— ft In summary, essentialiy no dental services are provided two urban centers. A traditional outside of the lack of fluoride and consumption of refined sugar has produced an epidemic of dental increasing disease. A systematic program of fluoride application, early detection ahd treatment, and dietary education is needed to siow down the epidemic. |The existing dental fload through staff may be able to handle the additional work reorganization, but the transportation limitations make thiq impractical for many atolls. Recommendations 1. Improve the equipment and supplies at Majuro and Ebe so adequate secondary level dental care is available at each site. 2. Add selected manpower (see section IX) to provide for re effective working ratios. 3. Develop in-service education, either in-nation or abroa ,; to maintain skills in each area. 4. Incorporate the application, early education assistants into dental public detection and the curriculum and health simple functions extractions, in-service educatio of fluoride and dietary for medica] (medex) ‘and health assistants so these sewvices can be available on outer islands through the regular health nqtwork. 2. Physical Therapy The services of a physica] therapist are extremely impprtant in the management of some acute and many chronic conditions. As thelfcategories of disease change more and more to that found in industrialized gocieties with more of the cardiovascular heaith problems, there is more andimore need for physical therapy services. orthopedic disabilities. Services are needed for victims of “stroke” and At the present time there is neefl of physical therapy for victims of polio with varying degrees of paralygis. and will always be a need for physical injuries to prevent deformity and therapy services maximize residual There is For traumatic funttion. contractures and functiona}] limitations could be eliminated of reduced with appropriate physical therapy begun shortly after injuries or [burns. 24 Many