Perched at 3000m, in the shadow of the Annapurna mountain range, the Humde Dental Clinic provides much needed dental care to the entire Manang District of Nepal, from Chame to Kangsar. Originally funded by Rotary and the Snow Leopard Foundation, the clinic is hosted by the local Tibetan school and managed by the Manang Youth Society. Prior to the clinic's opening, residents had to walk six days to the nearest road before boarding a crowded bus to the dentist another three hours away.
The region experiences two types of dental problems that are generally stratified by age. Periodontitis (gum disease) is the greatest problem for the adults in the area. Their diet is primarily rice and grains, so they do not develop many cavities. However, without regular cleaning by a dentist, they accumulate heavy tartar build-up and consequently suffer from gum disease. It is common to see young adults in their 20s or 30s with no cavities, but several mobile teeth with associated gum infections. Children, however, suffer from decay due to the introduction of sugar from the advent of tourism in the area. Unfortunately, the majority of cases involving all patients in the area are due to pain. Traditionally, preventative dentistry has not been a part of their way of life. So long as there is no pain, residents typically do not seek treatment. Unfortunately, premature tooth loss often results when pain, rather than prevention, finally motivates a patient's visit to the dental clinic.
Dental care is improving with the introduction of the resident Oral Health Worker, Karma Buti. A local graduate of the high school in Manang, Karma has been working at the Humde Dental Clinic since it opened in 2004. In addition to the instruction and guidance Karma has received from various visiting dentists, she has further enhanced her skills with training in Kathmandu during the winter. She is adept at performing simple dental extractions, thereby providing immense relief to numerous patients. She also has basic knowledge and skill at providing deep cleaning (scaling), and placing simple fillings.
Wisdomtooth's ongoing work at the Humde Dental Clinic remains focused on two substantial goals: to expand the present proactive prevention program, and to improve Karma's clinical skills. The clinic's proximity to a Tibetan school has facilitated excellent oral hygiene, instruction, and care in the local student population. We would like to expand this level of prevention to all area schools. In addition, Karma would like more mentoring in providing fillings. While she has training in Atraumatic Restorative Treatment (ART), Karma still feels hesitant placing fillings confidently. Additionally, the clinic has a dental unit (drills, generator, and compressor) to prepare teeth for definitive (amalgam and composite) fillings. With the addition of a 220V amalgamator or curing light, she could be trained to place more definitive restorations. In short, additional hands-on instruction from visiting dental professionals would support the clinic and Karma in providing essential services to the local people.
As you see, there has been great progress, investment, and hard work to improve the oral health of the people in the region. However, there is still significant opportunity to develop new programs and clinical skills. We invite you to come share your expertise with the hearty people of this high Himalayan region. Your effort and skill are essential to building an on-going sustainable program to improve the dental health throughout the Manang region.
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Isolated in the Indus River Valley, high on the Tibetan plateau, Leh serves as the capital of Ladakh, India. Originally from Mongolia, Ladakhis settled the valley over a thousand years ago, farming barley in the marginally fertile soil. Here lies the Lamdon School. Founded in 1973 by the locally created and administered Lamdon Social Welfare Society, the school has grown from its original seven students and one teacher to a local enrollment of 1200 with an additional 800 students in 10 remote sites. The school consistently produces highly educated students, many of which are full time boarders, coming from poor families on full scholarships, and places a strong emphasis on maintaining local Ladakhi and Buddhist culture. 
