Exeley Inc.

Zhang, Jia-Nan

Chen, Si

Zhong, Chong

Yu, Feng-Yang

Lu, Hai-Ping

Retreatment of a skeletal Class II postpubescent patient with a convex facial profile and temporomandibular disorders

Wishney, Morgan

Darendeliler, M. Ali

Dalci, Oyku

Craniofacial growth studies in orthodontic research &ndash; lessons, considerations and controversies

Studer, Vera

Koletsi, Despina

Iliadi, Anna

Eliades, Theodore

The effect of headgear treatment on the development of obstructive sleep apnoea. A systematic review

Meredith, Lydia

Mei, Li

Cannon, Richard D.

Farella, Mauro

Interproximal reduction in orthodontics: why, where, how much to remove?

Bavbek, Nehir Canigur

Tuncer, Burcu Balos

Tuncer, Cumhur

Gungor, Kahraman

Ozkan, Cigdem

Arslan, Emre

Altinova, Alev Eroglu

Akturk, Mujde

Toruner, Fusun Balos

Cephalometric assessment of soft tissue morphology of patients with acromegaly

Bonic, Anita

Poon, Mack

Woods, Michael G.

Trounson, Alan O.

Expression of neural crest markers by human embryonic stem cells: an introductory project

Dreyer, Craig

Count the cost

Literature reviews

Australasian Orthodontic Journal Volume 33 No. 2  November 2017 149
Editorial
A lucky country
Recently, a group of orthodontic postgraduate students 
from the University of Adelaide visited Timor-Leste to 
learn from and help in the management of patients suf-
fering cleft lip and/or palate. For many years, teams of 
plastic surgeons have been visiting the country to per-
form surgical repair of the lip to make affected children 
aesthetically presentable. Due to the lack of dental and 
orthodontic services, further treatment has not been 
possible and the cleft patients have been left to endure 
their physical and psychological disability.
Timor-Leste is a third world country on Australia’s 
doorstep. A little over an hour’s flight from Darwin 
lands passengers in Dili, where the obligatory entry tax 
was applied and airport screening detected the smuggled 
dental materials in our checked-in luggage. Taxi drivers 
vied for our fare. The traffic was horrendous as we were 
taken to the ‘clinic’ at the bottom of a ramshackle, 
unpaved street that nearly ripped the bottom out of 
the car. The dilapidated road system, lax road rules 
and helmetless motorcycle and scooter riders made 
travelling a risky business.
The clinic was rudimentary, containing one operatory 
fitted out with donated equipment, instruments and 
materials. The dentistry practised was also rudimentary 
and largely involved the extraction of teeth, ravaged by 
caries that left black stumps for removal. Broken-down 
crowns and periapical lesions were commonplace 
and the resulting treatment left unaesthetic and 
dysfunctional spaces not conducive to orthodontic 
treatment.
The cleft management area contained one run-down 
chair and it was fortunate that headlights had been 
brought. Each day there was a power failure for two 
hours around noon, which brought most work to a 
halt except for the extraction of teeth. The cleft patients 
examined were assessed for further treatment and most 
needed additional surgical repair to graft alveolar clefts, 
close fistulae and generally repair the hard palates. A 
sixteen-year-old boy with an unrepaired hard and soft 
palate had been banned from school classes because 
his speech was so unintelligible that his teacher could 
not understand him. However, he maintained an acute 
sense of humour and could do a fantastic fist pump. 
The unrepaired hard palates in most had allowed 
maxillary expansion to continue in an unrestrained way 
so that the transverse occlusal relationships remained 
acceptable.
A forty-six-year-old cleft female had a canine 
in crossbite, which produced a mild functional 
mandibular shift. A removable appliance should do 
the job of tipping the tooth out of premature contact 
and enable the replacement of the adjacent lateral 
incisor absent because of the cleft. Other patients 
needed upper bandings to align displaced anterior 
teeth and improve aesthetics; however, the follow-up 
care needs to be considered carefully. 
Infection control in the clinic was minimal and 
occupational health and safety non-existent. There was 
no regulatory body to ensure competency and recency 
of clinical practice or to ensure that operators were 
not spreading contagion. Informed consent was just 
a nod as teeth were consigned to the bucket. Patients 
were exceedingly grateful for the services provided, as 
were the staff in the clinic, but oral health remains a 
fundamental challenge that will only improve through 
government will and intervention. 
The people are exceedingly poor and a few dollars 
goes a long way. There are no mega-supermarkets but 
recycled, corrugated iron roadside stalls selling fruit, 
vegetables and soft drink. The people are happy and 
friendly without a hint of obesity in this deeply reli-
gious country. While the locally grown and produced 
coffee is to-die-for, the hotel accommodation was 
non-descript, tired but comfortable. There was a most 
out-of-place, upper-deck bar and restaurant through 
which the cooling evening breezes blew and which 
served only one highly acceptable, international beer. 
This was a place of western respite in a city handicapped 
by its political and financial circumstances. 
The periodic orthodontic visits have been organised 
through the Australasian Begg Society of Ortho-
dontists, which has developed a roster of attendees. 
Systems and cohesive treatment plans need to be put 
in place through co-ordination and communication, 
but the establishment of a significant orthodontic 
response in Timor-Leste requires careful consideration 
when the need for basic dental and medical services 
exists.
Compare that with the lucky country to which we 
returned.
Craig Dreyer


A lucky country

Not a member yet

Retreatment of a skeletal Class II postpubescent patient with a convex facial profile and temporomandibular disorders

Craniofacial growth studies in orthodontic research – lessons, considerations and controversies

The effect of headgear treatment on the development of obstructive sleep apnoea. A systematic review

Interproximal reduction in orthodontics: why, where, how much to remove?

Cephalometric assessment of soft tissue morphology of patients with acromegaly

Expression of neural crest markers by human embryonic stem cells: an introductory project

Count the cost

Literature reviews

Literature reviews

A lucky country

4,746

6,096