From the 2025 Spring Journal of the Colorado Dental Association
By Casey Rhines, D.D.S., CDA Editor
Often when I travel abroad, I find myself looking at people’s teeth to evaluate the oral 
health of the country as a whole. When I was in Italy, someone asked our tour guide how people knew we were American. He rolled his eyes, shrugged his shoulders and said, “it’s your teeth.”
I went to Cuba in January to fulfill an international elective for my Master of Business Administration; the focus of the trip was entrepreneurship. Most people don’t associate entrepreneurs with Cuba. This is because from 1968 to 2011, the private sector was completely illegal. Only recently have people been able to obtain jobs outside of the government. Nevertheless, dentistry — and all healthcare — is still controlled by the public sector. This means that a dentist in Cuba makes approximately $20 per month. For comparison, my tour guide, Ycel, made $1,500 in two weeks of tips. As I got to know Ycel, she gave me some insights on her experiences with Cuban dentistry.
Many dentists in Cuba have resorted to seeing patients in their private homes to have more control over their income. Patients who can afford treatment, like Ycel, are drawn to the opportunity to avoid long wait times and inconsistent conditions such as lack of materials and power outages that have plagued public health clinics. I learned about the vicious cycle of private companies needing to have generators to ensure income from tourists and thus, only companies that service tourists can afford generators. Similarly, the embargo inhibits government clinics from accessing materials but dentists illegally practicing in their homes try to find ways around this — even if it is expensive. Ycel needs #18 fixed as soon as she finds a new dentist — her last three dentists have recently left for the U. S.
Dentistry in Cuba is not completely dissimilar to the U. S. Genetics, diet and hygiene play a large role in the disease process of periodontitis and caries — both of which are prevalent in Cuba. This is not surprising since they are large producers of both tobacco and sugar cane — culprits for periodontitis and caries, respectively. The U. S. sees the same dental problems because of our consumption and use of these products. I found a major difference between our dental procedures when Ycel and I were teaching each other Spanish and English dental terms. Plancha means denture, impasta means filling, carie means cavity…but what do we call a curita? By definition, it loosely translates to band-aid. After hearing Ycel, who is a regular dental patient and not a dental professional, describe a temporary filling for the purpose of letting a tooth “calm down” before all of the caries can be excavated, I realized what a common procedure this must be for a patient to know the term. I explained to her that we would call it a temporary filling (we don’t even have a cute word for it because patients would rarely report that they had one) and we rarely do them because our patients should be numb during procedures. Anesthetic is one of those materials that they lack in Cuba.
My knowledge on Cuban dentistry is limited to my conversations with local people and some light research when I got home so I don’t claim to be an expert. I’m also not qualified to judge a country’s politics or economy. Nevertheless, Cuba and the U. S. have different political systems and yet similar dental problems. According to the World Health Organization’s Oral Health Country Profiles for both countries, we have strikingly similar rates of untreated caries on deciduous teeth and prevalence of edentulous patients. Despite having different approaches to solving these problems, we are left with many of the same.
We talk about politics in this issue, which can always add a little discomfort to the reading. As readers, we tend to get defensive (even subconsciously) and search for confirmation bias. You don’t have to have all the answers to huge political conversations to enjoy local politics through the Colorado Dental Association. We have a lot happening in our state with Medicaid reform, the Sunset Review of the Dental Practice Act and other topics in the Colorado Legislature and U.S. Congress that you can have an immediate impact on if you choose. Stay informed and stay interested!
