Screening each grade of the Primaria school children was an experience full of giggles and high fives, eagerly raised hands to answer oral health questions, and amazingly good behaviour; once we asked them to open their mouth to take a look they kept as still as a statue with their mouth wide open. I was so impressed that the children knew more about the prevention and process of dental caries (cavities) and gingival disease than I knew when I entered the dental hygiene program. I think this is due in great part to the dedication from the Primaria school teachers and community volunteers who have continued oral health education and daily practices at school between yearly visits from the Camosun field schools. Ada tells us that the grade five-six class had a markedly lower cavity rate than when they were in kindergarten five years ago when the first Camosun field school visited San Pancho. Personally, I feel like I had a small but powerful force in the wave of this generation of children as they’re growing up (OK, I had to make a wave analogy – we are having a beginner’s surf lesson tomorrow!). I felt my role in this force was two-fold: I was able to help modify some tooth brushing techniques to improve effectiveness with a few individuals and also I provided information for others to aid their parents’ decisions. For example, although one child had a cavity, it wasn’t imperative that he visited the dentist because the cavity was on a primary tooth that would be exfoliating soon. There were several factors to consider in reaching that sort of a decision, such as the risk of the infection spreading to permanent adult teeth, oral health status and practices, and financial barriers. A cavity restoration with the hospital dentist entails several costly appointments, time away from school and time away from work for the accompanying parent.
At first I felt unsatisfied with the short time for screening assessments and self-care. Being used to 20 minutes of intraoral time to gather information to create a care plan with a child patient, here I could only allot about 5 minutes of assessment time! The language barrier also was tough at first as I felt like I was unable to provide individualized care when I couldn’t speak with the child in Spanish. Being a perfectionist, I really struggled with these changes during the first day. But as I shifted my attitude from thinking about all the oral care I couldn’t provide for the child towards what I could show or tell the child to improve their situation, I started to enjoy the challenge and pick up speed without compromising care. To an outsider, this is a simple and obvious realization which can be followed by the appropriate courses of action. But it can be tricky when you are trying to shift your own way of thinking: I had to lose my inhibitions a bit. Feeling anxious when I couldn’t achieve perfection is not a great example to set for a child. I was able to tell those with tooth decay solely on mobile primary teeth that although "tu tenga caries, pero no visita dentista, y mas imporant por..." then I did the tooth brushing motion with my hand because I keep forgetting the word! But they seemed to understand and when they had questions I would flag down Ada or our accommodating interpreter, Indira. By focusing on finding balance in decisions like referring the child to the dentist, I am becoming more proficient at prioritizing interventions for an individual. Also, the variety of seeing and feeling such a wide variety of arrested decay, fluorosis, decay on mobile primary teeth and decay in pits of molars really fast-tracked my caries detection skills. This week I have felt empowered by being able to develop these affective, cognitive and psychomotor skills which I can apply to my future practice.