1. The kingdom of Tonga Presenter Sione Halahala Sitaniselao Kisina

2. Introduction Tonga is the only remaining kingdom in the South Pacific It consist of 150 small islands, which are scattered between 15 and 23 degrees south latitude and 173 and 177 degrees west longitude Tonga is divided into 3 main island group namely, Tongatapu, Vavau, and Haapai

3. The total area of the group is 748sq km (269 square miles) Tonga consist of 150 islands which are volcanic and coral Only 36 islands are inhabited Population is just above 100,000 The native people of the groups are Polynesians with our own native tongue (Tongan)

4. Tongan group

6. Organizational structure Minister of Health Director of Health Chief Dental Officer Pharmacological Division Dental Officer Dental Division Medical Division Laboratory Technical Division Nursing Division Public Health Division Preventive Health Planning Division Acting Director of Health ●Vaiola Hospital (Tongatapu) ● Prince Wellington Ngu Hospital (Vava’u) ● Niu’ui Hospital (Ha’apai- SDTh ] ● Niu’eiki Hospital (‘Eua-DTh] ● Likamonu Hospital- NTT-DTh ● Tu’akifalelei Hospital (Niuafo’ou- DTh] Ministry of Health of Kingdom of Tonga

7. Staff There are 7 Dentist and 1 volunteer dentist (JICA) with a dentist to population ratio of about 1:14,000. 11 dental therapist and 6 therapist trainee The population to working dental personnel is about 1:4000 We also have a sterilizing officer and 2 receptionist.

8. Disease prevalence Dental caries and periodontal disease are the 2 major dental disease that affects the group With changing lifestyle and diet Tonga has a very high caries rate dmft is about 4 -1986 There has been no national survey to confirm the dmft of 6yr old children, but records shows a very high caries rate

10. 407 students in class 1 in all Vava’u Primary schools, 2007 Average age: 5y 7m-Dr Fujise 5% Only 20 students 95% Healthy teeth Decayed teeth Prevalence rate of dental caries: 95%

11. An example case in the theater at the Hospital 5 years-old girl lost 12/20 teeth because of sever tooth decays and pain She has no pain anymore but it will take many years to get next new adult teeth after that operation

12. 20072006200520042003 No of pts seen3524733735387595153847180 No of teeth removed2203220456198152560736719 caries1569013738141401619420956 Perio544352224905367515763 Others899 Extract from Ministry of Health Annual Report 2007

14. Job description We provide general dental services and oral surgery as the only specialized field. In our preventive service we provide fluoride rinsing, fissure sealant of 1 st perm molar and tooth brushing. This fluoride rinsing is funded by the South Pacific Medical Team in Japan This aid had also provided 3 vehicles to carry out the fluoride rinsing to all the schools in the 3 major island groups

16. There is also a caravan in the main island that provides fissure sealants of 1 st permanent molars of students of about 6 years of age

17. Plan The department us fully committed to the fluoride rinsing program and is planning to set funds for this program as this is the only way to combat this disaster We are also liaising with the Ministry of education to include oral health in the school curricullum To educate people about the importance of oral health

18. Shortcoming As always with third world countries there is always the shortage of funds There is also shortage of manpower There is also the concern about lifestyle diseases and peoples awareness of their oral health

19. Malo aupito