Tackling Tooth Decay South of the Border

 Boston University dental students and professors provide free dental care and education for children in the fishing village of Teacapan, Mexico. Photos by Robin Berghaus

“Cierres la boca,” says Alexandra Antonescu, instructing a pediatric patient to close his mouth around a suction tube.

That’s one of the frequently used Spanish phrases that Antonescu (SDM’11) learned from a cheat-sheet taped to a wall in the St. Pierre dental clinic in Teacapan, Mexico, where last month, a team of students and faculty from BU’s Henry M. Goldman School of Dental Medicine provided free dental exams, sealants, and fillings to children from 3 to 17.

“Coming here was a culture shock,” says fourth-year dental student Antonescu, who works mainly with adults back in Boston. “I didn’t know much Spanish, and you need to talk them through procedures. It was hard, but toward the end of the week I got a lot more comfortable.”

Venezuelan native Jennifer Soncini, an SDM clinical assistant professor, steps in for Antonescu when communication is tricky. But, Soncini says, Antonescu doesn’t give herself enough credit.

“Even if she uses a wrong word, the kids still understand,” says Soncini (SDM’02), who has practiced pediatric dentistry for more than 25 years. “Language is not a barrier. If you smile, kids know you’re happy. We could take our dental students to China to treat patients.”

For this mission, SDM partnered with Project Stretch—a Natick-based nonprofit that since 1988 has provided free care for more than 20,000 children worldwide. The group visits Teacapan, on Mexico’s west coast, for three weeks each spring.

“They don’t get dental care until we arrive,” says Kathleen Held, an SDM assistant professor and the school’s assistant director of extramural programs. “When children have abscesses, doctors place them on antibiotics. They learn to live in pain.”

Daily wages for the farmers and fishermen of the town run from $5 to $40 a day, and a single tooth extraction can cost as much as a week’s pay. Even if care were affordable, it’s rarely available: the closest real dental clinic is 25 miles away. Project Stretch volunteer Brenda Irvin says many families can’t even afford the bus fare, let alone the cost of dental care.

It may sound bleak, but the St. Pierre clinic has come a long way. Back in 2006, when Held and Soncini traveled to Teacapan, the clinic didn’t have dental chairs or compressors. They worked outside in the heat, providing sealants, extractions, and fillings with a “scoop and fill” method (known as atraumatic restorative treatment), because they didn’t have a compressor to operate handpieces.

“We pushed back plastic chairs, wore headlamps, and operated with patients’ heads on our laps,” says Soncini. “It’s a way to understand how you can do so much with so little.”

Today, St. Pierre is a fully functional clinic, with real dental chairs and a compressor.

Project Stretch partners with Amigos de Teacapan, a group of Mexicans and Canadian and U.S. expatriates who host dental teams in their homes and run the clinic. They transport kids from schools, manage medical files, and while patients wait for treatment, teach them how to brush and floss. And to set them up a lifetime of better dental health, they teach the children about which foods make wiser choices. (Do not, for example, take a bottle of Coca-Cola to bed at night.) In addition to the educational outreach at the clinic, teachers are trained to give fluoride treatments, four times a year.

In week one, the first team of seven professionals—BU dental students, faculty, and staff, as well as a Boston-area assistant and hygienist—performed 350 dental exams and fluoride treatments, 900 sealants, 241 fillings, and 31 extractions over four and a half days.

Project Stretch dentists transport all supplies from Boston, stuffing gauze, gloves, tongue depressors, amalgam, syringes, anesthesia, and hand tools into extra baggage they check on their flight. Supplies are donated by corporations and local dental practices, including SDM’s clinic.

Like most international externships, competition for the Project Stretch program is fierce.

Of 110 fourth-year dental students, 2 were sent to Teacapan, an additional 12 to other locations abroad. The students’ airfare is covered by SDM’s alumni association.

“We need more young dentists excited about these missions,” says Frank Schiano (CAS’01, SDM’06,’07), an SDM clinical assistant professor and director of dentistry at Fenway Health.

“It inspires them to get involved in community health abroad and back here in Boston.”

Robin Berghaus can be reached at berghaus@bu.edu.

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