What is the cause of this?

What is the cause of this?

The answer: A huge increase in refined sugar intake - “a negative impact of tourism”

• Initially sweets from trekkers

• Sweets and soft drinks now ubiquitous

• Sugar is a cheap form of energy

• Children are grazing on sweets while parents work

• Caries not just a factor of poverty

Early dental care important

• Evidence from studies suggests that poor dental health in early life predicts a lifetime of dental disease, including multiple decayed, missing or filled teeth and gum disease

Multiple caries and missing teeth in 32-year-old female patient

Multiple draining abscesses in the primary dentition of a Khumbu child

SmileHigh Mission

To reduce the level of dental caries in all Nepalese children of remote communities

by education and

preventative

strategies in order to increase

their standard of living.

SmileHigh strategies

• School visits

• Free examinations for all children

• Tooth brushes and fluoridated paste

• Constant reiteration of importance of healthy diet

• Oral hygiene instruction

• Posters and, pamphlets

• Oral Health Day

• Prize for best smile

• Oral health related quiz

• Drawing

Clinical strategies - “SmileHigh is all about saving teeth” SSS- Simple, Safe, Sustainable

• Annual school dental camps• Hand scaling• Preventative restorations• Fissure sealants• ART- atraumatic restorative

technique (local anaesthetic not required)

• Caries reversal technologies• Referral to clinic for all extractions

The bigger picture; staying on-track • Empowerment “a hand up is much better

than a hand out”

• Sustainability- including support strategies

• Mission- adhere to it

• Efficiency- value for money

• Friendships- “All I have done is help my friends” Sir Edmund Hillary

Current Relationships – Friends of HDHF pro bono support• Baker & McKenzie (legal services)

• BDO Kendall's (auditing)

• Rotary Australia (RAWCS)

• Melbourne IT (website design and hosting)

• GC Corporation (innovative dental materials)

• Naked Communications (creative design & communication)

• KaVo (dental equipment)

• KEA (Kiwi expatriate association)

Local clinical personnel

• The core of SmileHigh. Happy, motivated, committed and determined.

• At present: Mingma and Pasang

• Kanje from Khumjung wants to join SmileHigh

• Therapist:2 year training program followed by VT

• Approx cost per year A$2500.00

Thinking ahead - the future

• Key objectives

– Train more dental therapists

– Commence SmileHigh Langtang Project

– Continue to review efficacy of existing projects

– Explore delivery of services below Kharikola

– Consider delivery of services to orphanages in Kathmandu

SmileHigh Expedition 2008

• 4 Weeks

• 15 People

• 9 Dentists

Key outcomes:

• Very young are the most vulnerable

• Must continue to do more

• Need more therapists to work in the field

Thank you for your attention