An oral surgeon recently invited me to his son’s wedding. At the reception, my wife and I were seated at a table that seemed reserved for dentists. The fellow next to me was friendly and the conversation rolled around to gratis treatment. He periodically volunteers for MOM (Missions of Mercy), which sponsors free medical clinics in economically depressed areas, particularly in Appalachia.
He had access to a portable dental operatory to provide basic treatment: restorations, extractions and denture services, mainly. In private practice, he was big on endodontics but knew that there would be no follow up here. Perio consists of oral hygiene instruction and maybe a prophy if time permits, which it usually doesn’t, as hoards of people show up for these free clinics.
I shared that I’ve been around the world with teams that treat indigenous peoples in hard-to-access regions where medical treatment is unavailable and dentistry unheard of. In many dialects, there is no word for dentist.
With the exception of two or three of my overseas trips, all I could perform were extractions, which don’t take much in the way of instrumentation: forceps, needles, syringes and local anesthetic, along with gloves, gauze, and cold sterilization; a stuffed duffle bag will suffice. And the relief from chronic and/or extreme pain is always greatly appreciated.
I once spent two days trekking through remote a jungle and climbing a rugged, rock-strewn trail behind a burrow that carried my supplies. In a village high in the Sierra Madre del Sol, the people spoke an ancient dialect, Chinentaco; only a few men spoke Spanish. To communicate, my guide interpreted from English to Spanish while another man translated further into Chinentaco. It took forever to explain how Septocaine works… or anything else.
The patient sat on a simple wooden chair that was perched on four rocks so I didn’t have to contort my back. Positioned under a shade tree in the village square, a villager grabbed hold of the patient’s head from behind to act as a headrest. It was primitive, but it worked. Still, it’s a long backbreaking day and the line never gets shorter.
Things were going well when my guide/interpreter was called away. Left on my own, I resorted to pointing and grunting with the next person in the tottery chair. After he was numb, I began to pull a particularly stubborn molar. Without the benefit of radiographs, I never knew what I was getting in to. I struggled for a while, thinking that this thing was never going to come out, when suddenly the chair shook and tottered, almost dumping the patient off. At the same time, I stood up to steady myself and saw that I was holding the tooth in the forceps. I looked at the tooth, and then at the villagers circled around me. They were all applauding and having a good laugh. His wife later brought me a small brown egg. It was the most meaningful payment I’ve ever received.
Later that night, while eating dinner around an open fire, my guide asked me what I thought of the tremor. I thought, “What tremor?” but then realized that the undulating ground had helped me extract that stubborn tooth. Whatever had happened, the Chinentaco man had been relieved of the agonizing pain he’d been in for weeks.
After relating this incident, my new dental friend at the wedding spent a lot of time explaining what the poor people of Appalachia are like, how they don’t understand modern hygiene and the benefits of modern restorative techniques. He intimated that I don’t have to go halfway around the world to help people. I didn’t have the heart to tell him that my roots are Appalachian and that’s why I do what I do. And I didn’t tell him that my office consistently performs pro bono treatment for the surrounding community. It doesn’t matter who you help—a good portion of the world needs assistance—as long as you selflessly serve.
Jim Rhea, DMD