An Interesting Excerpt from the Hard Daily Routine of a Dental Team - Dr. de Teilez
Geschrieben von Dr. Birgit de Teilez -Veröff. Franka Selz
Montag, 9. Januar 2012
A Summary by Dr. Teilez of the Trip with DWLF in Mongolia, Erdenesant, Aug 16-Sep 4, 2011
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Observation period: 20 days
Location: Erdenesant (Small town, 250km SW of Ulaanbaator)
Population: Town dwellers with nomadic background; compared to European standard of living, very poor. Diet still predominantly nomadic: airag, yoghurt, milk (horse, goat, sheep, cow, yak), butter, unseasoned cheese, dried yoghurt; meat; white flour products in the form of dough pockets of all kinds, rice; small amounts of cabbage, carrots, very small amounts of other vegetables, practically no FRUIT; water, vodka, and ever and again meat of goat, sheep, cow, yak and horse; sweets are luxuries and are favorite gifts.
Clientele per handler (there were two of us): 185 patients, ca. 120 extractions, 150 fillings, 10 tartar removals, ca. 5 primarily healthy sets of teeth (here I would like to postulate that in the countryside of Mongolia nobody seeks out a dentist ONLY to have his teeth looked at).
Prophylaxis and fluoridation can probably be excluded; basic oral care does seem to be generally practiced, for I found toothbrushes stuck under the roofs of the yurts of even very poor nomads, apparently one for each person. . .
Things for Work:
Coffer dam along with staples and forceps / tweezers Amalgam in capsules (mortar and pestle, in case the mixing machine is missing or inoperative)
FINE tweezers and elevators (there is enough of the standard instruments)
Diamond- and rose-tip drills
Materials for capping and dentin replacement
Matrix system (steel)
Suction tubes, Ubestisin
Tupperware containers (or good boxes) for organizing and keeping materials together
A LOT OF SWABS AND COTTON ROLLS (for treatment without facilities for suction and rinsing)
Your own supply of gloves and hand disinfectant
Laminated notes with pictograms and directions in Cyrillic script for post-extraction care or taking medicines, to show patients (important, otherwise the attempt to communicate in gestures results in burlesque comedy--entertaining, but time-consuming and imprecise)
I would recommend establishing only one system of artificial materials at each site, since the current random nature of donations leads to a tremendous squandering of materials.
Dental prosthetics:
From expired (or nearly expired) artificial materials that I found and brought with me, I fashioned prosthetic teeth at home in my practice, using simple forms.
I will take these with me on my next mission.
The patients often come with the simplest, worn down clamp-on prosthetics, which could be repaired with simple resources.
The sterilizer could also be used as a pressure cooker for the prosthetics; with a little manual dexterity, simple repairs could be performed and the methods passed along to the Mongolian dentists.
Collaboration between Mongolian and German dentists
At our mission site there were definitely too many dentists in a tight space.
1. One young dentist, who was supposed to be learning the ropes. That was OK, and the young woman was very open-minded, if a bit anxious and easily overwhelmed.
2. A young Mongolian dentist with experience in treatments; at first, a difficult relationship, as our views on hygiene are diametrically opposed.
3. A Mongolian dentist, who had come to us after a week to learn from us. We were not asked whether this might be too much; additionally, the lady was rather uncooperative and regarded her stay more as a compulsory exercise.
Basically summarizing:
We (two dentists, one student, three assistants) traveled to Mongolia with the goal of treating as many patients as possible among the population of the countryside. We looked forward to our mission and started off at full strength (thanks to our group leader and a 1000-volt town); we let ourselves in for everything (mutton, vodka, airag, yoghurt, fleas, outhouse, water shortage, working conditions, nepotism).
It demanded all our power and strength. Where we distinctly had no power, and something that needs improvement, was in communicating finer details and complex ideas with the dentists assigned to us. This language barrier is a significant problem, and one interpreter would simply not have been enough, divided as we were among three treatment rooms.
Our time there will remain with us unforgettably, and we will definitely travel somewhere again. It would be nice, however, to formulate the expedition goal better beforehand: treat the rural populace, educate dentists, or both . . .
Erfahrungsberichte 
