Inside Dentistry
February 2020
Volume 16, Issue 2

Dental Team Serves Hundreds of Underprivileged People on Trinidad Mission Trip

Ten-year-old Nathaniel Noel steadfastly refused to open his mouth for an injection of lidocaine. The child knew he had a tooth that needed to be extracted-it had been bothering him for months-but he was petrified of the needle and the subsequent extraction process. Twice, he left the clinic without having allowed the dentist to perform the necessary work. The third time was a charm, though, as Nathaniel's mother, Afishar, summoned her husband, Aldell, to drive from work to the clinic. With his father watching, the child finally allowed Jasmin Henville, DMD, to extract the tooth. He left the clinic with gauze in his mouth and instructions to rinse with warm saltwater over the next few days.

"It was heartbreaking," Henville said, "because that was such a bad abscess, and they do not have access to antibiotics here."

That scene played out in Toco, Trinidad, during a 4-day clinic held by International Medical Relief (IMR) and Aspen Dental, with 2 days in Toco and 2 in Port of Spain. The dental portion of the clinic included five dentists, two hygienists, and three assistants.

"The demographic we are serving is people who might be having their first interaction with a dental professional, so we need to make it a positive experience in hopes that they will value their oral health in the future," said Anita Imadomwanyi, DDS, Director of Clinical Support and Charitable Giving for Aspen Dental. "Because of resources or transportation, it also may be their last interaction with a dental professional for some time, so there needs to be a sense of urgency. We need to quell that anxiety and fear, and help them understand the gravity of their condition, and why we want to get them out of pain."

Nathaniel Noel's mother was so persistent about having her son's tooth extracted because she knew this was her son's best chance in the foreseeable future to see a dentist.

"They tell me it could cause infections beyond just the tooth," she said. "It needed to come out today."

Noel was one of nearly 1,000 patients who were treated during the 4-day clinic. Toco is a rural village in northeastern Trinidad, where the Caribbean Sea and Atlantic Ocean meet; the second part of the clinic was in one of the poorest sections of Port of Spain, the capital of Trinidad and Tobago. The clinic was set up in conjunction with a local organization, FEEL (Foundation for the Enhancement and Enrichment of Lives).

"There are so many communities that are in dire need of support, so it is a great joy to help these people," said FEEL Coordinator Elena Villafana Sylvester.

At the Toco Foundation Agro-Tourism Centre on Day 2, one elderly patient had to choose which two of his four severely decayed teeth could be extracted because his high blood pressure prevented the dentists from taking out all four. One 9-year-old's extraction was so challenging that Henville needed to call Imadonwanyi over to relieve her (they high-fived afterward). Some patients struggled mightily, like the man who moved around so much that Arun Srinivasan, DMD, needed to call over an assistant to hold the man's jaw in place. Others were determined not to show that they were in any discomfort-Srinivasan even needed to tell one man who was enjoying Pink's "What About Us" on the speakers, "I'm glad that you're feeling well enough to dance, but please don't do it while I'm working on your teeth!"

The common thread among all these patients was their appreciation of these dentists for coming to an area that has none.

"It was amazing," said Andy Noel of the Toco Foundation, which organizes community initiatives such as a recycling program and collaborated with FEEL on the Toco portion of the clinic. "The dentists worked so hard. Their commitment, heart, and giving to our community was tremendous."

One teenaged girl in Toco struggled noticeably with both the injection and the extraction, but she had a big smile on her face afterward and even asked for a photo to be taken of her with Srinivasan and the tooth. She said that even though she was still numb, she already felt better, and that the tooth had been bothering her for months.

"It meant a lot to us here-a very poor community that needs to travel 59 miles to get proper healthcare," said Martin Terry Rondon, Chairman of the Sangre Regional Corporation. "As the mayor of this town, I appreciate everyone coming here to offer these services."

The second part of the clinic was at the Beetham Gardens Community Centre, in a Port of Spain slum once known as "Rat Town" that still struggles with gang violence. Armed guards were present, and the dental and medical teams were warned not to leave the property.

"We are in a hot spot," FEEL Assistant Coordinator Andy Mayers warned upon arrival. "Some people, when they come in, will be very touchy, so let's try not to offend them."

The day went without incident, however. Despite long lines-several schools brought busloads of children at a time-the patients generally showed gratitude to the dental team. Cefean Dyer, 24, brought her young son and daughter back in the afternoon after having a tooth extracted herself in the morning, and she was beaming with happiness.

"I am so relieved," she said. "My tooth had been bothering me for a long time. I was even taking days off work because of the pain."

Kevon Rennie, DMD had a difficult time extracting tooth No. 3 from young Israel Henderson, but the boy proudly brought in his mother and brother afterward to see the tooth.

"Wow," his mother said. "It's rotten."

At Villafana Sylvester's urging, Rennie spoke to one large group of schoolchildren about how he grew up only an hour south of Port of Spain before attending college and dental school in the US.

"When you are from a community that perhaps is best described as impoverished or disadvantaged, they only see people of a certain segment in terms of their capacity for employment-sanitation workers, housekeepers, etc-so interacting with people on a different level and opening their minds to different opportunities is exciting," Villafana Sylvester said.

As the clinic wound down, the dentists took every opportunity to sit and rest their bodies.

"My old back is barely holding up today," said Jeffrey Wilson, DDS, who sold his private practice a decade ago but decided retirement was not for him.

Minutes later, however, when another patient walked in, Wilson was back on his feet, ready to get to work.

"If the principle truly is to help people," Srinavanen said, "you're never really exhausted. Dentists are all different, and for us to all come together is impressive, but it is not because of who we are; it is because of what we are doing."

Rennie said helping his countrymen was a "icing on the cake" but that his real passion is just helping people in general.

"This has been overwhelming and exhausting," Rennie said, "but very rewarding more than anything else."

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