Zabul PRT uses the visits to address these problems, which normally consist of extracting the bad tooth. (U.S. Air Force photo/Master Sgt. Keith Brown)

PRT on 'cuspid' of success with Afghan dental training program

Published Oct. 18, 2008
By Staff Sgt. Tammie Moore
U.S. AFCENT News Team

QALAT, Afghanistan -- In Afghanistan, the average daily income is less than one dollar a day. In the remote southern province of Qalat, it's even less. Their money, more often than not, goes directly toward the necessities of life. So when the decision to pay for any type of preventative medical care is weighed against the immediate demands for survival, survival wins out for these hardened people.

The reality of their plight is evident as soon as they open their mouths. Many have never seen a dentist or used a toothbrush.

To help remedy this situation, the Zabul Provincial Reconstruction Team united with the U.S. Public Health Service to offer an emergency dental care certification course to Afghan dental professionals from the province.

"Dental disease is the most common disease in the world today," said Capt. (Dr.) Charles Craft, USPHS dentist. "The World Health Organization has stated that there are 6 billion people in the world and 5.2 billion have dental disease. For most Americans, it is not a problem. But for most of the developing world, if you have a severe toothache, you are not going to be able to sleep; you are not going to be able to eat; you are not going to be able to concentrate; and that affects the quality of your life."

Officials launched the five-week emergency dental care course here to enhance the skills of five area non-governmental organization dental professionals. It provided them with the ability to establish free field clinics, complete with infection control standards in place, to offer emergency extractions and routine cleanings.

"We put them through pretty fast training, but they already had a background in dentistry," Dr. Craft said. "It was just a matter of showing them a few different techniques, emphasizing infection control, patient care, organization and professional set up. They picked it up quickly. That is the advantage of this type of training. It is something that can be easily taught, easily learned and easily reproduced after we are done, so it is an exciting program."

Dr. Craft and the rest of his team believe the training will translate into Afghan residents receiving better treatment than they have had in the past.

"It is important to bring this here because the villagers rarely receive dental care, and when they do, it is not always up to the same standards as in the U.S.," said Air Force Staff Sgt. Nestor Albalos, PRT member and aerospace medical services technician. "It is not uncommon for a root to be broken off and left in the gum when a tooth is pulled out, which can cause infection. This training will teach them the proper techniques to avoid that."

As part of the course, students set up a series of free clinics providing emergency care to villagers. The exercise was not only designed to provide students hands-on experience in field dental care, but to also provide them with the skills and knowledge to establish a clinic.

The clinics are very low tech, but have high standards, Dr. Craft said. Although the services offered at the clinics are extremely limited, it provided Dr. Craft a chance to focus on areas of care he believes need improvement.

Because so many residents have rarely seen dentists, Dr. Craft stressed the importance of patient interaction.

"I would say a vast majority [of our patients] have never been to the dentist and those who have, received some emergency extractions [without necessary] pain control, infection control or proper medications," Dr. Craft explained. "That is one of the reasons they are apprehensive, and they have a sense of fear of the health care system here.

"When this team utilizes the proper national standards, we have already seen the people gain confidence quickly," he added. "So those obstacles can be overcome very easily, and I think we are going to be very successful in the future. We are treating the patient as well as the tooth."

Sharing his knowledge with doctors in less-developed areas isn't new to Dr. Craft, who has worked in the Cambodian Embassy for the past eight years. He's learned to overcome common obstacles, which has made his impact here even stronger.

"Whenever you work in a foreign country, I think language and culture is an obstacle to overcome," he said. "We have been able to have a very dedicated Afghan dentist to work with, so those challenges were easily overcome."

Throughout the course, students saw patients, and Dr. Mohammed Ahmed, dental course student, noticed how pleased they were.

"They are very happy," he said. "This is a very good program."

Under an agreement with the non-governmental organization, the course graduates will continue to provide free dental care to Afghan citizens.

"We expect this team will go out to areas where even the coalition can't go and will be able to provide this dental care [twice a month] long into the future," Dr. Craft said.

"The fact that Afghans, themselves, will be able to do it means that they will not be relying on the U.S. or coalition forces," he said.