Putting teeth into outreach
It’s the hugs and the newly polished smiles that have kept them coming back year after year for more than 25 years.
They volunteer, usually in far-flung places and often in less than perfect conditions, to deliver services free of charge to patients in need.
And what they do is sort of a dying art form, a craft needed less and less by city dwellers, and taught in fewer and fewer higher education settings.
But still, the need for their services continues, mostly in impoverished areas, especially rural communities throughout the United States.
In years past, this group, responsible for covering the American Southwest, mostly concentrated on delivering their brand of care to Native Americans. They’ve previously set up their mobile clinics in places such as Montezuma Creek in southern Utah, or at the Goshute Reservation that sits astride the Utah-Nevada border, even in tiny Duckwater, where a small band of Shoshone have a reservation in north-central Nevada.
This year, these men of the Academy of Prosthodontics, came to Price.
For four days beginning Sept. 17 they saw about a dozen local patients and constructed dentures and other dental prostheses out of Dr. Paul Martinez’s dentist office on S. 100 E.
The volunteer work is part of an outreach effort started in the early 1990s by an Academy of Prosthodontics foundation. Volunteer prosthodontists and dentists have delivered more than 2,000 pairs of dentures to more than a 1,000 needy patients.
Dr. Geoffrey Thompson is one of the volunteers who came to Price this year. He is program director for post-graduate prosthodontics at Marquette University in Milwaukee, Wisc.
He brought two of his graduate students with him.
He said Martinez—he is a general dentist, but has known some of the prosthodontists since he was a student himself—is instrumental to the work the foundation does in the Southwest.
“I’ve been doing it for 10 or 11 years,” Thompson said. “Paul is kind of the center of our universe around here. He will find places for us to go either in Utah or Nevada or New Mexico. We have other groups that go to Wyoming, Nebraska, Alaska, a group that goes to Mexico and a group that goes to Africa. We’ve got five groups and we are one of those.”
Thompson said the group typically arrives at a location on a Monday and constructs the prosthetics and dentures over three and a half days, usually returning home that Thursday.
When they are not creating new dentures, sometimes they are merely adjusting them for patients.
“Just because you make a set of dentures doesn’t mean it’s good to go forever. There’s nothing that doesn’t need maintenance, including dentures,” Thompson said.
In Price he said of some of the patients, “We’ve done some special needs people here. We’ve got some recovering addicts. So you can imagine trying to get a job and your teeth are all fouled up, how maybe that would allow you not to get a job. So we are making teeth for those guys.”
A lot of preparation goes into this work. Martinez does most of this. Often this includes multiple appointments, extraction of diseased teeth, even surgical procedures.
Thompson said more dentists could open their hearts and contribute this type of time-consuming prep work.
“For Paul to get things ready, he’s got a big heart and we’d like to see other people increase their heart size, too. It’s hard to get people to volunteer,” he said.
One of the reasons Thompson said he brings students along with him as volunteers is that they get more from the exercise than mere practical experience.
“Mostly what I want them to see is that giving back is good,” he said. “They always get a kick out of doing this.”
To become a prosthodontist take a general dentistry degree and then three years of post-graduate work. Thompson said it’s the second-year graduate students that accompany him on these trips.
“Interestingly, we get people from around the world and they get national dental insurance and things like that, so they don’t get to do a lot of denture work in their own countries,” he said.
Dr. Ossama Raffa, from Jeddah, Saudi Arabia, was one of the graduate students who volunteered this year. He said he’d never quite experienced anything like it.
“The patients are really nice, nice people. It’s been really good,” he said of the trip.
Raffa said he will go back home to practice in Saudi Arabia when he graduates.
“For us it’s a lot of experience. Also, we get to see so many patients in such a short time,” he said. “Plus, it’s fun.”
Classmate Dr. Mohamed Elshewy is from Cairo, Egypt. He’d never visited Utah and enjoyed the trip.
He’s undecided on whether he will practice in the U.S. when he graduates or whether he will return to Egypt.
“It’s quite an experience for us just to see different techniques,” he said. “For sure it’s fun to come here to Utah. I’ve never been here before. It’s also good to do good things (for others).”
Thompson and the students were also joined on the trip by Dr. Ken Sobczak, a prosthodontist and longtime professor at Marquette who is semi-retired.
The trip to Price was his third as a volunteer for the academy’s outreach program.
“I’ve gone every year since I retired,” he said. “The important thing is these guys (students) get to see me outside of the venue of the school. I make these periods an educational experience for them.”
Rounding out the group was Dr. Ed Plekavich, a prosthodontist who operates a private practice in Sterling, Va. He’s been a volunteer since the program’s inception. He also was Martinez’s professor at Georgetown University School of Dentistry in the 1980s.
Plekavich recalled why he and other prosthodontists started the volunteer project.
“There’s less need in a lot of the urban areas for that because people don’t lose their teeth as often,” he said. “But there are lots of underserved areas where dentists themselves don’t have that extra training to do it. So our group was perfectly situated to do it, to provide that care to different places. So we thought it would be a good project to start, so we did.”
Martinez remembers how he got involved.
“I went through dental school and graduated in 1986. In 1987 or `88, they called and asked if I could start arranging things out here for those guys to come,” he said. “We did that for years, went all over the place. Taos, New Mexico, Northern Arizona, then we started some in Oklahoma and South Dakota and Alaska.”
Over the more than 25 years of travel and volunteer work, Martinez said the group started noticing changes in the needs of patients. First, fewer and fewer Native American reservations suffered from lack of dental care, mostly thanks to the investments made by tribes that received mineral lease funds.
“I started recognizing that seven or eight years ago. But at that same time we started with this drug epidemic. We started getting meth people in, missing teeth, people on narcotic analgesics, people on long-term pain management,” he said.
The shift required the volunteers to refocus efforts closer to places like Price and other rural communities closer to home.
“Our economy changed. Our economy is really bad compared to when I first started practicing. So people I’ve known for 30 years started to retire and they didn’t make enough money,” Martinez said. “So you start thinking, instead of going all over the place to help other people, why not try to help our people locally. There’s a lot of people who need it.”
Martinez said if anything, he’d now like other dentists and dental clinics to help him prepare patients in advance of future outreach care.
Two federally-subsidized clinics, one in Green River and another in East Carbon, don’t allow patients to get preparation work done for their dentures there in advance of the prosthodontists arrival. Martinez said that’s unusual.
“I don’t know if it’s different out here. But in other parts of the country they do prep our people for us. We do it right out of their facilities a lot of time. But they won’t allow it,” he said.
Martinez says if there is one stumbling block to his ability to continue providing the free care locally, it’s not having any help in th prep work.
“It’s tough. Half of the ones we are doing today, I had to take to the OR (hospital operating room). I take them to the OR and get them prepped to come over because their medical conditions dictate such,” he said. “You can’t do these surgical procedures chairside. They have to be done at the hospital.”
Hospital bills for such procedures can be as high as $10,000, and as low as $1,600.
“We donate our part of that, our services, but you’re not getting the donation from the hospital. I really think it takes a communitywide effort in order to support a program like this,” Martinez said.