Improving the Provision of the Basic Package of Oral Care (BPOC) in Cambodia

Since 1992, 330 medical nurses have been trained to provide basic oral health care (including ART restorations and dental extractions) in remote areas of Cambodia. However, a range of barriers prevent dental nurses from providing these services, especially a lack of dental materials and instruments. Objectives: To increase dental nurse (DN) outputs through the regular provision of dental materials and instruments. To improve cross-infection control procedures through the provision of necessary equipment, supplies and training. Methods: Six health centres with active DNs participated; three (experimental) health centres received sufficient supplies of dental instruments and materials for one year, and 3-monthly visits by a dentist from the Ministry of Health. The other three health centres (control) did not. Results: During the project period, the experimental group extractions increased to an average of 119 extractions per quarter (a three-fold increase compared to the baseline), 51 ART restorations, and improved compliance with cross-infection infection control protocols. In the control group the number of extractions remained similar to baseline and no ART restorations were placed. Conclusions: The provision of the BPOC increased in the health centres when sufficient supplies of dental materials and instruments were provided. Increased monitoring and communication with MOH dental colleagues was also associated with the increased outputs and resulted in improved compliance with cross-infection control protocols. The MOH should increase supplies to DNs and provide ongoing monitoring and support in order to improve the access to and quality of dental care provided in rural Cambodia.