Taking a full-service dental clinic to the edge of the Gibson Desert

The Royal Flying Doctor Service (RFDS) Central Operations has been conducting full-service remote mobile dental clinics throughout South Australia for the past 11 months; prior to that there was an abridged service in three outback communities (Marree, Kingoonya and Marla) as part of a pilot program in collaboration with the University of Adelaide Dental School.
 
In May this year, the RFDS Remote Oral Health Program performed its first outreach dental clinic in the Northern Territory – in the remote Aboriginal community of Kintore on the edge of the Gibson Desert, 530 kilometres west of Alice Springs near the Western Australia border.
 
This milestone required 12 months of planning and hard work. In collaboration with NT Health’s Central Australia Health Service, the RFDS conducted scoping trips, engaged the local community and partnered with stakeholders to design and implement logistical and clinical protocols for delivering a fully mobile dental clinic in one of the remotest parts of the country.
 
Suddenly, all of that was forgotten when the RFDS Oral Health Team touched down on the runway in Kintore in a in a RFDS Pilatus PC12 aircraft. The team comprised a dentist, a hygienist and two dental assistants.
 
The support of the Pintupi Homelands Health Service was tangible from the outset. A ‘troopy’ was waiting at the airstrip ready to transport the team and all the portable equipment and supplies required to run the week-long dental clinic. Upon arriving at the dental clinic – a retrofit shipping container – the team set about preparing to see patients.
 
The remoteness of this location deep within the Australian interior makes it almost impossible for the residents to access dental care. However, the distance travelled has no bearing on the quality of service provided. Curious children and adults start peering into the clinic to see the dental clinic open for the first time in over a year; a sign of how enthusiastically the team’s visit was embraced within the community.
 
Preparations continued, setting up processes for identifying and managing patients with complex needs. Chronic kidney disease, liver cirrhosis and rheumatic heart disease, all conditions with dramatic impact on and consequences for oral health, are a common part of life here.
 
The RFDS Remote Oral Health Program has been designed with a prevention focus. The strong link between oral disease such as gum disease and general health and the disadvantage of remoteness and isolation drives the service. Mainstream formulation of health care services often places oral health as being separate to the rest of the body. A goal for the RFDS is to bridge the divide and place oral health within the integrated model of care for the body as a whole.
 
In the first two trips to Kintore the team carried out over 120 appointments. The health centre staff provided introductions to the aged care facility and childcare centre. Armed with capabilities of portable chair, hand pieces and suction, the team move around the community and delivered the message of prevention into the community.
 
An early goal is to build trust with the community, which experiences services that arrive and deliver with the best intentions but are unable to provide continuity of care. This is the sobering reality which grounds the RFDS Remote Oral Health Program and puts each patient and community member at the centre of the RFDS approach of taking the finest care to the furthest corner.