Oral health is a crucial part of childhood healthcare, no matter which country you’re born in. In Timor-Leste, however, access to a toothbrush – let alone a dentist – can be limited or non-existent. As a result, oral health can become a challenge to overall childhood health and wellbeing, with untreated decay and preventable pain developing into potential long-term consequences.
At Maluk Timor, protecting the oral health of Timorese children is one of our key priorities. Through a combination of outreach, education, and direct healthcare support, we’re working to build a new foundation for Timorese children’s oral health.
A widespread – but preventable – problem
A 2019 study reported that the oral health for children in Timor-Leste was deteriorating, rather than improving. With 40% of school-aged children experiencing toothaches in 2014, the easy access of many Timorese children to sugar, coupled with poor food security and lack of water fluoridation, all contributed to the increased risk of dental issues.
These environmental problems are only made more difficult by the limited access to trained oral health professionals. Demand still far outstrips capacity, even with increasing progress in the number of registered dentists and dental nurses since Timor-Leste’s independence. This is particularly the case in rural and remote areas, where geographical challenges can keep entire communities from having easy access to all forms of medical care.
While the odds may seem against us, we’re driven by the knowledge that childhood dental issues are entirely preventable. That’s why our approach is grounded in prevention first, with a range of initiatives designed to stop decay before it begins.
Preventing cavities with Silver Diamine Fluoride
One of the most powerful preventative tools we have at our disposal is Silver Diamine Fluoride (SDF). This treatment can stop cavity-causing bacteria in its tracks, as well as preventing existing cavities from getting worse, or from spreading to other teeth. In 2023, we treated over 1,000 children with SDF with this painless treatment method. By 2024, these numbers had increased again, with Maluk Timor’s team reaching 4,012 children and adults (including in remote areas like Atauro island), strategically expanding access to preventative care.
Building skills through competency-based training
As dental nurses are the main providers of dental healthcare in Timor-Leste, any development of their skills and knowledge leads to direct benefits for local communities and children. With limited professional development opportunities, however, they can face increasing pressures on their abilities to provide sustainable care.
Maluk Timor is helping to address these skills shortages through the development of targeted competency-based training modules. These national training models(SDF – Utilizasaun Silver Diamine Fluoride hodi Hapara no Prevene Karie Dental and Atraumatic Restorative Treatment & Fissure Sealant)are aligned with national standards before being translated into Tetun Dili. Delivered in partnership with the National Institute of Public Health Timor-Leste (INSP-TL), these modules ensure that dentists and dental nurses alike receive up-to-date, high-quality training. As of 2024, 23 dental professionals have been trained in SDF application across four municipalities.
Supporting clinical services and ongoing knowledge-sharing
At Maluk Timor, we’re firm believers in the power of collaboration. We provide crucial support to the clinical services delivered by our partners at Ryder-Cheshire Klibur Domin. We also work in active partnership with other NGO clinics, receiving dental consumables and equipment from Australia and other countries.
By equipping our partners with crucial tools and knowledge, we’re able to expand our impact beyond our own team and resources, making it more efficient and accessible for clinics to deliver essential childhood oral healthcare services.
Promoting oral health through public education
As in many other countries, public health education is at the forefront of prevention. This is what led us to launch our first oral health social media campaign in 2022, using creative engagement strategies (such as tooth brushing video demonstrations) to build community awareness.
This campaign received participation across Timor-Leste, and even reached Portugal and Brazil. With a focus on World Oral Health Day, this was an easy way for us to demonstrate the power of tooth brushing through an attractive, engaging campaign.
Developing national treatment guidelines
Our team is actively developing and implementing national guidelines for childhood oral healthcare throughout Timor-Leste. These guidelines are essential tools in the ongoing standardisation of care, serving to improve service quality and support healthcare professionals in making informed decisions about treatment for Timorese children.
Our collaborative efforts involve partnerships with the Ministry of Health, Ministry of Education, the National Institute of Public Health (INSP-TL), the Klibur Domin Foundation, and the Dental Association of Timor-Leste (ADETIL). Our continued work together means we’re each able to take a unified, sustainable approach to improving oral health across the country.
This strategic work couldn’t be achieved without our oral health team, including:
- Flaviana da Silva – Program Manager, Oral Health, who’s responsible for leading strategy, coordination, and integration of oral health into broader health initiatives
- Jenifer Apriana Martins Ximenes – Deputy Program Manager and Dentist, responsible for providing clinical leadership and overseeing professional development
- Efigenia Pereira dos Santos – Dental nurse, responsible for delivering frontline care and supporting the training of other dental nurses
With national training modules for dental care, the training of 23 dental professionals in the application of SDF, and 30 schools reached with oral health education for children and parents, we’ve been able to achieve national recognition of SDF as a formal component of school health activities.
Conclusion
While we have a long way to go when it comes to protecting children’s oral health in Timor-Leste, we continue to make significant progress every day. At Maluk Timor, we’re working in collaboration to deliver healthcare that makes meaningful differences in the health and wellbeing of Timor-Leste’s vulnerable children. Find out how you can join us in this powerful work and put a smile on the face of Timorese children for years to come.