Improvement of Visiting Dental Care System in Dental-Medically Underserved Islands

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Toshima Village consists of seven isolated islands located on southwest sea of Japan and it is also dental-medically underserved area. The residents are inconvenienced to receive sufficient dental service since it takes more than 8 hours by ship to visit the closest dental clinic. Additionally, aging of residents makes it more difficult for them to go out islands and see a dentist. Therefore, they expect a visiting dental care that is performed two times a year. However, most of prosthodontic treatments in previous cares have resulted in temporary and interim ones because dental staff could not stay at one island for more than 2 days, and instruments and materials were insufficient to do conventional treatments. In this study, some new prosthodontic treatment methods were developed and evaluated clinically to improve the quality of visiting dental care and enhance the longevity of restorations. The methods evaluated were as follows: 1. Reinforcing systems, ready-made clasps and adhesive repair resins for repairing removable denture. 2. Air-particle abrasion with cartridge-type and portable sandblaster. 3. Surface treatment of abutment tooth with metal-core to enhance retention of replaced crown. 4. Dentin coating with new bonding resin. 5. Metal-free restorations using new indirect composites. 6. Resin-bonded fixed partial denture using composite denture teeth pontic. 7. Safety and functional transportation of instruments for treatment. Based upon the results, it was found that these methods were effective for visiting dental care in dental-medically underserved islands. It was also suggested that these methods and materials could be available for visiting dental care in urban area.