GREAT DAY!!  TODAY WAS ALL ABOUT PREVENTIVE DENTISTRY!  We were asked by the schools to come up with a program to teach the kids.  SO, we implemented what we do in Twin Falls, but we customized it to fit the age group that we were talking to (age 11 and 12 year olds).  Once the principle of this school saw our program, she wants us to come back for the whole school.  We were excited!  We dressed the kids up as teeth, used our beach towels as the gums, made a "redneck" toothbrush with a small broom and stick, and used some rope for floss.  We did a 40 minute presentation and Dr. Johns and his wife did a power point presentation that was fantastic.  Below are some more pictures of what we did.  We did programs for two schools today.  Since we got here, we are now going to implement preventive care programs to schools every Thursday.  This is what Tonga needs.  They need EDUCATION about oral hygiene and diet.  I can't help but feel this is a large part of why we are here.  To help implement this program to these kids.  I feel we are helping stop this multigenerational cycle of dental decay that is happening here in Tonga.  If we can help even a few kids understand and make changes, I feel we've done our part.  Hopefully, it's a lot more than that.  We are trying to "make a difference for the one."  

This group of kids were so great!  We had a TON of fun with them.  They don't have access to really any Dental Care on the island other than our clinic or the hospital (which only does emergency care). They don't understand oral hygiene and the diet component of overall health.  After today, our hope is that they realize what they have to do to maintain their beautiful smile and overall health.  They may have thought that we were crazy Americans, but we had a good time educating and spending time with them.

Have a good time with the kids!  

These are kids at a different Middle School that were ready to come into the clinic for Dental Screenings.  We did a similar program, but had them come into the clinic and showed each one of them how to brush & floss, educated them on oral hygiene and diet, and did Dental Screenings.  We saw quite a few kids and the Dental work that needs to be done will keep us busy for a long time.  

Fun kids!  It's not very often that they see white people.  They think we're a little strange.  Probably right.  :)  These guys were a very polite and kind group of kids.  The type of patients that you love.

These were our Dental Hygiene specialty team that helped educate the students on their oral hygiene. They did a fantastic job!  They used the EDGE model with the hygiene instruction.  Explain, Demonstrate, Guide, and Enable (Principle from the Boy Scout Program - it does come in handy in life :)).  It was very effective and the kids also did "Tell, Show, Do" with all of them.  How to brush, how to floss, how long, how often, what diet they should be having (good foods, bad foods, etc.), and had the kids tell and show us what they learned.   Good life lessons for our kids to learn as well.  Maddison said it was a little strange teaching kids that were older than her, but I think it's great that she has the learning opportunity to teach others.  The other kids were helping on the clinical side doing the screenings.  They did great and helped a ton with Dr. Johns and myself.

We see a lot of these situations.  The tooth on the upper left corner (where you see the whole tooth).  If you look at the center of the tooth, you will see a black shadow coming from the top of the crown of the tooth.  What's happening is clinically, the enamel looks completely healthy.  We don't see decay anywhere, but you take an x-ray like this and it shows there is decay (cavity) going into the nerve of the tooth.  This is why we have to screen these kids.  We want to try to catch things before they turn into larger problems.  We don't see this condition in the United States.  We're trying to figure out why this is.  They have a lot of mineral in their water here, and that might be a part of it, but it's a little strange.  The decay penetrates microscopically into the grooves and pits and causes large lesions.  Very interesting!  After the screenings today, we have our work cut out for us.

This is a 12 year old young man that doesn't know what happened with this tooth, but will have to have it extracted.  We have to figure out what to do long term.  I'm learning to make "makeshift" partial dentures to take the place of missing teeth.  I haven't done anything like that since Dental school.  Usually, I send off an impression to the lab and they make it for me.  HERE, we are the LAB.  We don't have any other option.  We are so spoiled in America.  Holy Cow!

Some fun right before dinner.  We went out and played some football, climbed on the basketball hoop, and played "500" with a group of Tongan young men that really wanted to play some football with us.  As we were passing the ball around, a group of young men gathered close to us and were watching us.  I asked if they wanted to play and they jumped at the chance.  It turned into a game of "500" (a fun game throwing the football).  We had a blast with them.  We had dinner with the kids, played some games, and then I went to the temple and did a session.    It was a great night.

Playing a game of "500".  The young men were really getting into it.  You have to watch out for them, they're really strong.  AND, they play barefoot.  A lot of the Tongan kids just run around barefoot wherever they go.  Tough people!

BUSY, BUSY, BUSY!!!!  Holy cow, today was busy!  We saw a ton of people (it felt like).  We put in another 10 hour day.  The kids are working in shifts, and it's working out well.  The kids get pretty tired after about 4-5 hours working in the clinic.  In their down time, they are practicing their violin and they have to do some homework for school over the summer.  The rest of their free time is spent playing outside (soccer, throwing the football, or going for walks).  They have been really good help in the clinic and their picking up on all the interworking of a Dental Clinic.  Logan, Makayla, and Maddison are all doing very great.  Maddison seems to be taking the most interest in things.  They've all seen some interesting cases come through the clinic.  What's crazy about the Tongan people is they have hard rock enamel on most of the their teeth, but inside their teeth, they are "bombed" out.  Meaning that the enamel is intact, but when you look at the x-ray, the whole inside is decayed.  It's the strangest thing.  We have a number of young kids that are coming in that have unrestorable teeth that we have to take out.  I had one girl today (about 15 years old) that came in that said she has been crying every night for the last couple of months or so because she has a tooth that has been hurting her.  I asked her how she's been dealing with it and she said that she cries for a little bit and then is able to get a few hours of sleep before it starts to throb again.  I got her numb, went and saw another patient, when I came back, she was asleep.  Poor girl.  I'm hoping she has some good rest tonight!  :)

This is Elder (Dr.) and Sister Johns.  They are some of the greatest people this planet has ever had!  They work their tails off to serve these people.  They are serving a 2 year mission in this clinic.  Both of them have to deal with so much every day in the clinic.  There are constant struggles with equipment, supplies, people to help, etc.  They deal with it so well and have the patience of Job.  They have taught me and the rest of the family to "do what you can with what you have".   They work crazy hours Monday through Friday and are making an incredible difference for these people. 

These are the Tongan youth of the church that are practicing for the celebration of the 100th Anniversary of the Tongan mission.  They are doing a large cultural celebration in August.  It was really cool to see them practicing.

A little game of "SPOONS" before bedtime.  The final 4 players!  I was taking the picture.  Heidi and Ella went off to bed.  Heidi told us to not stay up too late, BUT, you have to finish the game, SOOOO - we finished and ...........

 The final 2, and Makayla was kind enough to let me WIN.  Enjoy the moment because it won't last.  Next game, Dad will get beat by ......  probably Heidi.

We hope you're all well!  Have a great day!  

GOOD MORNING!   This is the scene most mornings in Tonga.  You see the morning mist rising from the ground as the sun rises.  Tonga is the 1st Country in the world to greet the new day.  The sun rises and sun sets are incredible!  There are a lot of the Tongans that get up bright and early around 5:00 to 6:00 AM to start work because it is nice and cool.  We have a neighbor that has a rooster that is confused at what waking time should be.  There are some mornings the rooster crows at 2:00 or 3:00 in the morning.  Crazy rooster - his internal clock is broken.  :) 

Today was the 1st day of school for the Tongan kids.  They just ended their break and back at it.  It's winter time for them right now.  How would you like your winter season to be 75-80 degrees, green, and beautiful?  Here at the Liahona school, the kids wear these green uniforms.  The girls wear braids in their hair.  This is one of our friends with our girls.  Her name is Lupe.  She comes around dinner time and wants to be with our family.  We ask her if she's hungry and she says she's good, but then will sit down at the dinner table and start eating some of our food.  We think it's kind of funny.  She's a cute girl and she has been a good friend to the family.

Today, we saw a lot of kids from the schools.  Mostly junior high and high school kids.  It feels like we got a lot accomplished today.  One thing that is lacking in a big way is a hygiene program.  That is one thing that Dr. John and his wife (Sue) are really interested in and trying to implement.  We sat down tonight and talked about it and how we can help educate these kids at an early age to start a new cycle of good oral health.  We're seeing teenagers with early Periodontal Disease that is Moderate to Severe.  We are doing a lot of restorative work and a lot of extractions, but we really need to focus on PREVENTIVE DENTISTRY.   We'll be implementing and perfecting a new program starting this Thursday in this clinic that gets me excited.  I feel we are making a difference with getting people out of pain and restoring a number of teeth, but the real difference comes in EDUCATION, and teaching them proper oral hygiene, diet, and the reason it's so important.  

Here is the reception room.  We have a schedule, but people just come in (walk-ins) and they sit for hours to be seen.  They are willing to wait 3-4 hours to be seen to get a problem taken care of.  So, they are so patient and then after the appointment, they are sooooo grateful.  They really appreciate what you're doing for them.  The attitudes and humility is like no other on this planet.  Just a happy, delightful people!  

This patient was one of our last patients of the day.  He was so great!  He is from America on Church Business and had some Dental needs.  We tried to get him taken care of until he can get back to the states.  We see a lot of people that come and go from different humanitarian groups, church groups, or charity groups.  We have a group living right next to us that are helping the Tongan people who have missing limbs.  They are a group out of Utah that are helping them get prosthetics (prosthetic legs mainly) to allow mobility.  That's a huge thing for them.  A lot of great people helping make a difference.

The family hanging out after a long day of working.  The kids love oranges and apples more than they every have in Idaho.  Not sure why, but they are.  We had to give all of you an "ORANGE SMILE".  We love you all and appreciate your love and support!

Some family games out in the parking lot.  We were throwing the football around and some other kids came running to play with us.  They brought a rugby ball with them.  Rugby is huge here in Tonga.  It's their #1 sport.  We passed around the football and the rugby ball and had a great time together.  This picture is as the sun was setting.  The sun goes down around 6:30 PM.

Good night!  Sleep Tight, Don't Let the Bed Bugs Bite!  Here, we say, "Don't Let the Cockroaches, Millipedes, or Geckos bite"

Fun Fact about Geckos - Most geckos cannot blink, but they often lick their eyes to keep them clean and moist.  Cool huh!

     Heidi assisted for her 1st time today.  She did great!  We had this little guy and his Mom as some of our patients and both were amazing patients.  We did some work on this little 4 year old and he handled it like a champ.  The Tongan people are very strong and handle Dental work very well.  Both Mom and her son were grateful for what we did for them today.

     Today, Heidi and Maddison assisted and Logan and Makayla worked in sterilization.  The little kids have been playing with friends outside the clinic.  

     Today was a crazy day.  We had tons of people lining up to be seen.  Sorry, I don't have more pictures.  It was about a 9 hour work day today.  We had a lot of fillings and extractions today.  Both Maddison and Heidi did great assisting.  After work, we went and played some games with the kids and some of our neighbors for FHE.  The Senior missionaries are so much fun!  They are incredible people with a lot of energy.

     Interesting story - We had a patient of one of the volunteers (senior missionary working as the medical Personnel for the Tongan mission - he's a PA) come into the clinic 1st thing this morning and he needed some Dental instruments and a surgical suction to clean out a bunch of build-up material (wax) in the patient's ear.  She couldn't hear and needed it all cleaned out.  There are some different and unusual things going on in the clinic.

    

     

We found another little friend (this time in the clinic).  Only in Tonga do we find these little friends in our clinic.  They are incredible little creatures.  The kids got a kick out of it.  The kids are getting a adjusted to all the "critters" that are out here.  Little Ella, the other day said, "Oh, that's just a little bug.  I'm not afraid of little bugs anymore."  

We hope all is well at home!  Have a great day! 

WE LOVE SUNDAYS!  Today was church and it was a great day!  This picture is us after church before we all got dressed into our comfortable clothes.  We are in front of our kids apartment.  The flowers were given to us from a Sister in the Ward that brings flowers every week for decoration.  She picks out the flowers from her back yard and does floral arrangements.  Every week is different.  She's amazing!  The talks, testimonies, and lessons were really great.  Not too much different than back home.  Braden and Ella have adjusted well in their primary classes.  

Heidi and I talked with the Bishop of the Ward and asked if Braden can be baptized in the ocean here in Tonga and he told us yes and there is a beach that would be perfect called the "Good Samaritan Beach" where we could have the ordinance done.  What a cool name and cool place to be baptized!  We are thinking of doing it in the next couple of weeks.  Of course, you all are invited to come.  :)

This is a map of Tonga.  It is about 22 miles long and 12 miles wide.  Braden said it looked like an elf's shoe.  He has a creative mind, but I think he's right (heel on the right and toe on the left).  We are on the Liahona campus which is directly below the "a" in Tongatapu on the sheet.  It's about in the middle of that section of island.  It's one of the highest points on the island.  Most of the island is farmland and is thick with trees, shrubs, and crops.  I thought you might like to see the map of the island that we're staying at.  It's not very big.  

One of our activities for Sunday was drawing these teeth on these T-shirts.  We are going to do some school educational programs this Thursday with some of the Tongan kids.  Dr. Johns asked us if we had any ideas and I told him about what we do in February for hygiene month.  We go to the schools, dress up the kids in tooth costumes and do some education about diet, oral hygiene, and how to be healthy.  We pretend the kids are teeth, use a giant toothbrush, floss, and demonstrate how to have proper oral hygiene.  They asked us to do the same thing with the Tongan kids.  Hopefully, it will help make a difference for these kids.  They are in huge need of oral hygiene instruction and diet instruction.  The introduction of sugar has really caused a lot of destruction to their teeth.  SO, the kids helped draw these teeth on these t-shirts to help with the program.  Great Sunday activity!

Crazy kids!  "Strike a pose"

Later tonight, we had a special dinner with a lot of senior missionaries and the Mission President and his wife and kids (President and Sister Tupo).  They are finishing up their mission and the new Mission President is coming this week.  This is a picture of them singing some songs.  They are a gifted musical family.  They are from Alaska.  Their two sons (Jesse-14 & Thomas-12) have befriended Logan and taught him some things about the Tongan culture and making him feel comfortable here.  They are a great family!

FANTASTIC 5!   Heidi timed this picture just right.  This is at the "blow-holes" where the water comes in and crashes against the coral reef.  From right to left - Braden, Makayla, Logan, Maddison, and Ella.   This is one of my favorite pictures.  It looks like all the kids are controlling the water with their "super powers".  :)  The are really enjoying the wonders of Tonga.  

Today was Saturday and we spent the first half of the day going to the market to get groceries and supplies.   The kids were a little bored, but we brought them along to give them a little bit of a cultural experience.  The markets were really neat to see and shop at.  In Tonga, they have a lot of little shops, so you have to go to about 6 stores to get what you need.  The open market where they sold all the fresh fruits and vegetables was really neat.  They had a market above the lower market that had a lot of arts, clothing, carvings, souvenirs, and things that the kids liked looking at.

Here is a really neat wood carving that was in the market.

A lot of fresh produce to choose from.

A very nice Tongan woman gave Ella a little fan as a souvenir.   We're just finishing up our shopping and the kids are just about ready for lunch.  Maddison was in heaven looking at all the crafts that the Tongan people are able to do.  Very talented people.

This is where some of the "flying foxes - Bats" live.  They are sleeping up in this tree.  In the kingdom of Tonga, flying foxes are considered sacred.  The bats are official property of the king, and no one but royalty can hunt these.  These bats didn't seem to be disturbed by us being there.  They really look unique.  Their heads look like a fox head and a they of course have a body of a bat.  These flying foxes are one of the wonders of the island.  You see them flying all over the kingdom.

In the afternoon, we went snorkeling on a favorite beach called HA'ATAFU BEACH.  It is filled with a lot of coral and all sorts of colorful fish.  You don't have to swim very far to see some amazing fish (big and small).  It was a perfect spot to snorkel for the kids because a lot of the areas were shallow.  You could stand up if you needed to, but you could still see so many different fish that were amazing. We spent a few hours on the beach, then came home, had dinner, and got the kids ready for church tomorrow.  It was a good catch up day and good day to spend some time together.

We love you guys!  We appreciate the comments and the love you send!  Have a great Sunday!  

This is Heidi and Sister Sue Johns working in the sterilization room.  This week, Heidi has been helping out sterilizing the instruments between each of the patients.  Next week, she will be helping assist in the clinic.  Sister Johns is the full time missionary assigned with her husband (Elder Steve Johns) in the clinic for about two years.  They are the ones that run the clinic and have been an amazing help to us and great mentors.  Working in this kind of clinic as really different and you have to work very differently than what we're used to.   You do what you can with what you have.  It's not perfect, but it's better than nothing.  The Tongan people are very grateful for anything that we can do for them.  

Patient of the Day --

 This is a patient that had #24 (tooth in front) that was very mobile, there was no bone to support the tooth (Severe Periodontal Disease), and was fractured on the end of the root because of the force from biting.  It was hurting the patient, so I decided to extract the tooth.  The patient did not want to go with a missing tooth, so we did something that we don't do in America.  I extracted the tooth, shaved off part of the root, and put the tooth back in by bonding to the adjacent teeth.  It's not ideal, but it works.  Below, you can see the tooth with the end of the root tip that fractured.  I shaved off about 3mm more of the tooth, and implanted it back into the site.  Ideally, this patient needed some Perio therapy, and some fixed prosthodontics, but we did what we could.

You can see he was a Class III malocclusion (his bite wasn't right).  I had to adjust his bite quite a bit, so it doesn't look ideal, but it will be functional and he was so excited that we could save his tooth.  The reason it was so mobile was the upper tooth was hitting it first all the time.  That's one of the reasons we had to adjust it down.  I'm hoping this will service him for a long time.  He's going to be the next Tongan temple President.  I wish he would come to our clinic in Twin Falls and I could treat it to last for a lifetime.   We do what we can.

Satisfied patient!  Very grateful and happy people.

We are able to wash our clothes, but "Mother Nature" does the drying part.  

Our kids playing with other kids on "Liahona campus".   These kids on the campus are a little more privileged than most Tongan kids.  Most are very poor and don't have a lot.  The kids manage to eat a lot of sugar though.  We see a lot of young kids with a lot of decay.

These kids have come over and befriended our kids.  They have had fun playing together throughout the day.

Our little Tongan princesses!  Little Ella has made a friend.  We have little kids that come over to our apartment and want to play.  The schools are out on break for just this last week.  They go back this next week.  We're hoping the kids can still play and have fun with our kids.

Bananas grow upside down!!!  Did you know that?  That's what the kids were saying.  This morning we went for a run and saw these fields of palm trees and a field of banana palms.  There are a lot of these coconut palm tree farms here in Tonga.  We had to stop and take a picture.  When we go running in the morning, we have to carry a stick with us because there are dogs that will chase us down.  Tongan's animals just run around without any fences, leashes, or any kind of restraint.  This morning, we saw a bull cow with huge horns and it was just feeding on the side of the road.  I think I would have got the horns if it charged us.  The kids are faster than what I am.  :)   We saw dogs running around from home to home like they are in a gang or something.  We saw chickens running around everywhere across the roads.   People were up working in their fields early in the morning around 7:00AM.  The picture down below is of a local farmer that is has a banana farm.  She was trimming up the trees and weeding.  The farmland here is lush and rich.  It looks like the "potting" soil that we buy at Lowes or Home Depot.  This picture of the this lady down below had a huge machete that she was cutting some of the leaves down with.   The people here are so humble and just smile all the time.  There are a lot of people that can speak English, but I'm surprised that there are quite a few that cannot speak English at all.  They are mainly the older generation and the young kids.  They start learning more English around Middle School.  

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Maddison assisted today!  We were doing an extraction case and Maddison stepped in and did one of the teeth.  She's a pro!  The rest of the day she assisted and did a great job.  It was her 1st day assisting.  The patients have been so patient with us while I'm trying to teach our kids how to assist and what is what with the instruments and the Dental terminology.  In some ways, it feels like I'm in Dental school again trying to get a system down and be as productive as we can.  Once the kids are trained well, I think things will flow better.  The kids are taking turns assisting and working in the sterilization room.  There really isn't any Dental Hygiene program here and we need to start something because the Tongan hygiene and their diet is terrible.  We could use the help of our hygienists back home.  This experience really makes me grateful for the wonderful team that we have back home.  If I had our team back home to help us out, we would be seeing 5 times that patients that we are seeing.  That's how awesome they are!  

Tonight, Heidi and I went to the temple right next door to do a session.  The older kids watched the younger kids and allowed us to go.  Every Thursday night, they have a Temple session that is in English.  It's a smaller temple, but has everything that all the other temples have.  What a great experience!  Well, have a great night!  Keep smiling!