Senior Tongan dentist Dr. Susitina Piukala spends a month on a dental education attachment in Ballarat, Australia

November 8th to December 4th2015

We were able to put together an interesting blend of professional clinical work, discussions with experts in a wide variety of dental subjects whilst combining this with an enjoyable social program

Dr Susitina Piukala is a Senior Dental Officer in the Kingdom of Tonga and her surgeon husband SaiaPiukala is the Tongan Minister of Health and a Member of Parliament

As Susi does not have registration with the Australian Dental Board she is not permitted to carry out clinical treatment on patients in Australia. However she was able to closely assist in many clinical operations, observe a wide range of dental procedures and do hands on technical dental prosthetic work. In addition many important contacts were made offering opportunities for sustainable projects in the future

Here is a brief summary of the wide range of activities we fitted into the four weeks

Professional Clinical sessions

  • Observing and assisting in clinical work at Ballarat Dental Group such as crown preps. with the latest in Digital Intra – Oral Scanning scanning techniques following crown lengthening periodontal surgery ,
  • aesthetic Porcelain Veneers with preparations ,impressions & temporaries. using a Diagnostic Wax-up technique,
  • placement of implant fixtures and Soft tissue Laser Surgery,
  • Observed clinically diagnosed cases Oral Medicine cases of Bisphosphonate induced Osteonecrosis of the Jaws (ONJ) and a fairly advanced cancer of the tongue,
  • latest fillings, new materials and clinical techniques in general dentistry
  • Lunch and Learn with GC rep. on the latest dental products from GC Japan
  • Physics style forceps use for atraumatic extractions
  • Hands-on work with Dental Prosthetist Bill Davies at his Ballarat Lab. covering a wide variety of dental prosthetic techniques and construction of appliances such as – setting up of denture teeth and injection moulding processing, construction of occlusal splints, mouthguards, special trays, bite rims, removable orthodontic appliances, duplicating techniques etc. Our PHF Bill Davies has a Tongan dental technician TalihouiLatu as a full time employee
  • Several clinical sessions with specialist Ballarat orthodontist Dr. Deborah Sykes coupled with instruction on placement of Braces and Arch Wires - Given samples to try out in Tonga. Deborah has offered to go to Tonga next trip as follow-up.
  • Sleep Disorders Interest meeting SJoG

Discussions and Contacts

  • Conducted Tour of St John of God (SJoG) Ballarat Hospital by International Project Co-ordinator John MacDonald with 4 Tongan staff as part of the SJoG/Vaiola twinning program
  • Tour of Ballarat Health Services new 20 chair State of the Art Public combined dental clinic and LaTrobe University dentist training centre.with BHS dental manager Jackie Nolan and discussions with Jo their nurse trainer. Also returned to spend time observing.
  • Visit to view work in progress on a Rotary Club of Ballarat West custom built Dental Prosthetics container Lab project.(RAWCS 43/2014-15)
  • Met with PHF Peter Copp who gave advice on present and future equipment repair /service options for Tonga and with also dental equipment engineer CaleZiola (who together with Peter Copp helped to train the current Tongan dental equipment engineer Uho Manu)
  • Dr. Cliff Trotman Lake Imaging Radiologist & Dentist – Cone Beam / OPG seminar + discussion on how to go Digital for Tonga OPGs (may need new machine?)
  • Melbourne Dental school; Prof. David Manton, Prof. Michael McCullough. DM excellent resource and advisor- ideas discussed included. Teleconference for islands/specialist help, Fuji VII sealants and F’ Varnish – has studies, Post Grad training (selection in April but hard to get in),can access supplies for donation, text books (gave 5 all new incl. Pathways of the Pulp for Susi), Pedo Association internet, Funding available for Conferences such as IADR (International Association for Dental Research) + APDC (Asia Pacific Dental Conference next Hong Kong June 2016) , can offer funding options and advice on how to access them.. Contact for RMIT training courses available
  • Discussions with Julie Taylor for BDG to check on dental materials and consumables supplies quotes for Tonga
  • Met with Dental Prosthetist Colin MacKay and visit to the Rotary container Pros Lab. – Colin does volunteer work in Vava'u
  • Dental Prosthetic donations including a large supply of denture teeth from Ultimate Dental

Social

  • Rotary Club Meeting Ballarat West
  • SJoG welcome and Morning tea in Bailey’s Building (the restored C19 original hospital building) and a farewell dinner for Tongans returning home at the conclusion of their twinning visit
  • Orientation tour of Ballarat including the prestigious Archibald Portrait Exhibition at the Ballarat Fine Art Gallery
  • BBQ at DG home in Mt Helen with John MacDonald,17 and Tongans Seini, Tali & a Tongan nurse
  • Sovereign Hill day visit and evening Blood on the Southern Cross sound and light show (Lake Imaging voucher)
  • Melbourne weekend visit with Tongan Radiologist Seini;- Visited Fed. Sq. Arts Centre, State Library, Melbourne Central, Emporium, Alleyways, Eau De Vie, Asian Noodle Night Markets and stayed overnight - Sunday; Queen Victoria market, Shrine of Remembrance, St Kilda, Luna Park, Acklandst, Meal at Gazi, modern Greek food
  • Tongan food and hospitality from Tongan dental prosthetistTaliLatu in Ballarat

Some Follow up options as a result of this attachment

  • Equipment repair & maintenance training (a 3 month Australian attachment of a Tongan BioMed engineer in Ballarat in 2016)
  • Setting up a pilot orthodontic program in Tonga
  • Liaison with Melbourne University Dental School and Tonga on a wide range of issues – education/support, funding for international meetings, teleconferencing, text books etc.
  • Continued targeted donations of Dental Prosthetic materials and other equipment and supplies
  • Equipment needs for Tonga (e.g. the islands of Nomuka and Ha’afeva)
  • Advice from Lake Imaging on the possibility of a digital OPG option for the Tonga dental department
  • Liaison with BDG on dental consumablesprices and supplier options to help reduce the dental budget in Tonga
  • Continuation of the RAWCS Tonga Project – RC Ballarat West / Vaiola Hospital dental services
  • Options and availability for future Australian – Tongan education attachments

David Goldsmith

Ballarat Dental Group / Rotary Club of Ballarat West