A Thanksgiving Tale of Two Patients
I was there to help change Mariel and Chantal's lives, but it happened quite the other way. We were in the Jericho Baptist Church in Providenciales, Turks, and Caicos. When most people think of Caribbean islands, they imagine beautiful resorts with fabulous sunsets and beaches. While those are accurate descriptions of parts of the islands, they do not remotely describe the livelihoods of its residents. Jobs are scarce, pay is minuscule, and poverty is a way of life for most of the population.
The Great Shape 1000 Smiles dental team is the largest volunteer dental charity in the world. This year's t-shirt for the group reads: "HOPE, One Love, 2022." Our job is to bring some "hope," one tooth at a time. I am privileged to be a "restorer," not an "extractor." My goal is to re-create a patient's smile. This makes it easier for the patient to find a job in tourism, the predominant industry on most islands.
Mariel appeared at the clinic with decay on virtually every tooth. This is not the kind of decay most of us see in the U.S. It is deep black decay, encompassing 30-60% of the tooth's surface area, and has been there for more than ten years. Amazingly, many of the teeth were salvageable, and the bacterial invasion had not caused pulp exposures. Sadly, it was impossible to know this until we removed the dense mounds of pulverized tooth structure. X-rays are hard to come by in volunteer settings, but thankfully, Great Shape projects now come equipped with portable X-Ray machines. Still, carious exposures can be challenging to read in decades-long decay. Oh, by the way, I forgot to mention that Mariel was only 19 years old.
Mariel's decay included filled-in black semicircles between teeth numbers 8 and 9, #10mfl, 6mifl, and 11mifl. Number 7 was missing - having been extracted and not replaced years earlier. This type of work is complex under normal work conditions, so it's not much better when you add in 90-plus temperatures indoors, equipment breakdowns, composites that melt in the mouth, dental chairs that are slightly more advanced than lawn chairs, no overhead lighting, and language barriers with many patients.
We accomplished our goal and ended up with a surprisingly accurate shade match for Mariel. A tip to dental volunteers: always bring enamel AND dentin shades, or else you end up with an overly translucent or opaque result!
My assistant, Allyssia Pena, and I were concerned about Mariel's reaction to the work. As stated before, tooth number 7 was missing, so her smile still contained ample open space. We handed her the mirror, and she smiled widely with exuberance as if, for the first time. And then she cried, Allyssia cried, and so did I. Her first comment was, "I can smile again!" I asked her, "When was the last time you smiled?" She stated, "when I was in Kindergarten."
We receive that reaction often at our clinics. Kindness and appreciation are the reasons we keep coming back every year. Imagine having a missing front tooth even AFTER treatment as a 19-year-old woman and still being beyond thrilled seeing your smile.
Chantal, an exuberant young woman of 25 years of age, had the most significant effect on us of any other patient. And yet, we never treated her!
She appeared with a broken, dark brown tooth #8. She had a big smile every time we saw her, brown tooth and all. Allyssia and I virtually salivated at the thought of making her smile whole. Then, we saw the X-ray. Years earlier, she had a failing root canal treatment that she thought was removed and replaced by a local dentist. Sadly, it was not. A huge access hole remained, and the entire root was riddled with decay; even the root had become a shell. The only answer would be an extraction and a bridge, implant, or at least a partial. Sadly, these options were not available on this project. We did not even have material available to take an impression for a flipper. We told her we could do no more than extract her tooth. She never stopped smiling and thanked us effusively.
Chantal worked at one of the restaurants at our hotel. She would run up to us with a big smile, hug us, and thank us for our kindness, even though we had done virtually nothing to help her.
The sweetness, appreciation, and genuine kindness these women showed us were life-changing. We could not leave the hotel without saying goodbye to Chantal and sharing photos of Mariel with all of our colleagues.
Both stories emphasize the sheer beauty of volunteerism-moments we will discuss for the rest of our lives. A little goes a long way. My dental world and life have been forever changed by moments like these over the past twelve years. If you have yet to volunteer to help people in need, find a way to get there. Volunteer to treat patients in the inner city, on a Native American reservation, for American Military Veterans, or join us in a 3rd world country.
Thanksgiving is a perfect moment to celebrate our reasons to be thankful. My list includes my family, friends, office family, and the food on our table. The pure joy of helping humans in need cannot be discounted on Thanksgiving. Regardless of your role in dentistry on the treatment or laboratory side, those moments will be remembered as huge positives when evaluating your year and life.
Thank you to our Great Shape family and the awesome people at MicroDental Laboratories for allowing me to spread the word!
Happy Thanksgiving!
About the author
Dr. Peter Auster continues thirty-five years of cosmetic and reconstructive dentistry in his private practice in Pomona, NY. He has written dozens of articles for major dental publications. He is a Fellow of the International College of Dentists and the American College of Dentists.
Dr. Auster is proud to be a speaker and product reviewer for Catapult Education. He completed two terms on the board of directors of the AACD, was chair of their leadership committee and is currently, the 2022 chairman of their Professional Education Committee. He is a “Dawson Scholar” and received a “Concept of Complete Dentistry Award” from the Dawson Academy. Dr. Auster is a graduate of the University of Pennsylvania School of Dental Medicine.
