A Dentist Abroad in Jerusalem

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My name is Jessica Hyker and I am a general Dentist currently practicing at a clinic that caters to a predominantly under-served population. I have been on several international volunteer trips including a stint in Tanzania working with the Muhimbili University of Health and Allied Sciences, but most recently, I travelled to Haiti to work in Jerusalem with a primary care medical team.  Initially, I was weary of one-week trip, but I was reassured by the fact that groups go every 3 months.  Sustainable and comprehensive care is an essential piece to global healthcare, and Community Empowerment’s commitment to these goals is what convinced me to join.

My first hurdle was trying to figure out how I could provide comprehensive dental treatment with only a room and electricity.  I researched how underdeveloped countries are able to provide care in rural areas with minimal infrastructure. Without the use of radiographs, I was limited to being only able to treat what was clinically visible. As a result, my treatment was focused on small cavities with fillings, gum disease with scaling and root planning, extraction of non-restorable teeth, and root canals on front teeth.  Thankfully, consumed materials like anesthetic and restoration material were generously donated by Dental Dreams. Additionally, patients were educated on ongoing dental care.

Most patients came in to see me with a specific complaint; however, I was able to provide most of the patients with complete dental care of all clinically diagnosable pathology, not just a solution for their one ailment. This is significant because I found that while patients were seeking treatment for a specific tooth pain, they had at least one other cavity in their mouth.  I had satisfaction in knowing that every cavity I treated was a tooth that would have eventually caused pain and needed extraction if left untreated.  Some patients required as many as ten extractions.  By doing so, I was able to provide immediate pain relief and, in many cases, cure chronic infections that had plagued them for years. Thus ridding them of discomfort they may have thought would be a permanent part of their lives.

I also found that approximately half of my patients had untreated gum disease. Periodontal disease leads to bone erosion and eventual loss of teeth. Untreated periodontal disease also increases the risk of STD transmission and has been linked to negatively affecting hypertension and diabetes management. While in Jerusalem I treated the patients with periodontal disease with full mouth scaling and root planning, thus halting the disease process. Oral hygiene instructions and encouragement for regular dental cleaning was also reinforced.

Lastly, I performed approximately five root canals on front teeth. This was probably the most difficult procedure to bring with me, but I found it significant. Front teeth that would otherwise need to be extracted were saved with those root canals, preserving both the patients smile and their dignity.

 

Overall, my experience was eye-opening.  Though I was prepared to be working in an under-resourced and under-served community, the amount and severity of dental disease was shocking.  There was rampant decay, gum disease, and I performed numerous extractions of adult teeth on people as young as 12 years old.  This small view into one community made me wonder about dental health in Haiti as a whole.  According to the Haiti Dental Association, it’s estimated that there are only 300 dentists and 5 dental specialists in Haiti to serve a population of over 10 million.  Based on this knowledge and my experience, I have three goals going forward: 1. Strong education of dental hygiene and preventative care; 2. Continued and regular dental treatment at the clinic for this particular population and; 3. Ultimately establishing relationships with local dental providers and the school of dentistry in Port-au-Prince.  I was happy to provide some much-needed services, but I look forward to helping create a self-sustaining system in which I’m no longer needed.  

 

- Jessica Hyker

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Annie Grossinger