21 July 2017
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My Dental Elective in Tonga

My Dental Elective in Tonga


Salma Daou is a Final Year student at Dundee School of Dentistry

Armed with 8 weeks off and a carte blanche to choose whichever countries we desired, we set off to plan our summer of a lifetime. Initially we decided which disciplines of dentistry we would most like to gain experience in, and what we would like to have achieved by the end of our elective. Next we matched these dental goals to the vast amount of countries and charities there were to choose from. As a result we found ourselves in London, New Zealand, Tonga, Nepal and Thailand. Each placement we carried out proved to be very different from the next, however all proved to be extremely beneficial to us.

In this article I have chosen to discuss our time in Tonga, as we were one of the first UK students to visit the dental clinic and I would love to make people aware of this fantastic opportunity.

Tonga is a Polynesian kingdom made up of a large group of islands and is situated near Fiji and Samoa in the South Pacific Ocean. To reach Tonga we travelled to Auckland, New Zealand and from here it was only a short flight away.  However in the space of this short flight we managed to change seasons from winter to summer and go from a metropolitan city to a minute rural island! Arriving into Tonga we were filled with excitement and anticipation, we spent our first day exploring the main island and where quick to realise it would only take a 30 minute drive (at the speed limit of 40km/hour) to cross the length of it. Tongatapu is unlike any other place I have visited before, there are very few shops, restaurants and imported goods. The atmosphere on the whole island is incredible, everyone is quick to greet you and they all have the most positive attitude.

We were working at Viola Hospital which is run by the Tongan Ministry of Health. The hospital was recently moved to a new building donated by the Japanese government, therefore the dental clinics were equipped with ten new dental units and an LDU. All treatment that patients received was free of charge, but mostly compromised of acute emergency treatments. Although the clinic was modern and well run it lacked instruments and materials necessary to carry out any complex treatment. The choice of restorative material was dictated by whatever was donated by visiting dentists and students at the time. The staff were very accommodating and helpful, I could not thank them enough for giving up their units and patients to supervise and translate for us all day.

Our days on the clinic typically consisted of examining around 20 patients each, out of which approximately 50% where extraction cases, and then rest simple restorations, first stage endodontics and referrals. I was glad to have practice in cutting access cavities and finding canal orifices. We mainly aimed to get as much oral surgery experience as possible and we were lucky to be able to carry out so many extractions and be given the opportunity to use numerous surgical instruments; we completed almost triple the number of extractions we have done over two years at Dundee.

Tonga is currently holding the title of largest BMI in the world,  therefore it is safe to say the people are generally of a larger build. This made it interesting to compare the anatomy and morphology of the teeth to those we have been treating in the last 2 years. . In hindsight we would have liked to carry out a comparison and measured all the teeth we extracted (an idea for the students going out next summer!)

Aside from our time spent at Viola Hospital we were given the opportunity to join the MaliMali outreach program in which dental therapists visit various schools on the island and deliver oral hygiene instructions and fluoride mouth wash. The children were so enthusiastic and welcoming, running out to the school grounds when they spotted our car  and began lining up with their toothbrushes in hand! Following the introduction of this program in 2007, Tongans have seen a large improvement in the dmft index. In addition to the MaliMali porgram we were able to accompany the consultant maxiollofacial surgeon in theatre. Here we were observed several surgeries being preformed under general anaesthetic, such as intermaxillary fixation, child extractions and a biopsy of a carcinoma.

The staff at the hospital were kind enough to show us around the island and invite us into their homes. They even planned a lovely evening of Tongan feasting and dancing at one of the local resorts. We were informed that if we had stayed longer than the two weeks we originally planned we would have been able to visit the smaller outer islands, as there were only dental therapists working on the islands and they are in desperate need of dentists The island and its people are absolutely gorgeous and I would highly recommend any dental student planning their elective to visit Tonga. No t only will you gain invaluable dental experience but seeing such a different corner of the world is a great opportunity in itself.


A big Thank You to Salma for sharing her adventure with us – we hope it will inspire dental students to go abroad for their Elective, which is arguably one of the best parts of being a Dental Student! We urge students to seize the opportunity while they have it, and hopefully more students will be going to the dental clinic in Tonga after reading Salma’s article! The experience she gained was invaluable and we’re sure the memories will live on throughout her practicing career. – The TeethGeek Team