First Regional Course in Public Health Dentistry, Singapore and Malaysia, 1 May - 30 June 1975 : final report

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(WP) IC P/OOH/OO2

7 August 1975 ENGLISH ONLY

,f-NAL REPORT ON THE

FIRST REGIONAL COURSE

IN PUBLIC HEALTH DENTISTRY

Singapore and Malaysia 1 May to 30 June 1975

by

Dr Chellie J.

Sundr~m

Course Director

Manila, Philippines World Health Organization Regional Office for the Western Pacific

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-

CONTENTS

1.

OR.J:ECTIVES ..... ~ • • • • . • . • • • . • . • • . • • . • • • • • • • • • • • • . • • • •••• ORGANIZATION ..••••••••.•••••.•.•••••.••••••.•••••.••••

1

2

2 2

3.

TRAINING PROGRAMME ..••.•.•.•.••••.••••••••••••••••••••

3

1

Dental services within an organized health service School dental services ....••..•••....•..••.•..... Prevent1 ve progralllDes .....................................

3·2

3.:3 3.4

Manpower production .,......................................

3.5 Epidemiology and biostatistics ..••••••••••.•••••. 3.6 Conduct of an oral health survey................. 3.7 Planning for dental services and manpower ..•••••• 3.8 Observation visits...............................

3 3 3 5 5 5 6 6 7 7 7

4.

DISCUSSIONS ................................................................... .

4.1 4.2

Topic 23 ................................................................ Topics 27 to 34 ...........................................

5.

EVALUATION OF THE COURSE 5.1 Selection of participants 5.2 . Impact on participants ..•••••••••••••.•••••••.••.

.................................

5.' 6.

EvalUation by the participants ..•••.•••••••••••••

7 8 8

AC~OWI.EOO~. • • • • • • .. .. • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

11/12

ANNEXES:

ANNEX 1 - LIST OF PARTICIPANTS ANNEX 2 - LIST OF CONSULTANTS. TEMPORARY ADVISERS. RESOURCE PERSONS AND WHO STAFF MEMBERS •••••• ANNEX 3 - PROGRAMME (COURSE SCHEDULE) ...•.•••..•.••••• • 15

19

ANNEX 4 - DOCUMENTS MADE AVAILA3IE AS REFERENCE MATERIAL AND WORKING PAPERS ISSUED TO PAR.TIC I PANTS ............................................... 31

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ANNEX 5 - PHOTOGRAPHIC ILLUSTRATIONS OF PARTICIPANTS AND SOME ACTIVITIES ..••••.•••.•••••••••••••••• ANNEX 6 - PARTICIPANTS' EVALUATION OF THE COURSE SUMMARIES OF REPLIES TO 'IWO QUESTIONNAIRES (CHECKLISTS), 1975 ..•••••••.•••••••.••••••••.• ANNEX 7 - SUMMARY OF COUNTRY INFORMATION ••...••....•.... ANNEX

49 :;"j

8 - PICTOGRAPH OF INTEREST LEVELS AGAINST PARAPHRASED TARGETS IN COUNTRIES REPRESENTED AT THE COURSE ..••••••••••••••.•••••.•••••••

57/5f

ANNEX 9 - SELECTED ILLUSTRATIONS OF THE NATIONAL DENTAL HEALTH EXHIBITION MOUNTED DURING "DENTAL HEALTH WEEK" IN SINGAPORE •••••••••••••

C;c

1.

OBJECTIVEI!

The general objective of the Course was to give key dental health workers theoretical and practical experience in the basic elements of dental public health practice in relation to on-going programmes, and 8 general view of the training and utilization of professionals and dental auxiliaries for the delivery of dental services. The specific objectives of the Course were: 1.1 To explain the principles of the establishment. orsanlzatlon, administration and evaluation ot a public dental health programae. 1. 2 To discuss the place of a dental service in the total health programme ot a country and areas tor integration.

To provide practical experience in the establishment and maintenance of a dental care service (within a tunctlon1nS health service and as a separate service). To describe alternative approaches to the tollowing tunctions of public health dentistry: (a) (b) (c) Prevention; Dental health education; Delivery of dental services.

1., 1.4

1.5 To provide practical experience in the collection of basic epidemiological data for the purposes of planning and evaluation of a dental health programme. 1.6 To demonstrate particularly the preventive aapects of a community dental health programme. 1.7 To demonstrate the mechanics of mounting and carrying out a community health education campaign on a specific topic.

1.8

To demonstrate the mechanics of organizing and maintaining preventive programmes for dental health in captive groups such as schoolchildren and the public in general.

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2.

ORGANIZATION

This First Regional Course was organized by the World Health Organization and hosted by the Governments of Singapore and Malaysia. The Singapore sessions were held from 1 to 24 May and from 23 to 30 June, and the Malaysian ones from 25 May to 23 June 1975. Thirty-five topics were dealt with over a two-month period. The activities included formal lectures. demonstrations of programmes on site, discussions. workshops. seminars and an epidemiological survey exercise in a village .nere there were neither dental services nor established maternal and child health services. The results ot the survey. although the population sample was not representative. formed the basis of discussions for planning dental health programmes (Topics 32 to 35). Eighteen dental officers and four dental therapist tutors or supervisors from 14 countries and areas in the Western Pacific Region participated in the Course. Seven nominees from South Viet-Nam. Cambodia and Western S8IIIoa were unable to attend. The participants are listed in Annex 1. with illustrations in Annex 5. Sixty-three reference documents were made available at the Course (Annex 4). The teaching staff provided by WHO were: four consultants recruited for specific topiCS; five temporary advisers from the host countries; the Chief of Dental Health from WHO Headquarters in Geneva, who dealt mainly with the health planning sessions; the dental officer of the inter-country project for dental health advisory services. who 1 was also the Course Director; a WHO dental therapist tutor from Saigon. Other main resource personnel provied by the Governments of Singapore and Malayda .are listed in Annex 2. Transport to the demonstration sites was provided by the Governments of both countries. A national dental exhibition and a national oral health contest were mounted by the Ministry of Health of Singapore during the last week in June.

3.

TRAINING PROGRAMME

A programme of activities with 36 topics was issued to the participants as Information Bulletin No.4. together with a day-to-day diary of activities showing the sites for the lectures. field visits

1

Now reassigned to Papua New Guinea.

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and demonstrations with the responsible officer in charge as chairman. coordinator or contributor. Also issued to participants was a compilation of 12 working papers. Ad ~ changes were made in the course schedule where necessary. A detailed programme of subjects to be covered and supplementary notes were issued by the contributors prior to presenting their topics. The course schedule is presented in Annex 3 and the list of working papers in Annex 4. Three tables which served as country information reports are presented in Annex 7. The working hours were generally from 0800 to 1200 and 1330 to 1630 from Monday to Friday. Only morning sessions were held on Saturdays. 3.1 Dental services within an organized health service

The topics of basic principles in the organization and planning of public health services. public health and management science. the vital issues faced today, delivery of health care systems and training of public health teams formed the basis for a series of lectures intended to provide background information and to stimulate individual thinking. The participants were given information on general health management so that they would appreciate that the organization of dental services was within the framework of an existing health service. This was to help them in their own thinking during the discussion of each of the later topiCS. Field visits in Singapore and Malaysia served to illustrate the principles ot organization and planning at dental services defined during the lectures. 3.2 School dental services

The use of operating dental auxiliaries was amply illustrated in the delivery.of dental care to schoolchildren. Modified incremental dental care, together with the delineated responsibilities of the dental officer and the school dental nurse, were illustrated in Singapore and Malaysia. The merits were demonstrated of various types of school dental clinics: 1. e.. those in separate "huts" on the school premises and those within the school building itself. 3.3 Preventive programmes

Techniques of preventive dentistry appropriate to the countries represented were discussed in detail. Greater emphasis was given to periodontal disease so that participants who had hitherto been concerned with caries control alone would appreciate the need for preventive programmes for control of such disease. 3.3.1 Periodontal disease

Illustrated lectures were given on the need for plaque control. Notes were issued containing sample plaque scores. d1etary record and analys1s and health record sheets. Periodontal disease control and

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treatment were also dealt with. Tbe participants were given a gingivectomy exercise using waxed-up models set in the jaws of phantom heads prepared by the conaultant. Aa the participants worked in pairs. those who had not previously carried out a gingivectQm7 acquired sufficient competence to apply the technique in suitable cases on their return home. The pairing of professionals and auxiliary personnel also enabled those with experience of periOdontal surgery to assist those without this experienoe.

3.3.2

Dental oaries

The need for routine dental oare was stressed. The importance of assigning a patient recall interval designed to cope with the incidence of dental disease in the country was deaonstrated during field visits and lectures. Mass preventive measures: (a) A visit was JD&d.e to the waterworks in Singapore. and the method of fluoridation of retioulated water supplies was studied by the participants. The current status ot the use ot fluorides for controlling dental caries was discussed. (b) Al ternati ve methods of fluoride therapy applied in cases where water fluoridation was not feasible, were seen. Of special interest was the mouthrinsing programme with weak solutions of sodium fluoride. demonstrated in selected schools in Malaysia. This method calls for use of the services of classroom teachers where possible. with a school dental nurse supervising the classroom activity. The mechanics of organizing a fluoride mouthrinsing programme was demonstrated.

3.3.3

Dental health education

Present day concepts of dental health education. the need for a method of evaluation of dental health education activities. deficiencies of traditional approaches, new approaohes, problems. objectives. types and methods of activities and fUnding tor dental health education were demonstrated in Singapore. Demonstrations were also arranged on the production of materials and exhibits and the organization of dental health contests on a national level at the Dental Health Education Unit in Singapore. In Malaysia. classroom activities of school dental nurses and collaboration with school teachers were demonstrated. The participants were able to see a national dental health education exhibition in the People's Park Complex in Singapore and witness the public judging of a oral health contest. arranged by the Dental Division of the Ministry of Health. (This annual event was held earlier in the year by the Government for the benefit of the participants. Some selected exhibits are presented in Annex 9.)

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3.3.4

Organized classroom toothbrushing

Classroom toothbrushing was seen both in Singapore and Malaysia. This activity was supervised by teachers in the school grounds mainly during the morning break in Singapore, and by school dental nurses in Malaysia. In the rural areas of Malaysia .nere water fluoridation had not commenced, mouthrinSing with weak solutions of sodium fluoride ... integrated with the routine toothbrushing programme. 3.4 Manpower produotion

The training of dentists and operating dental auxiliaries was seen in 8ingapore and Mala,.ia. Of particular interest was the training programmes for operating dental auxiliaries and dental laboratory technicians. Post-basic eduoational facilities in Singapore for dentists were described by the responsible offioers in charge of the programmes. The training and utilization of dentists and their supporting personnel in countries in the Region were outlined and illustrated with colour transparencies by the writer under the appropriate topics. Participants appreciated the need to develop training for operating dental auxiliaries in their countries either in a formalized programme or through on-site training. Special emphasis was given to the need for training of existing dental personnel or new personnel for the maintenance and repair of dental equipment.

3.5

Epidemiology and biostatist1os

There was a brief presentation on the role of biostatistics in biomedical investigations. the elements of analytical epidemiology, sampling methods, human and logistic problems in health surveys, the assessment of the health of a cOlllllWli ty. data SUEl&ry. the role of the computer in data processing and critique exercises. by the head and staff of the Department of Social Medicine and Public Health of the University of Singapore. This presentation formed the background for the later training of the participants in the use of standardized methods of examination and diagnostic criteria for the conduct of an oral health survey, and seminars on dental health planning.

3.6

Conduct of an oral health survey

The partiCipants were divided into five teams of four led by a consultant and four local dental publio health officers. Calibration training was given (i) to emphasize the importance of uniformity in the interpretation and application of criteria on the various conditions to be observed and recorded. and (ii) to encourage eaoh examiner to examine according to a consistent standard and to minimize variations between examiners.

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Participants were given the experience of conducting an oral health survey of children and adults living in a rural environment without dental services or organized health services. Kampong Suharto in TanJong Malim was selected by the Malaysian authorities for this purpose. For the first· time the oral health survey included consideration of the treatment required in the sample surveyed. Individual results were consolidated into team summaries and the participant leader of each team presented a verbal report to a plenary session. The data from each group were in turn consolidated into a set of 16 tables showing the overall state of oral health of the comnnmi ty surveyed. The data were then used as the baSis for the final week of seminar-type discussions on planning.

3.7

Planning for dental services and manpower

The objective of the combined topics 32 to 34 was to demonstrate a system of planning6 decisions and estimates using epidemiological data collected. These se.1nar-type exercises conducted by Dr David Barmes related to: (a) Integration with health planning activities and building of measurable goals for evaluation in each dental health programme. (b) Devising a five-year plan with specific goals and means of evaluation in five areas in order of priority: (i) prevention (using dental and medical auxiliaries, school teachers); (11) demand and emergency services (overall relief of pain using medical auxiliaries, traditional practitioners as well as dentists and their auxiliaries); (iii) systematic care (in primary schools using dental auxiliaries and dentists); (iv) manpower production (estimating and projecting needs of the country and devising local training whenever possible); (v) evaluation (testing and demonstration relevant to each progr8llllle area). The problema and constraints of planning were covered in the planning exercise using a five-year plan of another country as an example. In spite of fatigue and the time factor, the participants seemed to derive great satisfaction from the planning exercises in the Course and expressed interest in utilizing the methods they had learnt when they returned to their countries. The consultants felt that future survey and planning exercises should be held earlier in the Course and not towards the end. Opportunity was taken by the writer for up-dating of the country information with the assistance of participants and consultants. This information is presented in Annexes 7 and 8.

3.8

Observation visits

In Malaysia and Singapore 6 observation Visits made to successful on-going programmes 6 including visits to the various types of school oental clinics (Singapore and Malaysia), dental clinics manned by dental

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nurses and dentists at health centres or sub-centres (Malaysia), and the dental faculties and dental auz11iar.y training institutions of both countries. The methods of delivering dental care services to urban and rural areas and the periphery were observed. The "lightning dental squad" concept of delivering dental care to the periphery USing a team consisting of a dental ofticer and two school dental nurses was noted with interest. This system 1f&8 different from that based on a mobile dental clinic, in that only portable equipment especially selected for the purpose was used. Jeeps were used for transporting staff and equipment to schools inacessible by the mobile dental clinics.

4.

DISCUSSIONS

Throughout the Course, every atte.pt was made to maintain a dialogue between the participants and between the participants and the consultants. Two groupe of activities covering a number of listed topics elicited the ~ a.ount of aRdience participation. 4.1 Topic 23

A formal workshop was held where six pre-agreed questions on dental care delivery were presented and discussed, and group decisions were arrived at. It also served as an exercise for teaching a method of conducting workshops as a tool for decision-making and for resolving difficult problems. The consultant for this topic defined the requirements for a workshop with slides and handouts. The workshop also gave the WHO Secretariat the opportunity for deciding how the five groups should be composed for the field exercises which were organized later on. 4.2 Topics 27 to

34

These topics included calibration exercises, oral health and treatment requirements, survey and health planning seminars for two weeks of the Course. They provided a basis for frank discussion and dialogue between participants and between participants and conSUltants. Many observations were made by the consultants and WHO Secretariat, some of which are reported under section 5 (Evaluation).

5. 5.1

EVAWATION OF '!HE COURSE

Selection of participants

The Governments were invited to nominate candidates, in some cases serving dental officers and in other instances senior dental therapist supervisors or tutors in addition to dental officers. In two

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instances, dental officers were nominated by the Governments instead of operating dental auxiliaries. The participants themselves were nevertheless well-suited for a course of this nature and were ideal recipients of this learning experience. They were able to identify their countries' needs in relation to the topics presented. Two of the dental officers experienced in epidemiology found new areas for learning as the survey exercise with the "treatment requirements" component had not been organized anywhere else previously. The consultants were able to cope adequately in spite of a slight language difficulty with two of the participants. 5.2 Impact on partiCipants

.

,

The way in which the participants apply what they have learnt at the Course on return to their own countries, would constitute the real impact of the Course. This evaluation should be the basis of a special study in the future. During the discussions mentioned under section 4, it was observed that the Course was effective in motivating the participants towards modern approaches in dental care delivery and planning of dental services and programmes in the context of a country's needs and problems.

All 22 participants completed the Course and were awarded attendance certificates by the Regional Office for the Western Pacific of the World Health Organization.

5.3

Evaluation by the partiCipants

Two questionnaires were completed by the participants at the end of the Course. Questionnaire No. 1 dealt with the administrative aspect.s and Questionnaire No. 2 with the technical aspects of the Course. The analysis of both questionnaires was undertaken by Professor G.N. Davies and is presented here. AnalYSis of the replies to Questionnaire No. 1 (Administrative) leads to the following conclusions: (a) Travel arrangements and physical arrangements at the Course sites were very satisfactory. (b) There was some criticism of the standsrd of accommodation but the majority classified it as adequate to excellent. (c) The amount of free time available was satisfactory.

(d) The majority agreed that the length of the Course was adequate. One thought that it was too short and two thought that i t was too long.

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(e) The schedule and working hours were regarded as appropriate. Only one participant considered the schedule was too crowded. However, in the answers to the second questionnaire, attention was drawn to the crowded schedule in the last week. (f) The information bulletins were greatly appreciated.

(g) Library and reading facilities were regarded as reasonably adequate although there was no indication of the extent to which they were used. (h) Documentation on the subjects covered was regarded as excellent to satisfactory and there was a very satisfactory interaction between participants and between partiCipants and the staff. (i) There was general agreement that the leadership of the Course was outstanding. Indeed the only critical comment came from a participant who felt that the travel should have been first class and that a higher standard of acoommodation should have been provided. The personal comments are somewhat more revealing than the replies to the checklist. It is clear that all participants derived considerable benefit from the Course and that they enjoyed it. Many regarded it as stimulating and expressed the hope that they could obtain such intellectual and technical refreshment on a more regular basis. Despite the answers to the checklist it was clear that several of the participants found the travel to different sitea burdensome and that the schedule which included weekend work was tiring and reduced their ability to concentrate at more formal sessions. The opportunity to share ideas and discuss common problems with other participants and staff was greatly appreciated. All partiCipants recognized the complexity and difficulty of organizi~g a course of this nature and were grateful for the efficiency and courtesy with which the administrative arrangements were made and for the hospitality of the host countries. The inclusion of dental auxiliaries was appreciated. The replies to Questionnaire No. 2 (Technical) show quite clearly that the participants learnt a great deal from the Course and found it interesting. stimulating and very valuable. All of them indicated that they would be willing to reply to a follow-up questionnaire if one were sent to them in about one year's time. Appreciation was expressed for the opportunity to exchange knowledge and experience with other participants and staff. Fbr the most part the objectives of the Course and expectations of participants were attained. It is encouraging to note that most of the topiCS in the Course were considered to be satisfactory. The following topics are listed in order of frequency of mention: Calibration and dental survey

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exeroise (13), dental health education (7), training and util1zation of dental auxiliaries (6), principles of planning and their application (4), sharing of knowledge and experiments with people from other countries (3), school dental services and other health programmes (2), epidemiology and biostatistics (2), concept of equal relationship between dentists and auxiliaries (2), fluoridation and other uses of fluoride (2), workshop on .dental care deli very (2), keeping up-tel-date in recent advances (1). preventive measures (1), integration of dental services in general health services (1), undergraduate education (1) and visits to clinics (1). There were no serious criticisms of the content of the Course. Four partiCipants were critical of the repetitive nature of the visits to health centres and clinics, particularly when extra travelling was in".,lved. Such criticism needs, however, to be seen in perspective. When more than one country is requested to show the nature and extent of its services some duplication is inevitable. The interest of the respondents in epidemiology and biostatistics is reflected in the fact that several ~uggested that more time should have been devoted to these subjects. In answer to the question on the extent to which the Course would be reflected in plans for development and improvement of dental treatment and prevention in their own countries, participants gave somewhat vague repl1es. Several acknowledged that the Course would result in a general overall improvellent in the qual1 t1' of their dental services. Others referred specifically to promottns dental health education and the use of fluorides in the prevention of dental caries, as well as the training and employment of dental auxil1aries. The largest nUllber of posi ti ve responders indicated that the1' would cOlllll8nce an oral health surve1'. The last week in Singapore was considered to be valuable because despite the fact that a lot of extra work was required, it enabled participants to appreciate the problems involved in analysing results and to understand ~e way in which such data could be used for evaluation and planning purposes. However, attention was drawn to the fact that this important feature of the Course was crowded into the final week when participants were tired. Appreciation was expressed for the cooperation and helpfulness of officers of the Host Governments and of the WHO consultants, secretariat and temporary advisers. Some partiCipants expressed the hope that WHO would assist them to convince their Governments of the need to expand and upgrade the existing dental services. Others mentioned that they had developed a significant increase in their confidence to define more clearly the nature of the dental problems and to malte plans for the bettement of oral health in their home countries. A considerable number of topiCS were suggested for discussion at future courses or seminars. These included dental health education, the training and use of dental auxiliaries, epidemiology and biostatistics, the delivery of dental services, the conduct and interpretation of oral

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health surveys, conservative dentistry, periodontics, orthodontics, oral survey, maintenance of dental equipment, preventive dentistry, dentistry for children, public health administration, leadership, management and teaching methods. Such a wide range of proposals suggests the need for regular refresher courses for public health personnel. Several participants stressed such a need especially for staff working in small isolated communities where consultation and discussiDn between professional colleagues is very difficult if not impossible. The hope was expressed that such courses would be held regularly in future and that auxiliaries as well as dentists would be able to attend. Summaries of the replies to the questionnaires (checklists) are presented in Annex 6.

6.

ACKNOWLEDGEMENTS

The Governments of Singapore and Malaysia are thanked for their excellent arrangements and fine hospitality in hosting the First Regional WHO Course in Public Health Dentistry.

ANNEXES

ANNEX ANNEX

1 2

-

LIST OF PARTICIPANTS LIST OF CONSULTANTS, '.IEMPCRARY AD'IISERS, RESOORCE PERSONS AND WHO STAFF MEMBERS

ANNEX ANNEX

3 4 -

PROGJWI4E (COORSE SCHEOOIE) DOCUMENTS MADE AVAILABIE AS REFERENCE MATERIAL AND W<JUO:NG PAPERS ISSUED TO PARTICIPANTS

ANNEX

5 -

PHOTOGRAPHIC ILWS'mATIONS OF PARTICIPANTS AND 8M: ACTIVITIES PARTICIPANTS' EVAWATION OF THE COORSE AND SUfttttARIES OF REPLIES "TO '!WO QUESTIONNAIRES ( CHECKLISTS), 1975 StMo1ARY OF COONmY INFORMATION PICTOGRAPH: OF INTEREST IEVELS AGAINST PARAPHRASED TARGETS IN COON'lRIES REPRESENTED AT THE COORSE, 1975 SEIEC'lED ILWS'lRATIONS OF THE NATIONAL IEm'AL HEALTH EXHIBITION MOON'lED DURING THE "IENTAL HEALTH ~ IN 8INGAPam

ANNEX

6

-

ANNEX ANNEX

7

-

8 -

ANNEX

9

-

!

- 13 ANNEX 1

LIST OF PARTICIPANTS, 1975

Dr Philo A. Jermings (Amerioan Salloa), Clinioal Dentist, In charge of School Dental Services, I.BJ Tropical Centre, Pago-pago. Dr Kaa Henry (Cook Islands), Director of Dental Services, Health

Department, P.O. Box la>, Rarotonga. Dr Matakite Bamatang (Gilbert aJXl Ellice Islands) .. Dental Officer, Ministry of Health and Welfare, Tarawa. Dr William C. Slemons (Guam), Public Health Dentist, Department of

Public Health and Social Services, Agana. Ms IEUNG Cheuk-ha (Hong Kong), Dental Nurse 'l\ttor, Dental Sub-Department. Medioal and Health Depart.ent. Dr WONG Pak-yiu (Hong Kong), Dental Officer, Dental Sub-Department,

Medical and Health Department. Dr Johng Sai KIM (Korea), Assistant Professor. Department of Preventive

Dentistry. College of Dentistry, Seoul National University, Seoul. Dr Chung Suck IEE (Korea), Chairman, Department of Dentistry, Ewha

Medical Center. College of Medicine, Ewha Women's University,

72 Chongro 6-Ka. Seoul. Dr Tae Won lEE (Korea). Senior Staff of Dental Surgery, National Medical

Center, Seoul. Dr Siona Talagi (Niue), Senior Dental Officer. In charge of Dental

Services, Health Department, Niue Island. Dr Moi No Tapealava (Tonga), Acting Chief Dental Officer, Health

Department, Vaiola Hospital, Tofoa. Dr Momotaro Lani tulok (Trust Terri tory of the Pacific Islands), Dental

Officer, Department of Health Services, Majuro. Marshall Islands. Ms Katsumi M. Taima (Trust Terri tory of the Pacific Islands), Senior Dental Nurse. Koror, McDonald Hospital, Palau, Western Caroline IslalXls.

Dr Romeo M. Carreon (Philippines), Regional Health Officer, No.3, Department of Health, San Fernando. Pampanga. Dr Aquilino C. Rimorin (Philippines), Bureau of Dental Health Services, Staff Dentist Research Section, Department ~ Health, Manila.

- 14 Annex 1

Dr (Capt) Ernesto T. Gotos (Philippines),

5 Pipit street, Villilia Subdi vision, Tandang Sora, Quezon City. Dental. O£tioer.

Dr Stephen Peawai Pouru (Papua New Guinea), Dental Offioer, Port

Moresby Dental College, Boroko, P.O. Box 1881. Mr Ao Bue (Papua New Guinea), Senior TUtor Dental 'lherapist School, Port Moresby Dental College, Boroka, P.O. Box 1881. Dr (Mrs) Jiko Fatafehi Yasa (Fiji Islanda), Dental Officer, In charge

of Hausori Dental Clinic and School Dental Services, Nausor!. Mrs Susan A. Herman (Fiji Islands), Suva Dental Centre, CWM General Hospital, Suva. Dental Therapist Tutor. Dr Baetalua TaluOIII9a (Solanon Islands), Dental. otticer

, Ministry

of Health and Welfare Dental Clinic, Box

349,

Honiara.

Dr Khoo Swee Mar (Malaysia), Senior Dental Offioer, Government Dental

Clinic, Muar, Johore.

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ANNEX 2

LIST OF CONSULTANTS, TEMPORARY ADVISERS, RESOURCE PERSONS, AND WHO STAFF MEMBERS, 1975

1•

CONSULTANTS

Dr Innes Grant, Periodontologist, Perth Dental Hospital, Perth Western

Australia (30 April to 12 May). Brigadier J. Ferris Fuller, Kelvin Chambers, The Terrace, 16, Wellington, New Zealand (16 May to 1 June). Professor G.N. Davies, Professor ot Social and Preventive Dentistry, Dental School, Turbot Street, Brisbane, Queensland 4000, Australia (13 June to 3 JUly). Dr Blanche C. Barbers, ASSistant Professor, Institute of Public Health,

University of the Philippines, Pedro Gil, Ermita, Manila 2801, Philippines (30 May to 15 June).

2.

TEMPORARY ADVISERS

Dr Chua Sui Yeow, Assistant Director of Medical Services (Dental),

Dental Division, Ministry ot Health, Dental Branch, Palmer Road, Singapore 2 (32 days - Singapore). Professor Phoon Wai-on, Head of Dapartment of Social Medicine and Public Health, University of Singapore, Outram Hill, Singapore 3 (14 days - Singapore). Dr Tai Yen Hooi, Director of Dental Services, Ministry of Health, 2nd Floor.

MMA Building, Pabang~oad, Kuala Lumpur, Malaysia (16 days - Malaysia). Dr Abdul Rahman bin Awang, Deputy Director of Dental Services, Ministry of

Health, 2nd Floor, MMA Building, Pabang Road, Kuala Lumpur, Malaysia (16 days - Malaysia). Professor Ibrahim bin HaJi Mohd. Yassin, Dean, Dental Faculty, University of Malaya, Kuala Lumpur, Malaysia (12 days - Malaysia).

- 16 Annex 2

3. Singapore

RESOURCE PERSONS

Dr Tan Yok Lin, Senior Dental Officer, School Dental Centre, Pegu Roan,

Singapore 12. Dr Lim Kheng Ann, Senior Dental Officer, Prosthodontics; Deputy-Direct0,

of Postgraduate Studies, Outram Road Dental Clinic, General Singapore 3.

Hospita~,

Dr Wong Hee Deong, Senior Dental Office, Training and Dental Health

Education, Dental Health Education unit, Alexander Park, Singapore Professor F.M.S. Lee, Director, Postgraduate Studies, Dental Faculty, University of Singapore, Outram Road, Singapore 3. Professor Edmund 'nI!y, Dean, Dental Faculty, University of Singapore, Outram Road, Singapore 3. Professor J.A. Jansen, Department of Prosthodontics, Dental Fa cuI ty, Universi ty of Singapore, Outram Road, Singapore 3.

~.

Dr W.K. Ng, Associate Professor, Department of Social Medicine and Publir

Health, UniverSity of Singapore, Outram Hill, Singapore 3. Dr James Lee, Lecturer (statisticS), Department of Social Medicine and

Public Health, University of Singapore.

Dr Lee Hin Peng, Lecturer (epidemiology), Department of Social Medicine and Public Health, University of Singapore. Dr H.K. Leong, Senior Lecturer, Department of Social Medicine and Fuolie

Health, University of Singapore. Dr W.P. Wan, Lecturer, Department of Social Medicine and Public Health,

UniverSity of Singapore. Malaysia Dr A. Tajuddin, Assistant Director of Dental Services, 2nd Floor,

MMA Building, Pabang Road, Kuala Lumpur, Malaysia. Dr Chong Weng Hoon, State Dental Director, Pahang. Dr Yoong Kim Poon,

State Dental Director, Negri Sembilan.

Dr Ho Boon Keat,

State Dental Director, Kelantan.

- 17/18 -

Annex 2

Dr Or

Abdullah Johari, Principal, Dental Training School, Penang. Muhammad Yaacob, Dental Public Heal th Officer, Negerl Se.b1lan Haji Mohd. Ariffin, Dental Public Health Officer, MInistry of Health.

Dr

Professor Chin TUck Chiew, Dental Faculty, University of Malaya. Professor Dato Lee Seng Guan, Dental Faculty, University of Malaya. Mrs Theresa Al Rashid, Dental SIster, Dental Faculty, University of Malaya.

Mr Onn bin Kayat, International Health Section, Office of the SecretaryGeneral, Ministry of Health. Dr Dr Or

B.C. Seth, Senior Dental Officer, Johor Baharu, Johor. Foong Sim Kang, Senior Dental Officer, Mentakab, Pahang. Dzulkarnain Ibrahim Ali, State Dental Director, Perlis. IJlm~

Or Ong Cheng 1m, Senior Dental Officer, KUala Dr Dr

M. Mahendra, Senior Dental Officer, Klang, Selangor. Lam Cheng Kan, State Dental Director, Selangor.

4.

WHO STAFF MEMBERS

Ms Khoo Siew Thay, WHO Dental Therapist TUtor, Port Moresby, Papua New Guinea (25 April to 3 July). Dr

David E. Barnes, Chief, Dental Health Programmes, WHO Headquarters, Geneva, Switzerland (12 June to 3 July). Pacific Region, P.O. Box 2932, Manila, Philippines (20 April to 7 July).

Or Chellie J. Sundram, Course Director, WHO Office for the western

- 19 -

ANNEX

3

•

PROGRAMME - COURSE SCHEOOLE

FIRST REGIONAL COURSE IN PUBLIC HEALTH DENTISTRY

Singapore 1-24 May; 23-30 June 1975 Malaysia 25 May-23 June 1975 Singapore 1-24 May; 23-30 June 1975 .- -_. -

--

.-Type and

-

Topics and Dates 0 Topic 0: 1 day - Thursday. 1 May

Site

Cha1rman/Moderator Coordinators/Contributors

Registration. orientation. administrative matters

•

Hostel.

K1n& Edward VII Hall

12 College Road. outram Road General Hospital Compound Singapore

- Country Planning Committee - WHO staff

00

Topic 00:

10.00-11.00 a.m. Friday. 2 May - Guests - Formal Allen Lecture Hall Singapore - Regional Director. \VPRO - Permanent Secretary (Health)/Director of Medical Services. Singapore - Country Planning Committee. Singapore - WHO Representative

FORMAL OPENING OF COURSE by Regional Director. WPRO

•

\l 1

Consultants and advisers in attendance: Singapore Topic 1: Two 1/2 days Friday. 2 May (afternoon) Saturday. 3 May (morning)

Dr Innes Grant - 30 April-12 May Dr Chua SUi Yeow (34 days)

Professor Phoon Wai-On (14 days)

Basic principles in the organization of a health service including peripheral health services (Continued morning of 5 May.)

- Lectures - Illustrations • Lecture Room. Medical Faculty. Singapore .

a) b) c)

Professor W.O. Phoon (Coordinator) Associate Professor W.K. Ng Dr H.K. Leong

-

.

-

- 20 -

Annex 3

Topics and Dates 2 Topic 2: 1/2 day - Monday, 5 May ( afternoOl'l )

Type and Site

Chairman/Moderator COOrdinators/Contributors

Role of dental services in the general service of a country - the meaning of integration

- Symposium • Lecture Room, Medical Faculty, Singapore

a) b)

c) d)

Professor W.O. Phoon (Chairman) Dr' r. Grant Dr' ChUA Sui Yeow Dr C.J. Sundram

3

Topic 3:

1 day - Tuesday, 6 May - Presentations (morning) - Workshop (afternoon ) - Plenary session • Lecture Room, Medical Faculty, S'l.ngapore a} b}

Techniques of preventive dentistry appropriate in the countries represented

c} d) e) f) ()

Professor W.O. Phoon Dr r. Grant Dr Chua Sui Yeow Me Khoo Siew Thay Dr' C.J. Sundram (Moderator) Dr Wong Hee Deong (Coordinator) Professor W.O. Phoon (SUlllDlng-Up)

4

Topic 4:

2 days Wednesday, 7 May Thursday, 8 May

Periodontal disease - etiology, prevention, control and treatment

•

Lectures Illustrations Demonstrations Medical Faoult;r, Singapore

a) b)

Dr'

r. Grant PNG participants to assist

5

Topic 5:

3 days Friday, 9 May Monday, 12 May Tuesday, 13 May

Techniques of dental health education appropriate for the masses, for the community, for captive groups and for individuals

-

Presentations Field visits Demonstrations Seminar • IllE Unit Alexander Park • Selected Schools, Singapore

a) b)

c) d}

Dr Wong Hee Deong Staff of Dental Branch, Singapore Dr C.J. Sundram Dr ChUA Sui Yeow (Coordinator)

6

Topic 6:

1/2 day - Saturday, 10 May - Field visit - Demonstration • Singapore Water Department Dr Wong Ree Deong water Engineer, Singapore (l) Dr Chua Sui Yeow (Coordinator) b)

Technical aspects of water fluoridation

a)

- ?1 -

Annex 3

Topios and Dates

Type and Site

CoOrdinators/Contributors

Chairman~oderator/

6. 7

End of Dr Grant's consultantship - Monday, 12 May (debriefing in Singapore) Topic 7:

3 days Wednesday, 14 May Thursday, 15 May Friday, 16 May

Elementary epidemiology and biostatistics

• 8 TOEic 8: 1/2 day - Saturday, 17 May Reading and library assignments

- Lectures - Practical classes Lecture Room Medioal Faculty Singapore

a) b) 0)

Professor W.O. Phoon (Coordinator/Chairman) Dr J. Lee Dr H.P. Lee

Department of SMPH University of Singapore

Professor W.O. Phoon (Coordinator) Department of Social Medioine and Public Health (SMPH)

\7 9

Consultant in attendance: TOEic

Brigadier J. Ferris Fuller - 19 May-2 June (briefing in S' pore I -

1 day - Monday, 19 May The organization of dental health servioes in Singapore (examples of ongoing programmes in a highly urbanized cOlDllUIlity)

2:

•

- Leoture and a) briefing b) - Field visits On-site Pegu Rd. Dental 0 Centre, Singapore

Dr Tan Yok Lin

and staff Dr Chua Sui Yeow (Coordinator) Brigadier J. Ferris Fuller (summing-up)

10

TOEio 10:

2 days Tuesday, 20 May Wednesday, 21 May - Lecture - Field visi ts - Informal discussion Pegu Rd. Dental Centre, Singapore a) b) Dr Tan Yok Lin

The organization of sohool dental services in Singapore

•

0

and staff Dr Chua Sui Yeow (Coordinator) Brigadier J. Ferris Fuller (summing-up)

- 22 Annex 3

Topios and Dates 11

Type and Site

Chairman/Moderator/ Coordinators/Contributors

Topic 11:

1 day - Thursday, 22 May

Selecting methods of delivering dental services influenced by factors prevalent in the oountry

- Discussion of paper presented by Brigadier J. Ferris FUller - Forum

a) b) c) d)

Brigadier J. Ferris Professor W.O. Phoon Dr C.J. Sundrarn Dr Lim Kheng Ann (Moderator)

• Lecture ROOlll, Madical Faculty. Singapore 12 Topic 12: 1 day - Friday, 23 May - Forum

Professional education and training of dental auxiliaries in the Singapore Dental Faculty and General Hospital Morning - Basic dental education (a) - Post-basic dental education (b) - In-service training; continuing education and higher degree courses (b) Afternoon - Training of dental assistant nurses (chairside aSSistants) (c) - Training of laboratory technicians (c)

a) b) c) ()

• Dental Faculty, Singapore

Professor Edmund Tay (Dean) Professor F.M.S. Lee Dr Lim Kheng Ann Brigadier J. Ferris FUller (summing-up)

o

Party leaTee for Kuala LUlllPUr, Malaysia on 24 May by Mayfiover airconditioned bus see Topic 13

- 23 -

Annex 3 Malaysia 24 May-23 June 1975

Topics and Dates Consultants and advisers in attendance:

Type and Si te

Chairman/Moderator/ Coordinators/Contributors

Brigadier J. Ferris Fuller (until 2 June) Dean and Professor Ibrahim Yassin (12 days) Dr Tai Yen Hooi (16 days) Dr Abdul Rahman Awang (16 days)

13

Topic 13:

1/2 day - Saturday, 24 May

Major visits outside Singapore - Johore Bahru, Pontian, Batu-Pahat, Muar Malacca and Kuala Lumpur on 24 May (night). air-conditioned bus (WHO) Bri,~adier

Fuller leaves for Penang on 23 May (night) or on 24 May (morning) - assignment

- Field visit a) - Informal discussions b) ® CUstoms clearance at c) JOhOre Bahru 0' ® * Mayflower Tourist Service

MIS S.T. Khoo

(Coordinator) One Malaysian official Dr C.J. Sundram A dental officer in the Malaysian government service will do the briefing and will accompany the party from Singapore to Kuala Lumpur (Coordinator)

14

Topic 14:

1 day - Monday, 26 May - Presentation Dental Faculty, ~ Kuala Lumpur P Wesak Day Public holiday in Malaysia a) b) Dean Ibrahim (Chairman) Staff nomina ted by the Dean

Developing a dental undergraduate curriculum to suit the needs of the country

15

Topic 15 (a + b):

2 days Tuesday,

W~esday,

zr

May 28 May - Presentation by panel - Field visits • Dental Faculty, Kuala Lumpur a) Dr A. Rahman

a)

Dental health education activities and p?eventive programmes in the country emphaSizing school programmes The mechanics of organizing toothbrushing programmes in schools (see topic ~'1 for fluoride mouthrinsing)

b) ()

b)

(Chairman) Panel of Malaysian officers Brigadier J. Ferris Fuller (sunvning-up)

- 2'1 -

Annex

3 Chairman/Moderator/ Coordinators/Contributors

Topics and Dates OFFICIAL WELCOME - Morning, Malaysian Sessions Thursday, 29 May .First half of morning session official welcome • Coffee-break -

Type and Site

• Ministry of Health Conference Room Kuala Lumpur

a)

b) c) d)

.Second half of morning aeaeion Topic 16

Director-General Secretary-General WHO Representatlv", Kuala Lumpur Country Planning Committee (Dr Tal and Dr Rahman)

() Inche Onn bin Kayat () Dr Ahmad Tajuddin (special responsibilities) 16 Topic 16: Morning, Thursday, 29 May - Briefing • Ministry of Health Conference Room Kuala Lumpur a) b) Tan Sri Dato (Dr) Abdul Majid Brigadier J. Ferris Fuller

Delivery of the medical, health and dental services in MalaySia problems and priorities

(Chairman)

17

Topic 17:

1 day - Friday, 30 May

Delivery of health services - with integrated dental services

- Field visits - Demonstrations at • health centres outside Kuala Lumpur - Klang. Sg. Pelik. Semenyih. Kajang

a) b)

Dr A. Rahman Dr

Tai Yen Hooi

o

Brigadier J. Perris Fuller (summin~up )

18

Topic 18:

1/2 day - Saturday. 31 May

Delivery of dental services in an urban and semi-urban location

- Field visits • in Kuala Lumpur Bangsar Clinic. Kampong Pandan

a) b)

Dr Tai Yen Hooi Dr A. Rahman

o

Brigadier J. Ferris Fuller (slllllllling-up)

o

Party leaves on Sunday, I June for Kuantan by Malaysian Government transport Consultant in attendance: Professor Blanche C. Barbers - 1-15 June (briefing in Manila on 30 May; debriefing in Kuala Lumpur and Singapore on 15 June)

- 25 Annex

3

Topics and Dates 1/2 day - Monday, 2 June

Type and 5i te

Chairman/Moderator/ Coordinators/Contributors

19

TOEic 12:

Fluorides and dental health - review of current status. in afternoon: Commence Topic 20 - 1"1el.d visit

•

- Discussion of paper presented by Professor B. Barbers Kuantan

a)

Professor B. Barbers

6. 20

End of Brigadier J. Ferris Fuller's assignment on 2 June (debriefing, Kuala Lumpur) Topic 20: a) 1/2 day - Tuesday, 3 June

Mechanics of implementing fluoride and mouthrinsing programme in schools Fluoridation in Malaysia

b)

•

- Discussion - Field visits Kuantan, Pahang

a) b)

Dr A. Rahman and staff Dr Cheong Weng Hoon and staff

0 2l

Party returns to Kuala Lumpur on 4 June - a public holiday in Malaysia Topic 2l: 1 day - Thursday, 5 June - Visits - Demonstrations - On-site discussion Negeri Sembilan a) b) c) Dr Tai Yen Hooi Dr A. Rahman

Delivery of dental services in the periphery - "Pasokar) Kilat Pergigian" (Dental Mobile Squad)

• 22 Topic 22: 1+1/2 days Friday, 6 June Saturday, 7 June

0

(Coordinator) Dental service staff Professor B. Barbers (sUllllling-up)

a)

The training and utilization of dental auxiliaries regionally: (i) dental nurses, (11) dental chairs ide assistants, (11i) dental technicians; Re-visits by partiCipants and reading assignments

b)

- Illustrated presentation - Discussion - Field visits to demonstrate utilization

a) b)

Dr C.J. Sundram Dr A. Rahman and

0

staff Dean Ibrahim (summing-up)

- 20 -

Annex 3 Topics and Dates Type and Site

Ohairman/Moderator/ Coordinators/Contributors

23

Topic 23:

2 days Monday, 9 June Tuesday, 10 June _ • Presentations Disc!lssions Workshop Pl~nary session Dental Faculty Kuala Lumpur a) b) c) Dr C.J. Sundram

a) b)

Review - Regional dental health programme of WHO Integration of dental services in a health service - where, when, why, how ••• -~. Basic dental services definition of "basic" Basic dental biostatistics functional application

Dr Tai Yen Hooi Professor B. Barber-

c) d)

o

Dean Ibrahim (Chairman)

24

Topic 24:

2 days Wednesday, 11 June Thursday, 12 June - Illustrated panel presentation - Forum (questions and answers) • Dental Faculty Kuala Lumpur a) Dr A. Rahman and

National oral health surveys .as organized in Malaysia - adult survey (current) and a survey of schoolchildren (past)

()

staff in TopiCS Z7 to 29 Professor B. Barbers (summing-up)

~

(briefing in Kuala Lumpur; debriefing in Singapore on 3 July) End of Professor B. Barbers' consultantship in Malaysia. proceeds to Singapore on 12 June (debriefing in Singapore on 15 June) Topic 25: 1 day - Friday. 13 June - Conducted tour • Kuala Lumpur a) Dean Ibrahim Yassin

Consultants in attendance:

Dr D.E. Barmes and Professor G.N. favies - 12 and 14 June

25

Visit to Dental Faculty Kuala Lumpur

26

Topic 26:

1/2 day - Saturday, 14 June - Presentations • Dental Faculty Kuala Lumpur a) b) Professor G.N. Davies Dr D.E. Barmes

BasiC oral surveys - methods of assessment of oral lesions for public health purposes

- 27 -

Annex 3

Topios and Dates 27 Topic 27: 1 Monday. 16 June

Type

and Site

Coordinators Contributors

'Cha1rman~derator

day -

Calibration training 5 teams of 4 each team

•

- Exercise - Demonstrations On-site Kuala Lumpur Sri Petaling School

a)

Prot'essor G.N. Davies

Assisted bl: Dr A. TaJuddin Dr Mohd. Yacob Dr Foong Sim Kam Dr Ho Boon Kiat

28

Topic 28:

1 day - Tuesda:r. 17 June

Preparation of survey reports and continuation of Topic 27 (Calibration training)

•

- Exercise On-site Kuala Lumpur Sg. Belli Army Cantonment

a)

Professor G.N. Davies

Assisted bl: Dr A. TaJuddin Dr Mohd. Yacob Dr Foong Sim Kam Dr Ho Boon Kiat

29

TOEic 22:

3 days Wednesday. 18 June Thursday. 19 June Friday. 20 June - Exercise • On-site Kuala Lumpur Kampong Suharto a) Professor G.N. Davies b) Dr D.E. BaI'llles Assisted bZ: Dr A. TaJuddin Dr Mohd. Yacob Dr Foong Sim Kam Dr Ho Boon Kiat

Oral health survey of children and adults in a village which has an MCH unit but no den~l services

0 0 30

Participants leave on 20 June (evening) for lpoh by Mayflower Coach (night in Ipoh) Participants leave on 21 June (Saturday) for Penang (night in Penang) TOEic ~O:

2 days Saturday, 21 June Monday, 23 June - Visits • lpoh and • Penang By plane a) Dr Tat Yen Hooi (Coordinator) b) Dr A. Rahman c) Dr A. Johari (Penang) d) Dr C.J. Sundram) WHO e) Me S.T. Khoo )

Observation of utilization of dental auxiliaries in Ipoh (cf. Topic 22 (a) ) and training in Penang

0

Return to Singapore on 23 June (night)

- 2'3 Annex 3 Singapore 24- 30 June 1975

Topios and Dat.es

Type and Site

Chairman/Moderator/ Coordinators/Contributors

31

TOEic

~l:

1 day - Tuesday, 24 June - Exercise • Lecture Room. Medical Faculty Singapore a) b) Dr

Preparation of survey report.s

Professor G.N. Davies D.E. Barmes

32

TOEic a)

~2:

1 day - Wednesday, 25 June - Exercise - Seminar Lect.ure Room, Medical Faculty Singapore a) b) Dr

Planning a community dental health programme using findings of the sample survey Identifying alternat.ive methods of delivering dental services

b)

•

Professor G.N. Davies D.E. Barmes

33

TOEic

22:

1/2 day - Thursday, 26 June - Exercise - Incorporating ideas and facts gathered in Topic 15 (b) a) b) Dr

Instit.ute a toothbrushing programme includ1ng fluoride rnouthrinsing and dental health education (cOlllllence Topic 34)

Professor G.N. Davies D.E. Barmes

34

TOEic

34:

1 day - Friday, 27 June - Exercise - Seminar • Lecture Room, Medical Faculty Singapore a) b) Dr

Institute the utilization of operating dental auxiliaries best suit.ed to: a) sample group; b) your country - type and period of training - scope and Umi tations of duties - professional leadership (Commenoe Topic 35) 35 Topic 35: 1 day - Saturday, 28 June a) Preparation of reports describing and evaluating what was done and making reoommendations for the future b) Evaluation of the Course (WPRO) Topic

Professor G.N. Davies D.E. Barmes

- Exercise - Seminar • Lecture Room, Medioal Faculty Singapore

a) b) e)

Professor G.N. Davies Dr D.E. Barmes Dr C. J. Sun dram

36

36: 1 day - Monday, 30 June

Closing ceremony and administrative procedures

•

Lecture Room, Medical Faculty Singapore

Country Planning Committee, Singapore and WPRO

- 29/30 Annex 3 Notes: Topics 26 to 35 Professor G. N. Davies and Dr D.E. Barmes will be in attendance and conduct most of the sessions listed under Topics 26 to 35. They would like the participants to be divided into five teams with four participants in each team, under the direction of those listed in Topics 27, 28 and 29 (page 9). It should be possible for each team to be organized in sub-teams of two - one to ~ct as examiner and the other as recorder and then change around. If the number of participants is 30, then we would have five teams of six in each team. They will be assisted in the field work by Dr A. Tajuddin, Dr Mohd. Yacob and Dr Foong Sim Karo, and Dr He Boon Keat. all of whom are experienced dental public health practitioners in the Public Health Service of Malaysia. These same officers will also participate actively in Topic 24 under the leadership of Dr Abdul Rahman, wherein the Malaysian experience will be described. Continuity will thus be maintained. Dr Horowi tz, Dr Barmes and Professor Davies have made a start in Geneva wi th revision of the WHO Manual for Basic Oral Health Survey Methods and among their recommended amendments they have included provision for a combined oral health and treatment assessment. A preliminary draft of a form they have prepared will be used in the oral survey exercise in Malaysia. Each participant would examine a minimum of 20 persons, if possible. If it is necessary to limit the survey to specific age groups, pre:ference will be given to the :following: 6, 12 and 35-44 years of age. It appears difficult to choose different locations for the various groups although this would be preferable. In any case, data from the surveys conducted by the five teams will be used as a basis for the seminars listed under Topics 31 to 34. Professor Davies and Dr Barmes would like to point out that the survey cannot be carried out on a representative population sample as it should be. But for the benefit of the discussions, we shall assume that the data were collected from a representative population sample. The consultants will lead the discussions on the methods of realistic programming within the context of the particular areas surveyed and the knowledge acquired by the participants during the Course.

Professor Davies and Dr Barmes will be present from 14 June till the end of the Course. The sessions Sessions in Singapore and Malaysia will be conducted from 9.00 a.m. to 12.00 noon, with a coffee break at 10.30 a.m. The afternoon sessions will be from 2.00 to 5.00 p.m. On Saturday from 9.00 a.m. to 12.00 noon, and on Sundays participants are free for social engagements. Ad hoc changes may be necessary during the actual conduct of the Course and provision has been made in the curriculum design for some flexibility,

- 31 ANNEX

4

DOCUMENTS MADE AVAILABLE AS REFERENCE MATERIAL WORKING PAPERS ISSUED TO PARTICIPANTS, AND

1975.

FIRST RmIalAL COtlBSE .

IN PUBLIC HEALTH DENTISTRY Singapore and Malaysia 1 May to 30 June 1975

•

REFiRENCES dD WCJW:NG PAPERS

G (a)

WHO PUBLICATIONS (Gene.,.)

Tecbnie' Rtw1j Strig WHO (1959), Expert Co.; twe • AplUisy Tech. Rep. Series, No. 163. Gelle.,. WHO (1958), Expert til

DIp.'

P!r!op"1.

Tech. Rep. Seri.. Ne. 1

copaae Vater nugridttiop. ,Gene.,. No. 207, Gene.,.

3· 4.

.WHO (1961)~

Peri-PPI! Piaue. Teoh. Rep. Serie.

WHO (19(2),

DeDa]

IdpcatWb TecJl. Rep. Serie. No.2", GeM.,.

5. 6.

WHO (1962), Sp"'mlieti. gt "partiv at dlla' dim- .m coDditiops. Tech. Rep. Serie. No. 2~, Gene.,. WHO (1965), CFganizati.. of elM.' pgbl.io

Tech. Rep. Serie. No. 298. Ge.e.,.

Malth arriqll. Rep. Seri•• No. "9, Geneva dUB] ...ryice. ?'Ties.

7. 8.

WHO (1970), DeD.... '

Btal. ld!IMtiM' Tech.

WHO (1972), The etiologr aDd pNDDg09 Teoh. Rep. Series No. G....,.

491i,

of

(b) WHO (1971), HaDual,

Ckal. beal.tb surveys - basic

-thod"

Geneva

10.

WHO (1973),HaDual,

of Diseases to DentGti;0lftd Si_tolKY ICliDA; Gene.,. (WHO Sp9D8ored)

;t: ~~::,of ~ N."

ti=oo,] C]I!'jf'ication

~ 11.

RESEARCH PUBLICTIONS

Adkins, B.L., hrales, 0.1., SOhe ....bula, R.G.,(1974) Eti01~sO{ cari•• in PtpM, Glljpea. Ball. Wld. Hlth. Qrog.,

SO. 4 -

- 32 -

Armex 4 12. Davies, G.N., Horowitz, H.S., and Wada, W., (1973) The Bll8ss.Pt of denSl' caries (or public health purposes. Communi ty Dent. Oral lpideaio1ogy 1 I 68-73

13.

_ _-:-~~~~_ _-."._ _..,...".-:-..."--.,,...,.,...__ (1973).

period".' 9 I

The MH''"Pt of

~-70

disease for public health purposes. J. Periodont. Re••

~

VRO/VPRO PUBLICATIONS ( Manila ) Group Idgcational Activities in Dentistry

Ca}

14. 15. (b) 16.

VBO/SPC (1971) Sellinar on Dental Health Services. Developaent and Co-operation in the Pacific. Noumea, (mimeo) IfflO (1972), First RegiC'Dil) Workshop on Dental Health Seryices. Siagapore, May (docUllent WPRO 5503 , WPRO, Manila

VPIlO (1971), Guidelines on <ral Health - a JIIIUlual far health personnel, )lan;la

(c) Msigp!lent Reports 17. Allwright, V.A. (1969), WHO AssiQUlKlnt Report. dental heal,'Ih. Philippines, June - August, (document 509-E), WPRO, Manila _..,..--_ _ _"..,.".".. (1972), WHO Assignment Report. dental .health. Philippines document 5501-E, WPRO, Manila

18. 19.

20.

_ _ _ _ _ (1971). WHO Assignment Report. dental health. March. docUllent WPRO 5501 - Khmer Republic, WPRO, Manila ......,~~.....,...._

Khp"r

R.pubfu,

21.

(1971), WHO Assignment Report. dental health. Sjpgapore. 2 October - 1 November 1971, document Singapore 5501, WPRO, Manila

22.

Drinnan, A. J., (1971), WHO Assignment Report. Port Moresby Dental College, Papua New Guinea, April - July, doc1llllent II'PRO 5501, WPRO, Manila

23.

cadell, P. B., (1966), Training Course on Denta' Epidemiol.OCY Methods for countries in the Western Pacific Region. 18 February - 8 May 1964, document WPii!JJ4!64, WPRO, Manila Fuller, F. (196 3), WHO Assignment Report. Den tal heal th advisory services (inter-country WPRO 0160). WPRO, Manila ~=~.....,..........,.."..

24. 25.

J..

(1966), Assignment Report. Phase IV (Inter-country visits),

WPRO, Manila

- ')"3 -

Annex

'*

26.

Fuller, F.J., (1969), WHO Assignment Report. dental health. China (Province of Taiwan). Hong Kong. Republic of Korea. Sebah. Singapore. West Malaysia. document WPRO 0160, WPRO, Manila Goodall, T.G. (1974), Assignment Report I raining COurse in PrOSthOdontics. Fiji, document WPRO 5501 (Fiji Manila

27. 28.

29. 30. 31.

(1971), WHO Assignment Report. Korean national den~ Survey. 4-27 May 1971, document WPRO 5501, WPRO, Manila Laws. A. J., (1973), U;e~~~!....:.l~~~....l:C~~~__~~~~~"""Ii~~ Fi ii, 16 - 28 June, Maier, F.J., (1971), WHO Assignment Report on water fluoridation, Taiwan. document WPRO 32Ol-E, China 0169, WPRO, Manila

32. 33. Sundram, C.J. (1971), WHO Assignment Report. Port Moresby Dental College. Papua New Guinea, February - April 1971, document WPRO 5501 TPNG, WPRO, Manila (Province dental health Manila

34. 35.

a

_-:;-:.--:-_--:-_ (1972), WHO Assignment Report. dental health. Viet-Nam, 16 August - 15 October, document WPRO 550l-B, WPRO, Manila _-=-_..,....".-:--_.

36. 37. 38.

(1972), WHO Assignment Report. dental bre 1 the Khmer Republic. 11 - 31 December, 1972, document WPRO 5501-E Khmer Republic, WPRO, Manila

_ _ _--,-__ (1973), WHO Assignment Report. dental heal th. Laos. 1 - Jl January 1972, document WPRO 5501, Laos, WPRO, Manila

39. 40. 41. 42.

(1973), WHO Assignment Report. dental health. Western Samoa. 8 - 16 June, document WPRO 5501, Western Samoa, WPRO, Manila

(1973), WHO Assignment Report. dental health. Hong Kong. 24 August - 16 September, document WPRO 5501 - Hong Kong, WPRO, Manila (1973), WHO Assignment Report. dental health. Republic of Korea. October, document WPRO 5501, Republic of Korea, WPRO, Hanila

- 34 Annex 4 43. Sundram, C.J. (1974), WHO Assignment Ret:rt, Papua New Guinea, March, docUll8nt Icp/nNH/Ol, WPRO, Man! _~-:--~:--~ (1974), WHO Assimment R~1J~, den!2J. :heSlJ"th, Viet-Ham,

44. 45.

27 April - 18 May 1974, document ICP/DNH/01, VNR/HHD/03-E, WPRO, Manila

46. 27 October Manila 14 June

48.

(1974), WHO Assj!p~eport. den@] health, ---=R~e-p-ub""l""i:-c-of"'" Korea, docuMnt ICPiDNi/Ol, Republic of Korea, WPRO, Manila Shroff, F.R. (1971), WHO Assignment RePort. Papua New Guinea. Dental !dgcatigp. 7 June - 1 September, document PtG 5501-E, WPRO, Manila

50. 51.

Williams, J.F. (1969), WHO Assignment report. school dental health, taiWan' docUJllent China 0061. WPRO, Manila Wong, K.K. (1965), Report of a Survey of DeDta] Diseases am Conditions in ,i ji. 15 February - 10 1965, document WPRO 5501, WPRO, Manila (re-edition, 24 January 1969)

Mar

52.

53.

(1970), WHO Assignment report for the South Pacific Islands, BSIP, Tonga, Western SaBoa, Gi1bert-and-E11ice Islands. Fiji, June - September 1969 (document WPRO 0160), WPRO, Manila PIlBLlCATI(J(S UNDER OTHER AGENCIES on

~

54. Asian Pacific DeDtal Federation APRO of FDI (1974) Panel Discussion

Dental Health Prob1e!S and Priori ties in the Area of the Asian-Pacific Dental Federation. Jakarta Congress, June 1974

55.

American Dental Association, Co. .ants on the opponents of fluoridation, Bureau of Public War_tion al (1974) Evaluation of Self-adllLinistered prophylaxis ,00 supervised toothbrushing with acidulated phosphate fluoride, Caries Res. S. 39-51

56. Herschel S. 8t

- 3" -

Annex 4

57.

Heifetz, S.B., et al (1974) Utilization of fluorides in areas 1acking central water supplies. Journ. canadian Dental Association, Vol. 40, No. 2 Heifetz, S.B., and Horowitz, H.S., (1974) Eft'et of school water fluoridation on dental oarit.. interill results in Seagrove, N.C., a1'ter roar years, JADA. Vol. 88, Feb. National Institute of Health. U.S.A. Mura, R•• and Hollis, M.D•• (1974). Deppp) Epidemiology in the South Pacific. Tech. paper No. 168. Part 1. SGuth Pacific Collllission. Nouaea, (Part I Ck'al Health in New Caledonia. New Hebrides. British Solomon Islands Proteotorate. Gilbert and Ellice Islands CGlony)

58.

59.

60.

Sundram, C.J., (1973). DtliJ!D' gt dMP1 health seryices in the ..ian area of the Pacific Basin. Int. Dent. Journ. Vol. 23 • 4 Dec. MAGAZINE, GENEVA

~ WHO 61.

World Health Magazine. Decellbel' 1973 - devoted entirely to dentistry B()(J{S

~

(WHO)

62. Adler,P., et al. , (1970), Fluorides and Human Health , WHO Geneva 6). Davies, G.N.,(1974), Cost and benefit of fluoride in the prevention of dental caries, WHO Geneva

- 36 Annex 4

~ 1.

W(JU(ING PAPERS ISSUED TO PARTICIPANTS (May-June 1975)

Dr Innes Grant (WPR/DNH/l) Periodontal disease - etiology, prevention, treat.ent and control.

2.

Brigadier J. Ferris Fgller (WPR/DNH/2) Dental care delivery systems - a selection o£ I18thods and IIIUlpower in current use.

3.

Pro£essor Blanche C. Barbers (WPR/DNH3) Fluorides and dental health - the current status (eaphasiziug the aechanics o£ organiziug fluoride mouthrinsing).

4.

rrGf'essor G. N. Daries (wPR/DNH/4) !he assessment of dental caries and periedontal disease for development of a dental health progr. .e for a co_unity.

5.

Dr Chua Sui Yeft (WPR/DNHI5a) Dr Tan Yok l.i n

(wPRImrn/5b)

(ba) () 6.

Dental health services in Singapore - an outline (WPR/DNH/Sa) Organization of school dental health services (WPR/DNH/Sb)

Professor Phoon Wai-<kl (WPR/DNH/6) Basic biostatistics for assessment and evaluation for public health purposes.

7.

Dr 1ai Yen Hooi (WPR/DNH/7)

Dental health services in Malaysia - an outline (emphasiziug areas where dental services are integrated in the general health services). B. Dr Abdul Rahman bin mDg (WPR/DNH/B)

Preventive programmes and dental health services in rural co_unities in Malaysia; the role of dental auxiliaries. 9. Professor Ibrahim bin Haji Yassin (WPR/DNH/9)

Undergraduate dental education and programmes for continuiug dental education in Malaysia. 10. Dr D. E. Barmes

(WPR/DNH/lO)

Epidemiological profiles and planniug exercises for dental services. 11. Dr C. J. Sundram

(WPR/DNH/ll and WPR/DNH/12)

'lbe regional dental health programme (WPR/DNH/11) 'lbe utilization of dental auxiliaries in the Region (WPR/DNH/12) 12.

Dr Wong Hee DeOng

(WPR/DNH/13)

Dental health educational actirities in Singapore, toothbrushing and preventive progr&llllleS in schools.

, - 37 ANNEX

5

,

PHOTOGRAPHIC IUlJSTRATIONS * PARTICIPANTS AND SOME ACTIVI TIES AT THE COURSE, 1 975

Front row (L to R): Drs. M. BAMATANG, L. VERS'lVYFT (WR/ Singapore), C.J. SUNDRAM (Course Director), Ms S.T. KHOO (WHO Staff Member), F.J. DY (Regional Director/WPRO), G.L. HO ( Permanent Secretary/ Health, Singapore), S.Y. CHUA (Director/Dental Services, Singapore); Second row (L to R): H.D. WONG (Country Planning Committee Member), Ms K.M. TAIMA, Ms S. HERMAN, Ms J.K. YASA, Ms. C.H. LEUNG, J.B. KIM, Y.L. TAN (Country Planning COIIIDittee Member), K. HENRY; Third row (L to R): R.M . CARREO N, P.Y. W O NG, P. A. JENNINGS, T.\' . lEE , K.A. LIM, A.C. RIMORIN, C.S. lEE; M . TAPEAIJWA, S. TALAGI; Back row (L to R): 1. GRANT (Short-term Consultant), W.C. SIEMO NS, Mr A. BUE, S. POURU, Mr P. LAURIAULT (WHO Sanitary Engineer), Mr K.S. KRISHNAN (WHO Administrative Assistant). Participants are those where no designations are stated after their names .

I

• ,

*

Legends are presented on pages 46 and 47 for illustrations 1 to 26.

- 38Annex 5

,:

- 39 Annex 5

r

• .,

<.

-

. ,L'. ' ..

.. f "{, ....

. "

~

.

Annex

Is

- 40 -

- 41 -

Annex 5

,

l'fft .... -..:_ ~ Cll11'IU A".

.

_t«:.,. e... ·..."

., "

" lU

-

•

"

••

•

-

- 42 Annex po.j~ ;''l'

5

- 43Annex 5

-

L--

4 -

J

- 45Annex ' 5

- 46 Annex 5 IEGENOO FOR ILLUS'IflATIONS MJMF£RED 1 TO 26

1.

Partioipants. hosts and guests at the open1ng ceremony of the First WHO Regional Course in Public Health Dentistry on 2 May 1975. A visit to the reservoir and fluoride treatment plant in Singapore to see the system of water fluoridation. Dr Wong Hee Deong and the Water Engineer Public Utilities Board of Singapore explain the procedures. Inset: Professor Phoon Wai-On (WHO temporary adviser). Water fluoridation in Singapore. Insets: Dr W.P. Wan (Singapore University). Dr Grant (WHO short-term oonsultant).

2.

3. 4.

Ma Leong explains the prinoiples underlying poster production at the Dental Health Eduoation Unit in Singapore. Insets: Dr Chua Sui Yeow (WHO temporary adviser). Mr Krishnan (WHO staff) and Professor W.K. Ng (Singapore Un1 versi ty) •

5.

Field visit to study the meohanics of organizing a olassroom toothbrushing progr_ _ in Singapore supervised by sohool teachers. Inset: Dr S. Talagi (Niue). Consultant Dr Innes Grant. demonstrates the technique for gingivectomy in the treatment of periodontal disease. Dr Jennings (American Samoa) assisted by Ms S. Herman (Fiji) practising the technique of doing a gingivectomy on a phantom head. Professor Phoon Wai-On. Dr Tan Yok Lin. Dr Chua Sui Yeow and Dr Lim Kheng Ann - members of the Country Planning COUIDi ttee of Singapore. Dr'Imes Grant (WHO short-term consultant) and Dr Wong Hee Deong (member of the Country Planning Committee of Singapore). Visit to a school dental clinic in Singapore. Dr Kaa Henry (Cook Islands) and Ma S. Herman (Fiji) discuss with lady dental offioer of the sohool dental service. Insets: Ms SUsan Herman (Fiji) and Dr Tan Yok Lin (WHO temporary adviser). Visit to a main dental clinic in Kuala Lumpur. Malaysia. The Selangor State Dental Director. Dr Lam (wearing tie) briefs the participants on the facilities at the dental oentre. A school dental nurse in Kuantan. Pahang. supervising fortnightly mouthrinsing with a weak solution of sodium fluoride. Dr Tai Yen Hooi. Direotor of the Dental Services. Malaysia (also WHO temporary adviser) briefs the participants on the successful dental health progr&llllles of Malaysia. Insets: Dr A. Rahman and Professor Ibrah1lll Yusin (WHO temporary advisers).

6. 7.

8.

9. 10.

11.

12.

13.

- 47/48 Annex 5

14.

Professor Blanche Barbers (WHO short-term consultant) summing up a presentation by Dr Abdul Rahman (WHO temporary adviser) and Dr Yoong Kim Poon (state dental director). Insets: Dr Cheong Weng Hoon (state dental director, Pahang) and Dr Barbers (WHO short-term consultant).

15.

Dr David Barmes (Chief, Dental Health, WHO Headquarters/Geneva), outlines the principles of dental health planning, assisted by Professor George Davies (WHO short-term consultant). A school dental nurse demonstrates to a group of six children the correct way of toothbrushing. Brigadier Fuller (WHO short-term consultant) and some participants are the interested on-lookers. Partlcipants sit-in in the classroom while a school dental nurse gives a talk on "preservation of teeth for a lifetime" in a primary school in Kuala Lumpur. Insets: Dr A. Rimorin ( Philippines) and Me Khoo (WHO staff) with the school dental nurse. Most of the Malaysian parts of the lecture-sessions of the Course were held in the lecture room of the new Dental Faculty of the University of Malaya, Kuala Lumpur. Inset: Mr T. Ooman (Malaysia). Dr A. TaJJudin Yassin, Assistant Director of Dental Services and Member of the Country Planning Cantlli ttee of Malaysia conducts the participants to demonstrate a "lightning dental squad" in Negeri Sembi Ian. Inset: Dr TaJJudin assisting participants at the survey site. Dr Moi Tapealava (Tonga) discusses with school dental nurses the problems of delivering dental care in the periphery in Negeri Sembllan. Conducting an oral health survey. Inset: Ms Taima (Caroline Islands).

16.

17.

18.

19.

20.

21. 22. 23.

Professor Kim Johng Bai, Dr Chung Suck Lee (Republic of Korea) and Ms Leung (Hong Kong). Professor Davies supervising the survey exercise - Professor Kim Johng Bai (Republic of Korea), Dr Carreon (Philippines) and Dr Taluomea (Solomon Islands). Training of chairs ide assistants. Inset: Dr Taloumea (Solomon Islands).

24. 25.

Training of dental technicians. Dr Tae Won Lee (Republic of Korea), Dr Wong Pak-Yiu and Ms Leung (Hong Kong), Insets: Dr Pouru and Dr Tae Won Lee. Training of school dental nurses (operating dental auxiliaries).

26.

- 49 Annex

6

PARTICIPANTS' EVAWATION OF THE COURSE SlJM't1ARIES OF REPLIES TO '!WO QUESTIONNAIRES (CHECKLISTS) .INDIVIDUAL EVALUATION QUESTIONNAIRE NO. 1 (AIMINISTRATIVE )

This questionnaire haa been prepared for the purpose of assessing, on an individual basis, the administrative aspects of the Course as an aid in the planning and operation of future courses of this nature. Please check the appropriate statements and write your comments ligibly. Since this form is to be unsigned, your frank criticisms, suggestions and comments are cordially invited.

1.

Tra ve 1 arrangementa were: Physical arrangements of the site of the Course were: AccOlDDodation and services were: The amount of free time available for personal matters and rest was: The total length of the Course was: The schedule of the Course was:

Excellent

@

Satisfactory

/6/

Reasonably satisfactory / 1/

Unsatisfactory

/1/

2.

Excellent Excellent

/17/

Adequate Adequate

/4/

Fairly good Reasonably good

/1/

Unsatisfactory / -/ Unsatisfactory /1/

3. 4.

!JIl

!Il

aJ

More Adequate

/11/

Just enough

/87

Not enough

than

/1/

enough

/2/

5•

Very satisfactory /8/ Very satisfactory

Satiafactory /11/

Too short

/1/

Too long

6.

W

Satisfactory /12/

Too crowded

/1/

Too loose

/ -/

7.

The working hours were: The information bulletins and circulars were:

Very satisfactory /9/ Very helpful

Satisfactory /13/

Too short Of

L.:.J

Too long Of little help

/ -/

8.

/19/

Helpful

L2I

some help

/ -/

L.:.J

I

- 50 Armex 6

9.

Library and. reference facilitie8 were: Documentation to cover the subject II&ttera were: Opportunities to become acquainted with other participants and staff were: The leadership of the Course

Aciequate

/11/

right

/6/

L1JDited

/4/

No Poor / -/ answer/l/

10.

Excellent

/13/

Satisfacto17

/7/

Fairly good

LiJ

poorQ

11.

Aaple

/13/

Sati8factOl7

W L2.I

Not enoush

L::.I

None at all

L::.I

12.

W&8:

Exoellent /151

Sati8facto17

Fairly good /2/

Poor / -/

13. What iJaprove_nts would lOU 8ugge8t for future courses of

thia nature?

14.

Comments:

A

51 Annex 6

•

INDIVIOOAL E'lAWATION QUESTIONNAIRE NO. 2 ('lECHNICAL)

This queationnaire 18 intended to aS88aa the technical aspects of the Course on an individual basis. You are kindly requeated to check the appropriate statementa and write legibly your frank opinion and comments. Your criticisms and 8uggestions are oordially invited. Please do not ~ your name. 1.

Were you interested in this oourse? Did you gain any new ideas or concepts? Did you have enough opportunl ty to express your own ideas at the course? Did you have enough opportunity to exohange knowledge and experience with other participants and staff outside the Course? Each of you came wi th specific objectives and expectations. To what extent do you feel these have been attained?

Very DIloh

Qui te

To some

/19/ a bit /1/ extent

LJ[7

Very No little / -/ answer/ 1,1

2.

Some

Very few

None / -/ at all / -/

,.

Just Ample

Not

/12/ enOUgh!J§J enough

G

None at all / -/

4.

Ample

/16/

Just enough /

Not

6/ enough / - /

None at all / -/

5.

For the Com most pletely/6/ part /15/

Some

G

A

little

G

(If the answer is either "Seme" or "A little", please give further details.)

/

- 52 Annex

6

6.

The acope ot atl.ld7 and discuasion

w .. :

Juat right

Too

large

7.

The Cour.. baa

H1chl7 valuable /1'/ Valuable

been to

7011:

L2I

or

.ome / -/

value

little value / -/

or

8.

Would 70U be w1l1ins to reaP<Di to a tollow-up queationnaire about the meeting to be aent to 70U ODe ,.ar t~ now? Yea @ No I - /

9. What 40 7G11l oanaider . .re soo4 teature. in the ocntent ot the Course?

10.

What teature. do 7G11l ooaaicier not so good?

11.

How will thia OCNrM be retleoted in 70ur plan for

of dental care deliver,-

.,..t.- or/and preventive prosra-a

develo~nt

am

iaprovement

in 70ur countr;v?

12.

COBIIenta:

1,. 14.

Other

c~nt.:

What other topics would 7011 propose to diaouaa at future coursea/aeminara/meetings?

SUMMARY OF COUNTRY INFORMATION* Table 1 Number of Is~ands

Geographical and Population Data Name and po!XJlation of largest town No. of children at school 2 451 8 531 2 590 000 6 000

Country 1 2 3 4 5 6 7 8 9 10 11

Total land Population area 1973 F;st;1.mate + (IIQ. Ion.)+ 197 7 686 848 234 18 272 32 000 13 132 000 20 000 -

Y

(Im~enc~~'!l81 No Yes No Yes No No Yes Yes Yes No ------

Fluoridation of water

American Samoa Australia (STC) Cook Islands Fiji Gilbert and Ellice Islands

6 ----

Pago Pago Sydney Rarotonga

1970 1971 1971 1968

+

6

15 300

------- ' - - -------- r11 388 Suva Tarawa Agana Hong Kong Auckland Alofi Port Seoul Honiara Singapore Nuku'alofa Dud Moresb~

1972 2 850630

55 000 63 000 ---_._-----

60 000 12 642 2 119

134 400 14006 27000 1 000 000 2 500 000 650 000

---!

---

---

29 1

886 549 1 045 329 749 268676 259 461 691 300 000 98 484 28 446 581 699 1 779

I

--

Guam Hong Kong Malaysia (Host) New Zealand (STC) Niue Papua New Guinea Philippines Republic of Korea Solomon Islands Singapore (Host) Tonga Trust Territory of the Pacific Islands

94 000 4 160 000 11 609 000 2 964 000 5000 2 563 000 40 219000 32 905 000 179000 2 185 000 92 000 110 000

-------------- ---- f--

1970 +

236

1973

747 339

170 3** 1 7 107

Kuala Lumpur 1974 1 008 701 1966 + 5 194 1971 + 76 507 1973 +1 435 500 1970 5 433 198 15 300 1973 +2 185 000 1972 1972 25 000 32 780 1972

t:l

--- f---

1 580 --

Yes No Yes No Yes No No

12 13 14 15 16

Manila

8 286 416 5 692 285 10 000 500 000 24 560 32 780 ------------

3 579 6 1 250 96

17

-

--

•~alnly participating countries - including host countries and countries of consultants (STCs) .. Main islands only. Sources: + UN ]):lmographic Yearbook 1973. New York: 21 '5-216. ~/

United Nations. 1974. Table 2. pp. 85 and 87; Table 7. pp.207-20B.

~

-.,j

-"he Far

~flst

and Austra1ifl 1974. London: Suropa Publications Ltd .• 1974. pp.1067. 1116. 1118. 1121. 1135. 1139.

Table 2 -

Dental Survey Prevalence Periodontal

Country

Conducted

"tr Whom

~lethod

All Al5es

Resul ts applicable to whole country Yes No No Yes No Yes

Mean dt; age

Mean IMF, age 13 - 14

5 - 6 1.0 ,.0 _6.0 7.6 4.2

~~~~~~__~IJ 98.8% 80-85% 98.5% .H

American Samoa Australia (STr:) Cook Islands

Yes Yes Yes Yes Yes Yes

~!ong

( 168)

Yes 6 - 19 242+Ot Yes Yes Yes

1.1 11 - 12 0.7 2.5 0.6

5 6

4

Fiji ---------

Masi • Wong ( 165) Wong. Malaki (168) Hollis (172)

Gilbert and Ellice Islands Guam Hong Kong

0115 3 0160

-~\~i-~ ~\% 37.4% 57.1%

Health Depart.( 172) 10ther Wong(168) ----._----------_ ...--.

6 - 15

71

~ Malaysia (Host) 91 New Zealand (STC) 10 I Niue 11 I Papua New Guinea

---+- .

Yes

I Other I __ _..

I1-- ----,• 5.3 6.3 7.2 1.1

16.1 (Dl1FS) 4.6 3.9 9 1.3 2.2 60.2%

Yes Yes Yes Yes

Min. of Health (172(0115 Hewat, .Eastcott('67) Ta1agi ( 169) New 3ealand Govt. ----..--- --_.. _----_._Barnes ( 162) Health Depart., Hubble. Mason( '66) Anderson ( 169)

I

r--

5-44 6 - 15 Yes Yes Yes Yes Yes

81~+_ 57.4%

Other Other

2-9. 10-15. 16-20. 24-25 Yes

I

If I 75%

Other

121 13 14 15 16 17

Philippines Republic of Korea Solomon Islands Singa pore (Host) Tonga Trust Terri tory of the Pacific Islands \11'Rll 011 ') ;oWI!O Techni ·::,1 Series 2}12

Yes Yes Yes Yes Yes yes

Health Depart.('69) 10115

4

..

Yes I

Y., Yes Yes 20 Yes Yes

K.D.H.A. (172) Wong ( 169) Ho11is~ 1

0160 0115

'/. - 52

I

4., - 4.9'~ ,. ---

(7) 2.8,

oYes

- - ----

---

Min. of Health ( '70)1 0115 Tapea1ava (169) Heal th Depart. (168) ,0115 Other

6 - 18+

5.113 1.2

J-3-;~O?4~:10~z~;5 .1j?8-~91% 1.0 3.7

_:~8~3-. 7~·4l~;:~: I ~.U

I::::: I ~.~

5 - 18

J

Yes

3\1PRO 0160 itKorean Dental He31 til Assoc iatlon

Table 3

~

[;ental Per.3onnel and Servlce Tre'l tmellt in Government Servlce Service for Preschool Children No yes Service for School Children No Yes : ____Ye~_r_-Yes Yes Yes __ __Yes . __ Yes 1

Dental Personnel" f' Operating 3uxlliaries ~

Johoo1 Dental Servi ~e !

country

Pro esslOn~l

Non~ operating auxiliaries 3 7/0 983/5270

~re~lm:~t t va Ada t e S1 0 u1 d on Deman No yes

Len"t~l

Frequency Toothbruzh months~ m Pro;,;ramme years - y ly No No

Fluoride TherClPY

Health I Education II

1

American Samoa

--------

7/0 710/3100

Yes Yes Yes No No .. . Ye~

No Yes Yes-Yes -. Yes --

2

Australia (STC) Cook Islands

48/0

3 4 5

_-~9/0 ____ 26/5 -

6/0--_~~/O---~~ ----~e-:-::-11/0 --1;0 2)/5 5/3 No

Y~s_______9m __ ~ ___Yes __ ~_ No Yes II.>

Fiji

ly, orr.:

Yes Y<:8 Yo" Yes . Yes No

Gi~~~:~d:;dEiil1ce-------~;----- --.-. 7/18 .. __

--~;~-- f----~~.--.----.- --.-- -/18 ---- -. Yes Yes Yes

I I ! ,

-t------------6 Guam f-7 Hong ~ong

- -- -Yes No _____6m om

1

..

lY'

69/)~17 229/160

27/4 551/0

~So/l?5 65CJ

' ;

8

Malaysi3 (Host] _ ... _

!- _

i

I . i

Yes . - - - ---Ye~_~ ______ ,

V1

Yes _,!es

t - - - t - - - · - - - - - - - - - - -..- - .. ~----" 12 13 14 -

~~ ::::a ~i;;a New

9 New Zealand (STC) -

__12.?!90~ __1340/~__

2~~~----'- 6~;----6~;~I

-/1320 _

Yes____ ..!..~~___

__ No____om _ 1 __ ----- ." Yes Yes Yes -

PhllipPIne_~__

. . __~62~/2?0~_ 187/2500 2/0

5/0 45/0 I/O

3_0!:'03~ 4/0

.----- -- .---. No No Yes Yes No

::s

-----~

::: yes yes Yes Yes Yes ..-

:::---: ____ ~y Yes Yes .

--------~-

+--:::-----:::-1- -;::i~=~--Yes --

I l

Yes ,!e"

~

VI

----.-- .--.

-------Yes Yes No

_l __._Yes._ . Yes Yes Yes -

-----

----.-

Republic of Korea

-

200/2717 .------ .--

-! l ---·-------1

i Yes ,--__

Solomon Islands -----

--.-.-

-----.-.-f-----.--

---. . . . . - , - - - , .. - . - - f - .

ly,

No

--.

-----~--

15

-+---Tonga

Singapore (Host)

----- ..--

-.. -

131/290 9/0 27/1

_..

217/0 %

-_ .. _, .. -

111/-

.. --_. .. 5/0

---'

-----

6m

i

Yes Yes No

- . yes' ~

No'

16 17

-,-----~--

-------

-- .. _-. --

-

ly ly f

-

.-.J

_ - - ' ' - -_ _ _ _ _ _ _ _ _ _.lL.._ _ _ _ _ _...L_ _ _ _...L_ _ _ _-''--_ _ _ _ _--"-_ _ _ _--'-_ _ _ _ _ L.

Trust Territory of the Pacific Islands

20/0

111/0

Yes,

Yes

Yes

yes' _ _ _

Yes

_ _ _

1 The answer is "Yes" if the majority of adults can receive dental services other than relief of pain on demand. Some countries answering "No" do provide services for selected groups of adults.

"" " ffi x --J

~umber before stroke refer"; to number in government service, number after stroke. the number in private practice. ~on-operating auxiliaries - laboratory technicians and dental surgery assistants with or without formal training.

- 57/58 -

ANNEX 8

PICTOGRAPH OF INTEREST LEVELS AGAINST PARAPHRASED TARGETS IN COUNTRIES REPRESENTED AT THE COURSE

Key to symbols used:

~

A= 6= f-<

high intensity of activity low intensity but high interest absent and/or

en 0= no interest "'., absent and/or " ... .., ..... ...: '" 8= low interest .., " ... :>. Ol " .... "" .c: .... ....... ... ., o..c: but hig ....... .... "" ... D =absent .c: CD" interest ., " ..... oou .... S .c:"" U ....

t..l

0

8 '" .... :> ..... .... '" .... " ..... "'.c: " .... " .., .., .... .c:CJ "" --en "'.., .,"" b"" ., ... ..,. :l.c: '" I:: ... '" ., .., '" .... "' .... .... '" CJ Ol· ... .... " .... I> ... ., .... CD ., .... ... .... " .., .., I-< 01

... 0

<1J

I-< ··0

"" .. ~ ~~ ~~~ ';;j H '81S~ "'''' .... .c: I-< 0 <J

.., '"

:> ..... <J

<1J

01 01

000

0 .... UQ)

~

.I: ...., .... 0

<! '"

01...,

· ... 0 000

N U .... 01

~I::

01 U

"0'"

"0 til

0.1::

.., 01

>

0.., I · ...

-

.0

U

01

01 til

f-<

""

.... 01

"'til

01 U "

o

Ol .c::>. .., .... "'1-< "0 Ol .... "0 "0

... ~

Ul .0 .... 0. " '" ''" .... " " Ul '" .... .... "" ... ., '" .... ., " .c: <J

..... " .., '" ....

.., ... 0

.., ..... .., til til

t;)

.., '" .... '" ' " """ " .... 0 "' Ol - 0. ' " .... ' " .., .... ..,CJ ... '" "" 'Ol " '" I> .... ....... .... > .c: .... +' .c: ... 0 0.01

" '"

0. 0.

"" .... o CJ

" 01

~

>. 0

I>

"'0 "00 "til

';;l~

....

.c: u "0

U

01

'"

01.>0

.... 0 .... 0

u ....

1 2

American Samoa Australia (S'ICS) Cook Islands Fiji Giloert and Ellice Islands Guarr:

3 4 5 6

••

.. ..

.e

.o.c: ~

.... :. .,., ..... <1J .... ., .... co <1J "" 0 oc:: .... ...... ... 8 ... u " ., 00" "'''' ;t; ~.t: g.~ .5~ 0 til

till-<

....

"

0

01

'" ... .... ., " ... ... " '" "" <;.<

.... .,

~

.... <J

0

01

;

Ol ;

0· ... I> ",I-<

;~

Ol ..... " " u· ... '" ., :. " ....... "tIl ., .... ..... .... '" .... 0." , .... '" ., " ....... " oOl 8 ., '" ... "tIl .c:CD ..c:: "0 "0 I-< .,-1 " ..... U

""'" •• .c:

"'01 UQ) " 0. ., <Il 01 " <;.<'

.......

. .... .., '"

u '" .... " .c: '"

o+' .., " ' " '" .... '" "-.., Ol " "" ..., " 0 <J

.., '" '" ., '" 01

.... n

" "" ... .... ....c .., Q) "

"" .c Ul

I::

0

Ol 8

U

I:: 00 ....

.... .,

... 0

I-< til

...

0"

... .0

0

0· ...

0

0

., .... Ul .c: '" ... ....... '" 'bIlCJ " '" .... .... ., ., . .., .c: ... o.bIl I:: " "0 '" .... 0 .... .... I:: .... .... .... ., ... .... .., c ... " .... "0 IV ...

8 •• 0 Ul 0 8 8

.c: ..,

en

....

0

U

I-<

01

til

>

III

01

U 0

~~

3..e I JiB

Ji

..c::

0

0

Ji

7 S

Hong Kong r·:alaysia (Host) New Zealand (S'ICs) Niue Papua New Guinea Philippines Republic of Korea Solomon Islands Singapore (Host) ':'anga

A A 6. ~ D A A A A A- 0 D D ~ h,. AD D 0 A- D A- A- D A- A6 D 0 A- AA- A- A- A- A-

9 10 11

D D 6 D 6

12 13 14 15 16 17

D D D 0 D A- AA- D 6 6 D 6

... ... ... .. ... t::.. D ... .. ... D ... ... .. ..

A 0 A- t::.. 0 D. D. 0 A8 0 AA- A-

.. .. ... .. .. ..

6 D 0 0 D A- D A A A A- AAh,. 0 0 0 0 A- D. D. D 0 A- 0 D A- D D. D. D. h,.

8 8

0

.. ..

,t" ~

~:5

• ....4 • .-4

0>

~ ~

......

D 6

0 0 0 6 D 0 A- D A- AA- A- D A- A-

Trust Territory of the Pacific Islands

.. .. D

D D 0 0 D AA- A6 A- D 0 0

...

.. ... ..

A0 D 6 0 0 0 D D 0 6 0 0 0 D 0 D 0 D D 6 D D 0 0 0 A- A- AAA- D 0 0 D

.. ...

0 0

...

6 6 6 6

6 0

...

0 0 6 0 0 6 D D D D 0 0 0 D A- D A- A0 A- D 0 A- A- 6

notes: Symbols and against countries quickly show the areas(targets) for further development. (Source: C.J. Sundram - by enquiry from participants at the Course 1 May - 30 June 1975)

0

- :59ANNEX 9

SELECTED ILLUSTRATIONS OF THE NATIONAL DENTAL HEALTH EXHIBITION MOUNTED DURING THE DDlTAL HEALTH WEEK IN SINGAPORE, 1975. (Legends for illustrations 1 to 8 are on page 62).

- 60 Annex 9 ----------:=

PREVENIIVE lQItlc!" . . . *""t\~'#; :t-;~,~

61 -

-62 :.. Annex

9

• LEGENDS FOR ILLUSTRATIONS NUMBERED 1 TO 8 •

1.

Singapore I s National Oral Health Contest judged by a panel of dentists. Free examinations and oounselling were given at the Dental IWalth Exhibition for the publio. '!he dental operatery was situated behind a huge out-out of an open IIOUth. Photographs of a few of the m.aaaoth exhibits on display with school dental nurses in attendanoe to answer questions from the viewers.

2.

3 to 8.