Word of Mouth - School of Public Health and Community Medicine ...

Filling the GapOne medical staff member saw his own effortsat oral health education as part of a greatereffort:Even simple things, about how many timesyou brush a day, that’s it. For a doctor to saytwice a day … well he’s just a layman, see; butif it comes from a dental hygienist over there,that’s gospel truth!One member of the dental unit staff relatedefforts made at the chair side:It’s easy to break the ice because when webook them in for a check-up comprehensive,we do all that then; that’s at the start of theirtreatment. So their brushing and all that, oralhealth hygiene … They know to brush theirteeth and that now; and that’s the start. Atleast we get them fixed. At the end of the visit,they’re walking out and they know how to lookafter their teeth, they know what foods to eatand not eat, you know … And so it works outreally good.Another in the unit reported that the volunteersdo review oral care practice with patients overtime. If the dentists see there is still need forimprovement, they will reiterate to the patient:You need to brush!However, time pressure makes it hard to sustainthe preventative work:They’re only in there to get what they come infor and then they’re gone, it’s just like a boombang! If they get continuous work done, thenit’s, ‘Make sure you brush your teeth.’ ‘Makesure you do this.’ Just little dribs and drabs ofthe education itself. When the hygienist wasup here, she was good … because the dentistsare like, get in there, get out; but the hygienistsdo clean [and scale], do basic hygiene (Dentalunit staff member).At the time of interview, oral health promotionresources were scarce – like hen’s teeth – as therehad been so many health promotion initiativesacross the service. Each year, oral healthpromotion takes place at National Aboriginal andIslander Children’s Day (4 August) and “KiddiesDay” during NAIDOC (early July), as well asDental Health Week (late winter), and morerecently National “Close the Gap day” (March -April).The mobile service also contributes to initiativeson the Atherton Tablelands, such as dental healtheducation with local Aboriginal day care centres,and the “Many Ways Strong” program thattargets children entering school. Other settingsinclude health promotion with 13 to 18 year oldsat Friday night basketball and seniors’ gettogethers.So, we’re doing quite a few things and it’s howwe deliver our health messages, but it has tobe subtle, otherwise people will say, ‘Ah … so’(Outreach clinic management).Several dental volunteers have devotedconsiderable time to working through oral healthpromotion strategies and participating in healthpromotion activities, while working closely withdental unit staff. A number of interviewees werehighly appreciative of this education, recallingseminars where it was provided to health servicepersonnel and other work with children. TheDental Manager, lamenting that most of theproblems encountered in the clinic are causedby the fact that people do not brush theirteeth, told of a particular education tool beingdesigned to assist with this.While the demarcation between oral andmedical responsibilities was respected, therewas some discussion of the possibility thattrained dental staff and volunteers could workalongside and share their knowledge with theAboriginal Health Workers, to further the aim ofbetter integration. The potential benefits werediscussed enthusiastically by one member of theoutreach clinic staff:The whole idea of Primary Health Care andimproving people’s health ... the nutrition sideof things is just as important for your teeth asit is for your body, that sort of thing. [The]same sort of things we’re telling them in thatbrief intervention that you might have, and that[the volunteers] have some way of impartingthat sort of message … the whole healthmessage.It also came to the attention of the EvaluationTeam that young people enter Wuchopperenas trainees in a variety of roles, some of them47