Starfish and Ripples

Molly PereiraFeatured News

By Dr. Brett Kessler
From the Spring 2018 Journal of the Colorado Dental Association

In March, my wife, Dr. Gina Kessler, and I, along with 15 other colleagues from Dentistry Making a Difference went to Guatemala for a dental mission trip. We have always wanted to do something along these lines, and when the opportunity presented itself, we decided to go for it.

I am in San Pedro, Guatemala on a dental mission trip with my wife, staff and several colleagues. We are seeing people who are in extreme poverty with huge dental needs. My comfort zone is being stretched in huge ways as I am not in my “cushy urban” office anymore. We are in a five-chair clinic that opened recently through the Spear Open Wide Foundation.

One patient I will never forget. Her name is Araceli. She is a beautiful 5-year-old girl, dressed in a pink jacket and a traditional style dress. I haven’t treated a child this age since dental school. I don’t know who is more nervous—her or me.

In the morning, she had been outside watching us do our work from a window outside the clinic. Her turn was in the afternoon. She came in terrified and reserved—probably frozen by fear. I had a translator help with the communication. I looked in her mouth and my heart sank. She had dental needs in every tooth due to rampant decay. I consulted with the staff dentist at the clinic hoping that she would say to refer her to a pediatric dentist—this kid needs to go to the OR for her treatment. There were none to be seen. The staff dentist and I consulted and it was decided to take out her five front teeth (C-G). This was just scratching the surface of her dental needs.

I gave her injections and pulled her teeth.

She screamed; I cried. I fought through my own emotions and got to work as quickly as I could. She screamed some more; I cried some more.

When it was over she calmed down and gave me a hug, and thanked me for helping her. I am not really sure if I helped her. She is a kid who, if in the states, would be brought to the operating room for her treatment. My mind was racing with questions probing the unknown. Did I really help her? Did I traumatize her? How will she get the help she needs? How will her dentition turn out? How will her psyche be affected? I took out five infected front teeth. Will her adult smile reflect the beauty of this girl as she grows into adulthood? If her teeth are this infected, how is her overall health?

There is so much dental disease here. There are not enough dentists in the world to fix all the decay here. How can I possibly be making a difference?

The answer: starfish and ripple.

I have come to the conclusion that I made a difference for Araceli. I may not have been able to address all the needs in this town but I made a difference for her. Our team of five dentists and 12 assistants/hygienists made a difference for the 100 or so patients who were seen in our clinic these past five days.

Hopefully she will start to brush and floss her teeth, and change her diet. I am not sure if there is clean water where she lives. She probably doesn’t even have running water let alone indoor plumbing in in her house. I tried to explain Araceli’s dire need for more dental work to a woman who said she was her grandmother. (She also said she was the grandmother to the several other kids who were there that day). I am not sure if she understood. I didn’t speak Spanish, she didn’t speak English, but my recommendations were translated to her. Were they heard?

Guatemala has what is considered extreme poverty. The average income for a family is $300 per month. Over 25% of the population is considered illiterate. School is mandated for six years, but the average attendance is a little over four years. There just aren’t resources for them, especially in the rural areas.

I know that there are similar situations happening in our communities in the U.S. as well. I feel that for most though, they have a chance. There is infrastructure to provide opportunities to get help. I also know there are substantial challenges. I know that this is not enough.

The dental future for Araceli and her family may have changed trajectory based on this experience. I hope so. I also hope that her experience in our clinic will ripple out in ways that she will be able to contribute to the world in her own unique way. Who knows, she may become a staff dentist at a similar clinic in her community.

We never know who we impact or how we affect someone—be it our patients, friends, colleagues, acquaintances, etc. It could be that we get someone out of pain, fix their smile and remove infection. It may be that a conversation we have with our patients every single day finally sticks with someone. We never know when someone hears something that catalyzes a much needed change in their life. All we can do is keep doing the best we can—sharing our unique skillset to those in need. I have had many patients come back for their six-month cleaning and check-up and tell me how our conversations changed the trajectory of their lives. I feel that a smile is a window to the soul and we do everything we can to help our patient’s soul shine through. A smile can change a person’s life.

I have come to the conclusion that we made a difference today for Araceli. We barely scratched the surface, but we made a difference for her. I hope that the difference we made for her (and our patients in the U.S.) ripples out into the world to create more positive difference.