Dental outreach services for preschool children and the elderly on Lamma Island

Abstract

Background. Lamma Island is the third largest outlying island in Hong Kong with a population size of over 6,000. It is only accessible by ferry and no dental service is currently available. There have not been any systematic reports or outreach service in relation to dental health. While preschool children and elders are susceptible to oral diseases and more dependent on caregivers, their oral health and dental needs can be a cause for concern. Objectives. To investigate the oral health of preschool children and the elderly on Lamma Island, to study their potential barriers in seeking dental treatment, and to evaluate the feasibility of providing outreach dental service on Lamma Island. Methods. The two target groups were preschool children aged three to six, and elders aged 60 or above. Preschoolers enrolled in Our Lady of Lourdes Catholic Kindergarten, and elders, in collaboration with Hans Andersen Club were recruited. A total of 92 children and 25 elders were involved. Questionnaires were distributed to caregivers of children to collect information on the demographics, oral hygiene behavior, dietary habit and dental service utilization of the participants, while those for elders were conducted through individual interviews. All participants were given an interactive oral health talk, followed by oral examination and simple preventive and restorative treatments. Results. (1) Preschool Children. Regarding the oral hygiene behaviors, over half (59.8%) of the children reported daily snacking frequency to be once or less and a majority (78.3%) of them brushed twice or more per day. As for their oral health conditions, the mean dmft was 2.33, with the mean decayed teeth (dt), missing teeth (mt) and filled teeth (ft) being 2.21, 0.03 and 0.09 respectively. The mean dmfs was 3.84, in which the respective mean decayed surfaces (ds), missing surfaces (ms) and filled surfaces (fs) were 3.62, 0.13 and 0.09. Over 40% had untreated decay whereas only a small proportion presented missing teeth due to caries (1.1%) or filled teeth with no decay (4.3%). Concerning their dental services utilization, 45.6% of the caregivers reported difficulties in accessing dental care, among which a majority (75.6%) attributed to absence of dentists on the island, followed by high financial cost (36.6%), long transportation time (24.4%), dental phobia (22%) and others. (2) Elders. With respect to oral hygiene behaviors, a majority (80%) of them brushed at least twice daily, but only 36% performed interdental cleaning. For oral health conditions, all participants were presented with bleeding gingivae while deep pockets (6mm or more) were more prevalent in sextant 05 (45%). All of them had caries experiences, among which 84% had untreated decay, 72% and 64% had missing teeth and filled teeth respectively. The mean DMFT was 11.44 with respective mean values of decayed teeth (DT), missing teeth (MT) and filled teeth (FT) being 2.64, 5.76 and 3.04. As for dental services utilization, all participants reported difficulties in accessing dental care. Absence of dentists on the island was the major obstacle (56%), followed by high financial cost (40%), long transportation time (24%), dental phobia (20%). Conclusions. The oral health conditions of both preschool children and elders on Lamma Island were comparable to general population of 5-year-old and non-institutionalized older persons (NOPs) in Hong Kong. The three major potential barriers in seeking dental treatment were absence of dentists on the island, high financial cost and long transportation time. Dental outreach service on Lamma Island was found to be feasible, in which oral health education and simple treatment could be effectively provided with the support from local community partners.