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Dr Jalal Khan believes the best way to improve oral health outcomes in the bush is to roll up your sleeves and get to work. By Frank Leggett
Quilpie, Cunnamulla, Thargomindah and Windorah are small towns in Queensland that are disadvantaged in regard to health services. In fact, these remote towns don’t even have a resident dentist. Regular check-ups don’t happen because a visit to the dentist requires a three- to four-hour car journey. For most of the local people, the cost in time and finances is simply prohibitive. It’s only when something is very wrong, very painful or very unusual that the long journey is made.
Of course, the standard of oral health in these towns is less than desired. Or, at least, it used to be. In 2017, Dr Jalal Khan began visiting in the Dental Truck, a fully-fledged clinic on wheels.
“Out of respect for my colleagues, I don’t visit towns that have a dentist,” says Dr Khan. “The Dental Truck is fully loaded and we offer check-ups and cleans, extractions, crown and bridge work, dentures, root canal therapy, mouthguards and dental splints. We have a digital X-ray unit on board and a ground-mounted chair.”
The only thing Dr Khan doesn’t touch is complex surgical extractions. If there were unforeseen complications, he wouldn’t have the equipment on hand to resolve the problem. He has also held off from performing fixed bracket orthodontics but hopes to include that service in the future.
How it started
Dr Khan can trace his interest in dentistry back to a traumatic experience while at high school. “I had two teeth that were completely avulsed,” he says. “Luckily, the school medico put the teeth in a glass of milk and that kept the tissues vital.
I was rushed to a dental hospital where a dental student popped them back in place. Amazingly they’re still there today.”
Dr Khan graduated from the University of Sydney in 2011 and worked for a few practitioners to gain some real-world experience. In 2014, just three years out of dental school, he purchased the Dental Station practice in North Sydney, which he still runs today.
“It was a risky move,” he says, “but I believe in jumping in the deep end and paddling like crazy until you eventually start to freestyle. I felt clinically ready and I wanted more autonomy. I also wanted to dial up my professional development so it was the right time for me.”
Dr Khan first experienced dentistry in the bush while on elective clinical placement as a final year student. He was sent to Orange in the Central Tablelands region of New South Wales, in order to use his learned skills in a real-life setting.
“What was refreshing was the nature of the patients that we were treating,” he says. “They were so grateful for what we were doing.”
Mobile dentistry had long held a fascination for Dr Khan, even though he admits he was drawn to the novelty and romance of the concept. In 2016, he discovered a mobile dental truck for sale on the Gold Coast. The dentist was close to retirement and had only operated the truck for 18 months.
“I flew up and liked the set-up,” says Dr Khan. “He’d done a very professional job of fitting out the clinic; all the electricals and plumbing were expertly installed. The back section is the clinic, the middle section is the living quarters where you can sleep, cook and eat, and the cabin is where everybody sits when the truck’s moving.”
Dr Khan purchased the truck—a horse float in a previous life—feeling he was fulfilling a passion and a dream. “My parents came here as migrants from Pakistan,” he says. “Australia has served our family incredibly well, as it has done for many migrant families, and this was my way to give back to our country.”
The Dental Truck is housed in Quilpie for most of the year. Dr Khan flies up and spends one week a month visiting the remote towns around that area. While he is away from his North Sydney practice, an associate dentist picks up his workload.
“I’m a big believer in continuity of care,” says Dr Khan. “It underpins my entire philosophy. You’re only going to create a shift in attitudes and outcomes to oral health if you reliably turn up. The other important factor is comprehensive care. I didn’t want to be in a situation where I was only offering relief of pain or basic emergency services. The work we do in the Dental Truck is completely proactive.”
The truck also spends three months of the year in Sydney where Dr Khan has organised a charity program partnered with House of Welcome, Mission Australia and Addi Road Food Pantry. He uses the truck to provide comprehensive care to disadvantaged communities identified by the partnered charitable organisations.
The COVID-19 border closures created quite a few difficulties for Dr Khan. When he was unable to enter Queensland, he turned to a trusted dentist who had already taken the truck out bush a dozen times. Dr Fran Wing, based in Tewantin on Queensland’s Sunshine Coast, was able to pick up the truck in Quilpie and keep the continuity of care going.
“Operating out of the Dental Truck is rewarding work but it’s also super hard,” says Dr Khan. “Fran is amazing. She’s been helping us for a few years now.”
Dr Wing first heard about the Dental Truck on an ABC television program. She got in touch with Dr Khan and discovered a like-minded dental professional.
“The Dental Truck is a hugely important resource to these remote communities,” says Dr Wing. “It provides a health service that’s sorely lacking and that’s a wonderful thing. Ensuring the Dental Truck service is regular and reliable is very important. People need to be able to depend on its regularity for continued success.”
The dental profession has a proud tradition of charity work. The dentists, nurses and staff who volunteer to keep the Dental Truck on the road are part of that tradition.
“I think the majority of dentists want to give back in some way,” says Dr Wing. “It can be more difficult for younger professionals as they’re often under financial and family pressure. Jalal loves the outback trips but he also has a young family, so I’m happy to step in. As an older dentist, it’s certainly rewarding to be able to give back and to draw on my experience. When everything is not on hand and you’re faced with a wide variety of issues, experience is how you create solutions.”
Cost of care
The Dental Truck is a registered charity and a not-for-profit organisation. Despite this, Dr Khan has been largely funding the operation out of his own pocket. Even Dr Wing takes financial hits every time she takes out the truck but, as she says, “I don’t do it for money; the reward of each trip is worth much more than money.”
Thankfully, the future may be easier with a large corporate dental organisation (to be announced soon) coming on board as a sponsor. While the details are still being ironed out, the company is honouring their commitment to improve the oral health of all Australians. Their support would not just be financial but clinical as well.
“They have a large cohort of dentists, dental assistants and other staff who could support an expansion of our services,” says Dr Khan. “To be honest, the people and the company want to get behind us because they feel it’s the right thing to do. I’m incredibly grateful for their support.”
In the short term, Dr Khan wants more trucks and clinical support supplied to remote communities. “Looking ahead, I also want to advocate for some health policy changes to dentistry,” says Dr Khan. “We’re in a position to show how oral health outcomes can be improved for patients in the bush. And I would really like to see more dental care added to Medicare.”
Dr Wing is blunt in her assessment of Dr Khan’s ambitions. “His dream and vision are inspirational and I’m happy to help him in any way,” she says. “He’s all about big picture solutions.”