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PROJECT ARCHIVES

GUATEMALA - FEBRUARY 2000

Familias de Esperanza
We had five days to see as many people as possible. So, we restricted our cases to treating only those with emergencies (pain or infection) or urgent needs (discomfort or likelihood of pain or infection). An exception was made for children who we thought would benefit greatly with tips on oral hygiene. From my last experience, I found that children were very impressed with us foreigners and regarded our advice very highly.

The clinic had fantastic facilities. There were three dental chairs, fully operational. A modern x-ray unit was available. There were full sterilization facilities. The compressor was brand new. Lighting was adequate. Supplies were abundant. This includes disposables, dental materials and dental instruments. We were lacking running water and a sink.

The manager of the medical / dental department was Theresa. She was most helpful right from the beginning. She ensured that we had breakfast and a hot lunch served in their cafeteria. She was most interested in our progress. She visited on a daily basis to make sure we had whatever we needed. There was a sterilization assistant named Carmen. She was a great help as a fourth member of our team. She was critical in freeing up Maritza, our "dental assistant"; to work closely with me at all times. Carmen also showed interest in assisting. John, the director of the project, was also interested in our progress. He understood that his clinic was new and perhaps lacking certain items. He wanted to know what items were missing such that he can purchase them for future teams.

In total, we saw 71 patients for dental procedures. Multiple procedures were often done on each patient. In total, 34 teeth were extraction and 45 teeth were restored. There were four consults. Six cleanings were done on children. In addition, about 15 children were seen for oral hygiene instruction only. For many, it was the first dental visit and likely the most significant one they will ever have. We impressed upon these kids so much to take their teeth more seriously. On one occasion, Liz and Maritza instructed a classroom of 30 kids on oral hygiene. Their enthusiasm was overwhelming. top

Analysis
The response was overwhelming. The most memorable scenes were the line-ups of people waiting outside the clinic in the early morning. We were all excited. Everything was planned out before we started. The office printed up medical questionnaires in Spanish and English, I also realized that it was going to be difficult to set up such an operation again with such a team. We tried to see as many people as possible, striving to give each the individual attention they deserved.

As the statistics show, our visit was very successful. Three chairs allowed us to see several patients at once. The abundance of dental instruments and sterilization equipment allowed us to work continuously without interruption. Translation was critical as well. Liz and Maritza made it so easy to clear medical histories and pinpoint the source of dental pain. A patient list and charts were available making it easy to document our work. This was important because many of these patients will return to seek further treatment. In fact, I found helpful notes left by previous teams.

A few items that would be helpful for future teams include:

•  A composite (white filling) dispensing gun for white filling material in compules
•  A radio to relax anxious patients
•  A sink to aid in sterilization

We brought with us a large supply of filling materials, disposables, and local anaesthetic. I would suggest that future teams use their discretion when leaving materials at this clinic. It seemed that some materials were in oversupply and became expired before they could be used. Perhaps dental teams could leave you some their supplies, so that they can be distributed to clinics in more pressing need. Such supplies would include local anesthetic and composite (white filling material). These are time sensitive.

The common dental problems seen by us were chronically infected teeth in both adults and children. The story always seemed to unfold in the same manner. Small cavities started undetected. These progressed unnoticed until they caused a severe toothache. Still unable to afford basic dental care, most people simply put up with the pain until the tooth died. The pain often subsided to a low-level ache. Many just accepted this discomfort without realizing that infection persisted in their jaws. top

Tim and Elizabeth Lee