1. Project Madhuban (2015)
1 INTRODUCTION
Project Madhuban began 3 years ago in the small village of Ramgarh, Uttarakhand. The objective of
this project is to educate the children of the village about oral health and carry out preventive dental
procedures to render the kids caries-free. The long term objective is to set up a self-sufficient system
by training local women from villages in the area to carry out preventive techniques and follow-ups.
The relevance of this on-going project is to determine the improvement in the oral status of the
children, if any, and to observe the change in the oral habits of the population.
2 BACKGROUND
The project was begun by Mrs. Suryagandhi, the executive of ADCERRA, with financial help from Shri
Aurobindo Ashram, Delhi. Three years ago, at the start of the project, the oral health of the children
was very poor but follow-up records of this year show a vast improvement. Each year two teams visit

2. Ramgarh, and reinforce the health education, carry out the remaining treatments and follow up on
the ones previously done.
3 THE PROJECT
Design
A list of all the instruments and paraphernalia needed was made, with the addition of light cured
cavity liner and flowable composite. Two big cartons of instruments were sent by air to the location
before we left. Our plan was to get to Ramgarh, unpack the cartons, set up the dental centre on the
first two days and start visiting the schools from day three. We concentrated on one school at a time,
starting with oral health education, checkup and followed by treatment.
Two teams were deployed. The first
team went to the school to carry out
basic treatment and for the more
complex treatments, the kids were sent
to the makeshift dental centre where
the second team stayed.
Implementation
Oral health education was the first step
where a comprehensive 20min talk was
given to the children about the
anatomy of the teeth, formation of caries, proper brushing technique and importance of oral hygiene.
Checkups were done by the first team at the school, after which some students were sent to the
dental centre to be treated, in groups of 3-4. In the dental centre we had a portable compressor with
a three way syringe and an air rotor. A table was set up for the child to lay down on and a stool at the
head of the patient for the dentist to sit on. On the left hand side of the table there was a sink from
which a pipe was attached, the other end of which was in a bucket. That was our spittoon. Along with
the air rotor we also had an air motor for small cavities.

3. Each day both the teams treated 20 patients together over a period of one month​.
We used innovative and interactive methods to gain the confidence of the kids. The anxious children
were explained the function of each instrument, the steps of each procedure done and were given
instruments to check the teeth of their friends to familiarize them with the procedures​.
A few children were given an opportunity to assist the dentist and take charge of passing the
instruments and materials. Not only did this reduce their apprehension, but it also helped them
understand the role of a dentist. The ones who were previously scared were then encouraging their
friends to get treatment done.
Optimization
We tried to optimize our project by
a. Making it cost effective: We tried to use materials which could be reused next year. 50 pairs of
stainless steel diagnostic instruments, 20 filling instruments were bought which were
sterilized every day, first by boiling it in a portable autoclave and then keeping it overnight in a
clear plastic box with sterilization pellets (formaldehyde). This not only reduced our cost
drastically but was also environment friendly.
b. Achieving highest quality of performance under the given constraints: Our biggest roadblocks
were no running water, a basic dental set up, no x-ray machine and limited time. Under these
circumstances we managed to do 305 sealants, 314 GIC fillings, 56 scalings.
c. Maximizing the desired factors: The desired factors being oral health awareness. A group of
young girls were asked to get their brush from home and asked to demonstrate how they
brush. Most of their brushes were splayed and they brushed using the scrub technique for
almost 15mins.
They were educated regarding brushing techniques, changing the brush when the bristles
start spreading, how much toothpaste to use and lastly for how much time.
They were encouraged to teach their siblings and family member the importance of proper
brushing.
The second desired factor was removing the fear of dentists which we succeeded in doing.
The third desired factor was making them realize the condition of their teeth. Each child was

4. shown the mirror before and after treatment, making him/her aware of how important it is to
take care of their teeth.
4 EVALUATION
Treatment done for school students
Sunrise Public
school
Saraswathy
Shishu Mandir
Saraswathy
Vidya Mandir
Global
Academy
TOTAL
Total no of students 57 72 109 31 269
New students 15 27 46 31 119
Male 29 42 87 17 175
Female 28 30 22 14 94
NAD 6 2 2 1 11
No.of scaling 8 5 33 6 52
No.of heavy scaling - 1 3 - 4
No.of milk tooth
sealant
9 19 4 3
35
No.of milk tooth filling 43 93 11 8 155
No.of permanent tooth
sealant
44 45 130 50
269
No.of permanent tooth
filling
15 15 110 19
159
No.of temporary filing 10 17 15 6 48
No.of redo filling - - 15 - 15
The project had a few glitches and many highlights. As compared to last year, most of the kids had
better oral hygiene. They remembered the health talk given to them last year and were diligently
following the right technique.

5. The number of new caries seen were reduced considerably. Most of the treatments done in the last
two years were intact. The ones which were dislodged were done again. The amount of trepidation
the children felt in the years before was reduced to such an extent that they were excited to see us
again and got onto the table at the drop of a hat.
On the flipside, complex procedures (read: extractions, pulpectomy, pulpotomy, root canals) which
could not be performed last year due to limited resources, remained impossible even after a year.
Chronic cases were still being ignored by the children’s families due to the lack of a proper dental set
up, the nearest one being 2 hours away in another town.
Going for the first time to Ramgarh, I also noticed that
● The health education given was obsolete, needed revision and to be made more interactive. I
felt that the content lacked expression.
● Data recording was not up to the mark as there were no standard guidelines. This can be
detrimental while analyzing the data, giving false results.
● The project could use more coordination and teamwork as I felt that we lacked
communication amongst each other.
● The ease of work was average which can be improved in the future projects by installing
portable compressors which can be carried to the schools that are far away from the dental
centre, thus saving time and energy.
5 CONCLUSIONS & FUTURE WORK
While the project was successful in it’s own right, there remains room for improvement. In the coming
year, I propose to rectify as far as possible the issues discussed in the evaluation. Moreover, the need
of the hour is a fully equipped dental centre to take care of the existing chronic cases.
Local women should be identified and trained in simple dental skills to make the model sustainable
for years to come. We have seen a great improvement in the oral health of the population of Ramgarh
which makes us believe that such a model can be reproducible in other remote areas, which is one of

6. our long terms goals.
The success of this program is owed to Tara Jauhar and Anju Khanna of The Aurobindo Ashram, Delhi,
for always supporting us and lending us financial aid, and most of all to the beautiful children of
Ramgarh whose unconditional love and zeal to learn more makes us want to go back every year.
We appreciate the commendable support from the schools, be it coordination or sending the kids
during examination.
The strength of the program was the
relentless effort put in by the team,
especially Mrs. Suryagandhi, without whom
the project wouldn’t have had the impact
that it has had. She was the backbone of the
project.
Banumathi and Rathna were my support
throughout, helping and guiding me.
This program wouldn’t have taken off if it
wasn’t for ADCERRA, and Dr Jacques Verre
who has put 20 years of strenuous work​ ​into
it.