Bachelor of Health students in the Northern Territory

As part of the Bachelor of Oral Health curriculum, students undertake a research project with a public health focus designed to extend their skills in one aspect of oral health therapy practice.

As health practitioners we have a special responsibility to consider the issues for rural and remote communities in achieving oral health and work toward reducing barriers, particularly for Indigenous communities. The Melbourne Dental School has made a commitment to Indigenous health and well-being through its Reconciliation Action Plan by embedding content to enhance the understanding and respect for Aboriginal and Torres Strait Islander cultures in our curricula. We consider it important to generate an ability in our graduates to provide culturally safe and sensitive health care through  the development of enabling relationships with Indigenous communities, and by improving higher educational and employment opportunities in our School.

As part of the Bachelor of Oral Health curriculum, students undertake a research project with a public health focus designed to extend their skills in one aspect of oral health therapy practice. Since 2008, in partnership with Oral Health Services Northern Territory (OHS-NT), the Melbourne Dental School's Bachelor of Oral Health students have undertaken placements in Darwin and the top-end working as clinicians and in oral health promotion with support and mentoring from experienced dental and oral health therapists providing school dental services. This program offers rich experience to the students, adds capacity for OHS-NT and works toward addressing recruitment issues in remote communities.  Beginning in 2015, we have been fortunate to have the financial support for this program through the establishment of the Trollplast Bachelor of Oral Health Indigenous Travel scholarship. Having Indigenous education and health determinants embedded throughout the Bachelor of Oral Health course gives students a strong foundation when they travel to Darwin and then into remote communities.

Research on tooth brushing programs in schools

In 2015, Bachelor of Oral Health students, in partnership with OHS-NT, undertook a research project as part of their placement program to evaluate school based tooth brushing programs in the Northern Territory (NT). School-based tooth brushing programs have been seen as one mechanism for improving access to fluorides and establishing good oral health practices among children and have been incorporated into the delivery of School Dental Services in the NT to rural and remote communities. Both the NT Oral Health Promotion Plan and the Northern Territory Curriculum Framework includes this strategy.

The implementation and support for school tooth brushing programs is undertaken by OHS-NT staff as part of their service delivery model during their scheduled outreach service visits. There is anecdotal evidence that implementation and sustainability of these programs is inconsistent over the period between visits. The aim of the study is to evaluate the processes and perceived value of tooth brushing programs in rural and remote NT primary schools from the perspective of school teachers involved in their delivery. The students have conducted semi-structured interviews with school teachers to collect data to evaluate the processes for supporting and delivering them and to identify the barriers, motivators and enablers for sustainability in schools.

The findings of this study will contribute to the ability of OHS-NT to develop ways in which this program can be encouraged and sustained in order to enable the oral health literacy of the children participating in the programs and contribute to reductions in caries experiences for these remote dwelling children. Preliminary findings have shown that crowded curricula and multiple demands on teachers' time in small and remote communities offer challenges to sustainability of these programs and that supply and storage of toothbrushes can be problematic. The study findings will be presented at the Bachelor of Oral Health Research Presentation Day on October 22, 2015 at the School.

Student perspective

Reaga Yousif (Bachelor of Oral Health, 2015)

Travelling to the Northern Territory opened my eyes to the diverse dental needs of different groups of people in various geographical locations. My clinical experience in Darwin, Katherine, Jilkminggan and Mataranka, under the supervision of experienced and talented Dental Therapists and Oral Health Therapists was an invaluable experience. A memorable learning experience for me during one of my school placements was working with a young Indigenous girl who had profound dental phobia and hypomineralization present on her 6-year-old molars with post-eruptive breakdown, successfully working towards the completion of a restoration under local anaesthetic, quite a feat for this child. I was also able to travel to some rural and remote communities to collect qualitative data related to a research project I am undertaking with three other students. Drawing on my own cultural heritage originating in the villages of North Iraq, it was a humbling experience to see such small communities located in what seemed like the middle of nowhere, thriving in the school as a central hub of learning and living. This experience has enriched my studies by affording me the opportunity to undertake a formal ethics application, develop my clinical skills, apply theory to practice and form bonds with colleagues' interstate, all whilst building my independence. More importantly, this experience has ignited my passion for Oral Health during my final year of study.

Emma Cubis (Bachelor of Oral Health, 2013)

"My time there proved firsthand how the social determinants of health affect oral health and the way services are able to be provided," said Emma. Isolation and access to nutritious food, dental hygiene products, expert care and reliable access to resources such as water and electricity all contribute to poorer oral health."

Lauren Bylart (Bachelor of Oral Health, 2013)

"I think about it often in my daily practice,' said Lauren who spent three weeks in Darwin, Gove and Tiwi Islands in 2013. "It taught me to look at the bigger picture surrounding our patients and not just at the immediate oral environment. There is so much more to patient care that just treating the disease present."

Warruwi reflection

Mallory McDonald

As part of my third year research project, I was lucky enough to participate in a three-week clinical placement in the Northern Territory. During my time, I was given the opportunity to accompany Kylie Innes (an experienced dental therapist) to Warruwi, a remote community on the South Goulburn Islands, to treat school-aged children and assist in the local schools' tooth brushing program.

During my time at Warruwi, I was exposed to a clinical setting that I have never experienced before, one in which at any moment there can any number of patients lined up waiting to see you, many of whom require complex treatment. After each busy day, I would leave the clinic exhausted, but with anticipation and excitement to go back the next day. I was challenged each day with new cases that I had not come across before and my clinical skills quickly developed. I was supported both by my mentor and her dental assistant, who trusted in me and encouraged me for each and every patient I saw.

This opportunity was an incredible experience and has been the highlight of my University years. I loved my time in Warruwi and was sad to say goodbye at the end of our trip. I learned a great deal within such a short period of time and am so grateful for the opportunity to have visited the community and treated in a remote setting.

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This article was originally published in 30 September 2015.