Rural Australian dental programme is a template for success

Anisha Hall Hoppe, Dental Tribune International

Thu. 3. August 2023

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HALLS CREEK, Australia: Ensuring timely and adequate dental care for remote Aboriginal communities in the Kimberley region of Australia remains a formidable challenge. Given the low population density and the high operational costs of fixed dental practices, the establishment of permanent, full-time services is neither viable nor sustainable. According to a recent report, the Kimberley Dental Team (KDT) has proved to be a successful, evolving model of non-profit, non-government, volunteer-provided care that operates through rotating teams who spend about three months in Kimberley collectively each year, delivering dental health education and treatment.

The situation

At the creation of KDT in 2009, approximately 70% of children had acute dental infections and severe early childhood caries. The ensuing collaboration with local schools and communities sowed the seeds of the KDT model, making volunteering a recurring annual event. With a focus on Aboriginal and Torres Strait Islander people, it has evolved over a decade and consists of several components: oral health promotion initiatives, dental service delivery via mobile units, volunteer recruitment, and integration with education and organisational governance.

The oral health promotion initiative includes a school-based programme called Strong Teeth for Kimberley Kids, which aims to tackle the high cost of oral hygiene products in remote communities. Annually across the Kimberley region, the programme distributes over 20,000 oral hygiene packs containing a toothbrush and toothpaste to each child at the start of each school term. Underpinning the programme is KDT’s motto, “Strong Teeth, Strong Body, Strong Mind”, reflecting the belief in the intrinsic connection between oral health and overall well-being. KDT complements its supervised toothbrushing programme with annual dental check-ups and promotes participation and enthusiasm among children using a mascot, Craig the Croc.

Besides the remote location, the Kimberley region’s geography and extreme monsoon climate further exacerbate healthcare accessibility. Torrential rains and flooding often cut off transport routes, isolating remote communities for extended periods.

Bringing in help

KDT began a collaboration with the University of Western Australia to offer supervised outreach placements for final-year dental students interested in remote and Indigenous oral healthcare provision. The integration of education and service helps students gain valuable exposure while being supported by an experienced team of clinicians and volunteers. Past participants have found the experience to be invaluable and inspiring. The programme also led to the creation of the role of oral health promotion officer, who engages with local teachers and nurses to support and evaluate the running of the programme in KDT’s absence.

Clear organisation

To service the vast Halls Creek district efficiently, a hub-and-spoke model was implemented, establishing a hub in Halls Creek offering full services and acting as a home base for volunteers and stock. This hub is complemented by secondary establishments (spokes) that enable day or overnight trips to remote communities, often using mobile dental units.

Critical to KDT’s sustainability and growth is its organisational governance and evaluation. A strategic plan was developed in 2012 after consultation with key stakeholders, and a steering committee of community members, volunteers and representatives of partner organisations was formed. KDT’s governance includes a board of directors established to support access to government grants and corporate sponsorships, increase Aboriginal input, improve health and safety policies, and support financial administration tasks, marketing, communication and IT systems.

Integration with existing Aboriginal community-controlled health services is a key aspect of the KDT model. This allows culturally secure care and fosters shared learning, facilitating the successful delivery of dental services to remote Aboriginal communities. Collaborating with these community-run services can overcome many hurdles associated with remote healthcare delivery and offers integrated multidisciplinary care, promoting a collaborative health service and a comprehensive disease prevention approach.

Ensuring success

Evaluating dental outcomes in remote communities is challenging owing to variables like socio-economic status; however, positive qualitative community feedback and a ten-year audit showing a reduction in emergency dental extractions validate the model’s success. Over the past decade, the KDT model has evolved from primarily providing emergency surgical treatment to one offering preventive and restorative treatment, centring on community engagement and integrated, collaborative care. The model showcases the importance of tailored, community-centric healthcare solutions in addressing unique, geographical challenges to care provision.

The report, titled “The Kimberley Dental Team: A volunteer-based model of care serving remote Aboriginal communities”, was published on 7 July 2023 in Rural and Remote Health.