AGD Impact
Deepening Your Knowledge
Experience a comprehensive selection of lecture courses designed to elevate your dental expertise.
Enhancing Your Career
Students and new dentists can take advantage of a range of resources designed to support early career growth.
Sharpening Your Skills
Explore hands-on participation courses that provide practical experience to refine your techniques.
Expanding Your Network
Take advantage of multiple networking opportunities to connect with peers, mentors and industry experts.
Dental Volunteer Trips
How to Plan and Stories from Abroad
Participating in a volunteer trip overseas is no small decision. Before boarding the plane, dentists must engage in a multitude of decisions to ensure the trip is successful — from properly vetting the sponsoring organization to accounting for business losses during the trip to familiarizing themselves with local customs. But, once they are set up and providing care for those who need it most, dentists who go on these trips report there is no greater sense of satisfaction.
We Are the Sum of Our Experiences
The other day, my son said, “Happiness, when shared with a good friend, creates double the happiness. And sadness, shared with a good friend, cuts the sadness in half.” It was a profound statement that made me think about times in my life that I wish had never occurred. Periodically, it may be healthy to relive the past. Trials and tribulations affect our sense of self. Negative events may even make us stronger and better prepared to conquer, or at least accept, the bad and replace those emotions with positivity — or at least lessons learned.
This leads me to a question that I have asked many individuals, from family and friends to colleagues and even patients: “If you could somehow eliminate one year of your life without any consequences, what would that be?” I consistently get a contemplative look from each person before they respond. Several will relay a suffering parent or child, a death of a loved one, an illness, an accident, loss of a job, financial stresses or divorce. Younger respondents discuss getting cut from a team, bad grades at school or an emotional breakup. Many items on this list are experienced by each of us at one time or another. How we process these events makes us who we are.
Opportunities to rewind a part of life may be wishful thinking. Choices are presented daily, and the consequences of each decision may affect not only our personality, but those around us. Like everyone, I’ve had several “I should have” or “I could have” moments. Looking at these times in the past creates a present feeling that it seems easier to just give up or escape. Feeling helpless can freeze us to inactivity or even lead to depression. Feeling annoyed, frightened, uncertain, worried, confined, stuck or unsatisfied
is common from time to time. Not knowing how to rein in those feelings is not healthy. Instead of being paralyzed by a fixation on negative events, focus on what you can control. Make a list of small steps that you feel confident you can achieve. Slowly climb out of the darkness, one small task at a time. Lean on others for help if you need it. Overcoming obstacles in life is never easy, and constructing personal and professional success takes time and the help of others.
Every person I asked about eliminating a stressful or traumatic year in their life contemplated carefully for several seconds. The interesting fact is that, although the singular stories were all different, they were generally overcome. The memories were bad, but time healed and provided a chance to persevere. A perfect life is not possible, but optimizing what is important, taking care of the present and living without regrets helps to achieve a balanced life and promotes prospects for contentment and joy. Regretting choices made or goals not achieved is counterproductive. No matter the suffering now, better things will come. While there are several events in my life that I would like to eliminate, I would never want to remove any year because, good or bad, the events that happened are what made me who I am today.
Timothy F. Kosinski, DDS, MAGD Editor
Editor
Timothy F. Kosinski, DDS, MAGD
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AGD Corporate Sponsors
Letter to the Editor
I would like to extend my gratitude to AGD Impact for featuring the article “Frenectomies in the General Dental Practice” in the October 2024 issue. As a dentist and member of the International Board of Lactation Consultant Examiners with a special interest in airway health and oromyofunctional disorders, I deeply appreciate the attention given to this subject.
The article’s emphasis on the need for further research and education is timely and significant, especially as many of us in the profession did not receive adequate coverage of this topic in dental school. Given the frequent public misperceptions surrounding treatment of ankyloglossia, it is essential for our profession to take the lead in promoting evidence-based best practices for diagnosis and treatment. General dentists, in my opinion, are uniquely equipped to identify ankyloglossia and educate patients on the possible benefits of treatment. From the benefits of breastfeeding and proper nutrition to the benefits of optimal oral function and sleep, we as general dentists are uniquely suited to identify patients who may benefit from treatment. With detailed education and training, general dentists can provide frenectomies that can benefit our patients in both oral and overall health.
Thank you for featuring this article. I look forward to seeing AGD Impact continue to highlight this and other solutions that we can provide to help our patients.
Carla Sullivan, DMD, IBCLC Tulsa, Oklahoma
Inside General Dentistry
Look for the following articles in the January/February 2025 issue of AGD’s peer-reviewed journal, General Dentistry.
• Impact of mouth breathing on physical proficiency in children and adolescents
• Coronal microleakage of endodontic access restorations in zirconia crowns
• Hyperpigmentation of the oral mucosa caused by dietary beta carotene
Read these articles and more at agd.org/generaldentistry.
AGD Podcast
Protecting Your Dental Practice from Embezzlement
In this insightful episode, AGD Podcast Series host George J. Schmidt, DMD, FAGD, talks with David Harris, CFE, CPA, founder and CEO of Prosperident, the leading dental embezzlement investigation firm in the United States. Embezzlement impacts over half of all dental practitioners at some point in their careers, often with devastating financial consequences. Harris has dedicated his career to uncovering theft and empowering practice owners to protect their businesses.
Harris talks through the warning signs of employee theft, the importance of balancing trust with accountability and strategies for implementing robust systems to safeguard your practice. Whether you’re a seasoned professional or new to managing a dental office, this episode includes actionable advice to help you prevent financial losses and ensure the long-term success of your practice.
Visit agd.org/about-agd/publications-news/agd-podcasts to listen now.
AGD Fact Sheets
Talking to Patients About Sleep Apnea
AGD fact sheets provide your patients with all of the information they need to maintain their oral health. Fact sheets on more than 25 oral health topics are available for downloading online and can be customized to include your name and practice information. Download the fact sheet “Understanding the Signs of Sleep Apnea” at agd.org/factsheets.
The Daily Grind
Look for the Newest ‘Daily Grind’ Blog Post
AGD’s blog, “The Daily Grind,” offers insight and reflections from dental students and practicing general dentists. Read this excerpt from “Thriving in Troubled Times” by Larry Stanleigh, BSc, MSc, DDS, FAGD, FADI, FICD, FACD, FPFA:
“In dentistry, we have the opportunity every day to build smiles and change people’s lives. Be the change, lead with kindness and choose to be better regardless of those around you, and our lives will be better, happier, healthier and more prosperous.”
Visit “The Daily Grind” to read the rest: agd.org/daily-grind
Three Components of Training an Office Manager
By Roger P. Levin, DDS
One of the topics that does not get enough attention in practice management is the training of an office manager. Most dental office managers have very limited management education, experience or training. Levin Group has reviewed the performance of hundreds of office managers over the last 39 years and determined that many would benefit tremendously from understanding the real role of an office manager — starting with their job description.
We always recommend that for every position in the office there is a clear, detailed job description that also includes a list of responsibilities. Job descriptions force the practice to think through exactly what they want the job to be. Some job descriptions are more straightforward than others. For example, it is easier to document what you want the front desk person and the assistant or hygienist to do. These are relatively clear and easy to outline. It is not as easy when you are talking about an office manager because the set of responsibilities varies widely from practice to practice.
Let’s look, for example, at three different types of dental office managers. In one practice, we found the office manager was
strictly in charge of the front desk area and also participated in answering phones, scheduling patients, collecting money and other typical day-to-day front desk responsibilities. In another office, we found the office manager, overall, knew the financial aspects of the office but had no role in employee management. In a third office, we found the office manager had full responsibility for all day-to-day operations, oversaw human resources (including hiring and terminations) and was responsible for day-to-day performance of the practice. These three scenarios — and there are others — represent the wide variation in office manager responsibilities and why job descriptions become essential.
What Should an Office Manager Really Do?
In the ideal practice business model, the office manager literally manages the office. This means complete responsibility for day-to-day operations, human resources and any other factor that is a normal part of creating excellent practice performance. This version of an office manager is more like example No. 3 above.
Having said that, what I’ve observed over the past four decades is that the majority of dental office managers have no manage-
ment education and have never managed a business before their current position. It is no wonder that so many office managers struggle to succeed. As an example, a manager of a McDonald’s (which is not a simple business) understands exactly what is to be done, how it is to be done, what the targets are, how to work with McDonald’s regional management, etc. The job is not only clearly documented, but McDonald’s managers receive extensive training on how to do the job effectively. This is why McDonald’s can reproduce the same level of performance in restaurants all over the world, day after day.
Dental practices would benefit from a higher level of training and experience of office managers. But how do they gain this?
It’s All About Systems
The most viable and effective training for dental office managers is to implement proven step-by-step systems into the practice. A system is a step-by-step process to be followed by each team member in order to achieve a specific result. Examples include maximizing insurance benefits through proper coding and submission, establishing a daily production goal for the practice, scheduling in a manner that is designed to achieve a goal, and so on. Systems work extraordinarily well when properly designed and followed. Systems are designed specifically to achieve targets and help each team member know exactly what to do, when to do it and how to do it. This makes the job of the office manager far easier and more effective in that the manager can identify exactly what is working or not relative to the steps in the systems. The best thing any practice can do to help an office manager excel is to implement proven systems.
But Is It Worth It?
Dentists excel at dentistry. Most dentists would like to spend their days treating patients, providing excellent clinical care, and creating satisfaction for both themselves and their patients.
So how do we create a scenario for dentists where the bulk of their time each day is spent facilitating patient care and not involved in other practice management scenarios, questions or decisions that are distracting and fatiguing, not to mention taking away from practice production? The answer is an extremely welltrained office manager. The office manager, in an ideal situation, should be responsible for all day-to-day operations. The staff should already be trained in the systems and know exactly what to do. If measurements or targets are missed, the office manager should step in, evaluate the reasons, and, in a positive way, work with the team member or members to achieve the right results. Dentists should be practicing dentistry while all this is happening. This is the key to practice success and enjoyment. If this sounds too good to be true, it is not. Many practices have office managers who are not experienced, educated or trained in management. Like McDonald’s, when systems go into place and are followed, you will have the same result time and time again.
Summary
Office managers can be extremely valuable but are usually underutilized relative to their potential. Most do not have a management background, and their jobs are a bit variable. The best scenario is when an office manager runs all day-to-day operations in the practice. In order to make this work, practices should implement systems for all operating areas of the practice, and the office manager’s role becomes implementing the systems, measuring results and making course corrections. A highly trained office manager allows a dentist to focus most of his or her time on dentistry, and practice production will rise. ♦
Roger P. Levin, DDS, is the founder and CEO of Levin Group, a dental management consulting firm. To comment on this article, email impact@agd.org
I Can’t Decide on the Title of this Column
By Clayton Sorrells, DDS
“Dr. Sorrells, what do you want to do with this old equipment we have lying around?”
“Well, Doc, if it was your tooth, what would you do?”
“Hey, honey, what do you want for dinner?”
“Hey, Clayton! Do you want to go to this football game with me this weekend?
Do any of these questions sound familiar? As dentists, we are faced with at least three million questions per day. OK, I might be exaggerating, but still. We are bombarded with questions at the office, at home, and from our family and friends. Sure, none of these questions seem very hard to answer on the surface, but, after fielding hundreds of them in a week, even a simple question like, “What do you want for dinner?” can send your brain into overdrive.
Decision fatigue is something I never experienced before becoming a dentist. Yes, I answered a lot of questions when I was a nurse, but, as a practice owner, the weight of every decision just seems heavier. The stakes feel higher, whether it is about patient care, practice management or even personal life. The constant pressure can be overwhelming, and a seemingly endless list of decisions can leave you feeling drained.
When I started preparing to write this column, I told my wife, “Hey, honey, I can’t decide if I want to write about decision fatigue or … never mind.” We had a good laugh because the topic was clearly staring me in the face. One of the most important things I have learned is the value of stepping back and simply breathing. This advice might sound basic, but it is incredible how much clarity you can gain by taking a moment to pause. I will never forget one of my very first molar root canals. There I was, staring at tooth No. 30. I could see two canals, but I knew there was a third. The problem was that I didn’t know where it was, and I could not decide whether it was the mesiobuccal or mesiolingual canal. The tooth was staring back at me, my assistant was staring at me, and the patient was staring at me. For a moment, it felt like a staring contest I wasn’t going to win.
I casually told the patient, “You’ve been lying there for a while; let’s take an X-ray to see things more clearly, and why don’t you stand up and stretch?” That radiograph served two purposes. It provided the visual information I needed, and it gave me a chance to step away and breathe. By slowing down, I returned to the operatory with a clearer mind, found that pesky mesiobuccal canal and finished the root canal. When faced with tough decisions, it is essential to pause, take control of the situation and give yourself a moment to think more clearly.
Last year was a whirlwind for our practice. We upgraded our practice management and radiography software, purchased an intraoral scanner and made significant office renovations. It felt like every week came with a new decision to make. I am the type of person who likes to be involved in every detail. Some might call it micromanaging, and I, begrudgingly, admit they are not wrong. But I
realized that trying to handle every decision on my own was not sustainable. One of the most effective ways to combat decision fatigue is to delegate. If you are dealing with decision fatigue, take a moment to look in the mirror and ask yourself, “Am I a micromanager?” If the answer is yes, it is time to let go of the reins and start delegating. You have hired great people for a reason, so let them make some decisions. Of course, they can still come to you for the big ones, but freeing yourself from the smaller choices can make a huge difference.
“When faced with tough decisions, it is essential to pause, take control of the situation and give yourself a moment to think more clearly.”
As dentists, we often put too much pressure on ourselves. We are so invested in our work, our practice and our patients that asking for help can feel like a sign of weakness. But it isn’t. I’m fortunate to have several mentors I can reach out to when I’m stuck. Whether it is a clinical dilemma or a personal decision, bouncing ideas off someone else can provide a fresh perspective. The person you talk to might not know much about the specifics of your problem, but they might say something that sparks an idea and helps you make the decision.
I have also found AI to be an invaluable tool for decisionmaking. When I have a quick question or need to brainstorm, I use AI to explore options, troubleshoot problems or validate my ideas. It’s like having a mentor available at all hours, ready to offer a fresh perspective. Whether the input comes from a trusted colleague or an AI assistant, seeking advice from others — human or machine — has made managing decision fatigue much more achievable. If you have taken the time to breathe and delegate but are still stumped, do not hesitate to reach out for help. You never know who or what might provide the insight you need.
At the end of the day, you are still going to feel tired from making decisions, but that is not such a bad thing. It is a lot better than the alternative of having no decisions to make. When I start to feel overwhelmed, I remind myself that it is a privilege to be in a position where I get to make so many choices. While I might not always make the right call, I find comfort in knowing that at least a decision was made thoughtfully. And that, more often than not, is enough to keep moving forward. ♦
Clayton Sorrells, DDS, is a new dentist and previous AGD chapter president at Louisiana State University School of Dentistry. To comment on this article, email impact@agd.org
To Do or Not To Do an AEGD or GPR After Dental School?
By Brooklyn Janes
Advanced education in general dentistry (AEGD) programs and general practice residencies (GPRs) often carry certain perceptions within the dental student community. These one-year programs are sometimes seen as options for students who lack the competence to enter private practice directly or who didn’t gain sufficient clinical experience during their four years of dental school. However, as I approach my graduation in April, my perspective on AEGDs and GPRs has changed significantly.
I am thrilled about my upcoming AEGD residency, having recently been accepted into NYU Langone’s AEGD program at Roseman University, which begins in July. My decision to pursue this residency was driven by the opportunity to gain advanced training in oral surgery, implants and endodontics.
Before applying, I had conversations with program directors about the value of an additional year of training. One director’s response really resonated with me: “Do you want to be a breadand-butter dentist, or do you want to be a super dentist?” That question made me pause and reflect on the type of clinician I want to become. It encouraged me to think critically about the procedures I want to master and the level of efficiency I am aiming to achieve in my practice.
Endodontics is a particular area of interest for me, especially mastering the treatment of molar teeth. At my dental school, endodontic training primarily focuses on anterior teeth and premolars, so gaining more experience with molars is a goal of mine. Similarly, my mentors have emphasized the importance of oral surgery for general dentists, particularly the ability to perform extractions. Helping an emergency patient get out of pain through a well-executed extraction is a valuable service we can provide as general dentists. While I’ve always been drawn to oral surgery, the more procedures I perform, the more I realize how much more I need to learn.
I’m also eager to expand my knowledge of implants. At my dental school, we were required to restore an implant with a crown, but surgical placement and associated procedures, like bone grafting, were not part of the curriculum. While I considered external continuing education courses for implants, many seemed expensive for a recent graduate like myself trying to manage significant student loan debt. This further reinforced my decision to pursue an AEGD, where I could gain hands-on experience in implant dentistry in a much more affordable and sure way.
To determine if an AEGD was the right fit for me, I spent some time shadowing the residents and program directors. If you are considering whether an AEGD or GPR is the right choice, I highly recommend reaching out to programs you’re interested in and observing current residents to see if the residency aligns with your goals. Can you envision yourself in the program? Do you connect with the program directors and attending faculty? Do the residents seem happy and supported? Can you picture yourself living that lifestyle in that location?
It’s also important to recognize that not all AEGD and GPR programs are the same. Each program has its niche, serving different populations and focusing on particular procedures. For example, some programs cater to pediatric patients, providing extensive experience in pediatric dentistry. Others are hospital-based, focusing on special needs dentistry, general anesthesia and oral surgery. Some programs collaborate closely with specialty residencies, such as endodontics, allowing residents to gain significant experience in those areas. Understanding the strengths of a program and its patient population is crucial to choosing the right fit for your goals.
I was particularly drawn to my upcoming residency because it offers the opportunity to work closely with multiple specialists, including cosmetic dentists, endodontists, prosthodontists and periodontists. For anyone considering a specialty residency, completing an AEGD or GPR is an excellent way to gain exposure to advanced procedures while enhancing your marketability for specialty programs. Many specialty residencies, such as endodontics, oral surgery and periodontics, often prefer applicants who have completed additional training beforehand.
Initially, I was 100% committed to starting my career immediately after dental school. However, after reflecting on my long-term goals and the kind of dentist I aspire to be, pursuing an AEGD became the perfect choice to help me achieve them. ♦
Brooklyn Janes is a fourth-year dental student and AGD chapter president at Roseman University College of Dental Medicine. To comment on this article, email impact@agd.org
The Promise
By Maggie Augustyn, DDS
Holding our diplomas and still wearing our caps and gowns, my best friend and I promised we’d travel the world providing dental care to communities that needed it more than our surrounding Chicago suburbs. Part of that was our wholehearted desire to make the world a better place. Part of it was a selfish craving to journey. But, nonetheless, that’s what we did.
A year after graduation, we boarded a small propeller plane with a man we didn’t know, balanced our luggage to the weight of the passengers, and flew south to Mexico. A resort nearby offered us accommodations at a significantly reduced rate, though it didn’t matter much because we spent less than eight hours in
our rooms. We worked in La Paz, Mexico, in a prison guarded by machine guns, and mingled amongst inmates. Thinking back, I’m in disbelief at how naïve we were. Not only did we go with people we didn’t know, we were locked up for 12 to 16 hours a day in a prison where it didn’t occur to us to question our safety. But those are, at least in part, the sacrifices you make when you go abroad to help those who have very little. Since then, I’ve made two more trips that were more organized and far safer — one to Nepal and another to Guatemala. My intention and my graduating promise were to give my time and talent to volunteer trips at least once a year, but reality didn’t pan out that way.
The Cost of Doing Business
Most people don’t realize what it takes to travel and volunteer abroad. Let’s start with the logistics.
Finding the right group: It’s far easier today to find a reputable group to travel with than when I first started in 2005. We found our first group to be unethical, withholding treatment unless the prisoners chose to undergo religious conversion. We were not told this when we signed up.
Cost of going abroad: Most groups keep the cost very low. Trips are usually booked to third-world countries, where room and board are inexpensive. But, in many of these places, the accommodations can be uncomfortable. Beds might leave much to be desired, temperatures might be poorly controlled, and there may be no hot water for bathing. However, in my experience, the food on my trips has been amazing. Those who cared for us made sure we were well fed.
Loss of income: What might not cost a lot in terms of travel does not begin to compare to what we lose as providers, practice owners or breadwinners in terms of production and income. If one is a sole practitioner, there is also an issue as to what happens with the team. The trips that I have taken have spanned at least seven days. And, though one might compare that kind of absence to taking a vacation, which might refresh a practitioner and keep them working at full capacity when they return, the reality is that being away from the practice to volunteer abroad requires a lot of hard work and carries with it tremendous emotional weight. It is not a vacation.
The Reconciliation
If it had just been about the money — meaning the loss in production — I probably would have kept volunteering. But the last trip I took, in 2009 to Guatemala, broke me emotionally. All of my trips affected me, but the last one was unrelenting. Coming back from serving abroad, the experience of having borne witness to the stark differences between the haves and have-nots, always weighed significantly on my soul. The homelessness, the poverty and lack of resources made it difficult to reconcile the life and gifts I had in my own life. Each time I came home, it took time to regain my footing. There was guilt, sadness, anger and tears, which soon turned into memories with a sense of absolute helplessness. With the first two trips, the guilt dissipated within several weeks. The trip to Guatemala was different. I couldn’t function. I came home and wanted to give away anything of value, everything my husband and I had worked for. I could not handle the guilt. I couldn’t live with it. I didn’t want to be me anymore. A big part of me was proud of the fact that I had made a difference. I understood, logically, that I played an important role — albeit it a small one — in making this world a better place.
“Remember that to hold those who have nothing and to carry them when we have more than enough deserves the highest of recognitions.”
But even that didn’t make me feel any better. It took a year before I was able to find acceptance for the life I was living. It took a year for me to somehow forgive myself for how lucky I was to have a home, a car, food, clothes, and all of the things I didn’t need and maybe didn’t even want.
Beholden to Those Who Can
I have the utmost respect for any person who travels abroad to volunteer. I thank them for their service and for their sacrifices, and for that of their families, too. Because, despite my best efforts, I could no longer do it. Despite my best intentions, I couldn’t keep that graduation day promise. For those who are considering it, I wholeheartedly encourage you to prepare yourself better than I did. I think if you leave better prepared for the potential emotional repercussions, your return to reality will be much different than mine.
First and foremost, travel with a group that you have thoroughly vetted, interview dentists who have previously traveled with the group, and make sure they are a true and established nonprofit entity. Prepare yourself emotionally for your return home. Be ready to come back emotionally unraveled. When you do, hold onto the beauty of helping those who have nothing. Remember that it made you feel whole to help and to give. Remember that to hold those who have nothing and to carry them when we have more than enough deserves the highest of recognitions. Those reminders will allow you to emotionally maneuver the unchartered waters you’ll return to. Also, it helps to keep in touch with the people you’ve traveled with; chances are they might feel like you do, and, if you communicate, you can help each other acclimate back into normal life.
Finding a mentor who has gone on many trips can also help you, as well as talking to neighbors and friends about your trips. Applause is never the reason for helping, but it can help put things in perspective and remind you that you have done something good for this world. Finally, keep going when you can, and stop if it gets too hard. After all, we have to keep moving with the life we have. I am eternally grateful for those who continue to carry the torch that I no longer could. We are all beholden to those who can, and we should show them our sincere and genuine gratitude. ♦
Maggie Augustyn, DDS, is a practicing general dentist, owner of Happy Tooth, faculty member at Productive Dentist Academy, author and inspirational speaker. To comment on this article, email impact@agd.org
Dental Volunteer Trips
How to Plan and Stories from Abroad
Serving the Underserved As an International Volunteer Dentist
By Jake Kathleen Marcus, JD, PGDip
Volunteering in international dentistry is a meaningful way for dental professionals to make a global impact by providing essential oral healthcare to underserved communities. International communities often require a mix of short-term relief efforts and long-term systemic improvements to meet their dental needs effectively. According to the World Health Organization, in 2021, “Untreated dental caries (tooth decay) in permanent teeth [was] the most common health condition.”1
If you wish to volunteer internationally — whether you are a dentist, assistant or hygienist — here is a guide to get you started:
Understand the Need
Many regions lack access to basic dental care due to limited resources or lack of trained professionals. Common issues in underserved areas include untreated cavities, gum diseases, oral infections and lack of education on oral hygiene. The World Health Organization reports that approximately “two billion people suffer from caries of permanent teeth, and 514 million children suffer from caries of primary teeth.”1 This deplorable state of oral health is attributed to diet, inadequate exposure to fluoride, poverty and lack of access to even the most basic dental healthcare.1
Benefits of Volunteering
There are many benefits to contributing your professional skills to underserved communities, both for the patients and for yourself. For example, international volunteering can result in such valuable benefits as:
• Personal growth by enhancing your skills working in diverse settings and addressing unique challenges.
• Cultural exchange through learning about local customs and traditions while sharing your expertise.
• Community impact of helping to reduce preventable oral health issues and improve quality of life.
Roles for Volunteers
Dental volunteers can serve many roles in international underserved communities. These include:
• Performing dental treatments (fillings, extractions, cleanings, etc.).
• Providing oral health education and preventive care.
• Training local healthcare workers in basic dental care techniques.
How to Get Involved
Many organizations coordinate dental volunteer programs globally, but it is advisable to join established organizations.
As an example, Global Dental Relief (GDR) (globaldentalrelief.org) focuses on providing free dental care to children in school classrooms in Nepal, Kenya, Cambodia, Guatemala and Mexico. Volunteer dentists, hygienists, assistants and general volunteers deliver treatment and preventive care in remote villages. Founded in 2001, GDR reports bringing 323 volunteers to its host countries each year.
Dentistry For All (DFA) (dentistryforall.org) offers comprehensive dental care and education in Guatemala, Nicaragua and the Philippines. Based in Canada and founded in 1995, DFA states that it has run 70 missions serving over 33,000 people who have undergone over 93,000 procedures.
Improving oral health through practitioner education is another way dental professionals can volunteer their skills internationally. Health Volunteers Overseas (HVO) (hvousa.org) matches dentists with teaching and clinical opportunities in Laos, Nepal, Tanzania and Uganda. Established in 1986, HVO uses a partnership model through which volunteers improve dental education at host dental schools.
In addition, some U.S. dental schools often organize international outreach programs for students and alumni. Organizations like the American Dental Association also provide resources for volunteering abroad. Churches or other nongovernmental organizations may have mission trips with dental services as part of broader health outreach. When considering such trips, it is important to investigate the organizations organizing the trip for the same safeguards as when traveling with established organizations. For example, faith-based organizations, while well-intentioned, may organize a trip with a house of worship in another country that does not have any medical or dental presence in the destination country. Traveling to perform dental work in another country requires a local contact with experience in the community and the government to ensure you can safely and efficiently provide services within the local rules of practice.
Considerations Before Volunteering Licensing and Certification
Some countries require temporary licenses for foreign dentists. Be sure the organization in charge of your volunteer trip provides you with the specific requirements for providing dental care in the country to which you are traveling and that the organization handles all aspects of processing your documentation within the destination country. You do not want to run afoul of the law outside the United States, especially in a country where you might not speak the language.
Cultural Sensitivity
It is important to be respectful of local customs and beliefs about healthcare as well as the local expectations regarding dress, language and behavior. It is particularly important to know whether it is acceptable to ask permission before taking photographs or if
photography should be completely avoided. Familiarize yourself with challenges specific to the region, like language barriers or common dental issues.
Funding
Most programs require volunteers to cover their expenses (e.g., travel, accommodation, supplies). Some programs may offer grants or scholarships, but it also may be necessary to organize your own fundraising.
Long-Term Impact
Focus on sustainability by training locals, donating durable equipment or supporting ongoing education programs. For example, GDR also runs a school lunch program for children in Kathmandu, Nepal, by adding two eggs and three pieces of fruit to the school-provided daily lunches. DFA supports a permanent dental clinic in El Remate, Guatemala, which is staffed by locals between mission trips.
Ethical Practices
Avoid “voluntourism” by prioritizing the community’s actual needs over personal experiences. Whether visiting a country as a dental volunteer or as a leisure tourist, photography requires respect for the desires of the people you wish to photograph and an understanding of the norms of the place or activity you wish to photograph.
Respect patient autonomy, and prioritize informed consent. While the laws governing informed consent outside of the United States will differ (be sure to ask your trip organizer about the specific country’s dental regulation), be sure a translator has fully explained any treatment before you perform it and that the patient has agreed to the procedure before it is performed. Also critical is your patient’s understanding of aftercare. Complications like infection may not arise until you have left the country, and the patient is unlikely to have access to someone with your skill.
As any dental professional knows, poor dental health often leads to serious disease in body systems beyond the mouth. Providing primary dental care can have a cascade of impacts, such as reducing infection risk and even improving cardiac health.2 Bringing your skills to underserved populations, either internationally or in the United States, is a way for you to grow as a person and to save lives. ♦
Jake Kathleen Marcus, JD, PGDip, has been a regulatory lawyer primarily in the healthcare space for over 35 years. They were recently awarded a postgraduate diploma in technology, media and telecommunications by Queen Mary University of London School of Law. To comment on this article, email impact@agd.org.
References
1. “World Health Organization Oral Health Fact Sheet.” World Health Organization, 6 Nov. 2024, who.int/ news-room/fact-sheets/detail/oral-health.
2. Shmerling, Robert H. “Gum Disease and the Connection to Heart Disease.” Harvard Health Publishing, 8 Oct. 2024, health.harvard.edu/diseases-and-conditions/gum-disease-and-the-connection-to-heart-disease.
Preparing for Your Trip
� Assemble portable dental tools and supplies if these are not supplied by the trip organizer. Do not plan to bring anesthetic with you, and discuss any concerns you have concerning what you can bring with the trip organizer.
� Pack personal essentials, including your own personal medications and toiletries. Make sure you pack these in your carry-on luggage, as it is unlikely you can readily replace these if your checked luggage is lost.
� Buy travel and local medical insurance (if available). Suggestions for companies from which these can be purchased should be available from your trip organizer.
� Learn basic phrases in the local language(s). It is important that you are certain of the correct way to say “please” and “thank you” as well as “excuse me” when you are walking in a crowd, as well as — critically — “where is the bathroom?” Be sure you can read common signs such as “restaurant,” “bathroom,” “hotel” and “hospital.” Use of a translation app may be of limited usefulness; however, the Google Translate app allows for the download of individual languages for offline use and also offers camera and microphone functions for ‘reading’ signs or text and listening to native speakers. If you have mobile internet access, ChatGPT is a helpful translator and can take into account different countries’ versions of a language (e.g., Guatemalan Spanish vs. Spanish spoken in Spain).
� Review travel advisories and vaccinations required for the destination. The organization in charge of your trip should provide you with accurate information about these. The U.S. Department of State issues comprehensive travel advisories (travel.state.gov) as well as information concerning visa requirements and recommended vaccinations. Keep in mind that the State Department’s travel advisory levels are numbered 1 through 4, with many countries to which volunteer dentistry groups travel — such as Guatemala — being ranked as “Level 3: Reconsider Travel.” This ranking should not necessarily deter you if you are traveling with an established organization and you take all the necessary precautions, such as knowing the local laws governing dental practice. Additionally, the State Department provides detailed information about the factors necessitating its advisory levels, as well as specific tips and precautions U.S. travelers can take to maximize their safety. It also offers the Smart Traveler Enrollment Program to further assist U.S. citizens abroad.
� Know what equipment is provided for you. GDR, for example, provides equipment and supplies to carry out preventive, restorative and palliative treatments in the global volunteer clinic setting. According to the GDR website, volunteers are provided with portable dental units consisting of high- and slow-speed handpieces, three-way syringes and venturi suction. Other supplies include surgical, periodontal and restorative instruments; local anesthetic; and needles and syringes. Volunteer dentists who bring their own equipment, such as burs, are expected to donate them for future clinic use. The organization with which you choose to travel may provide some or all of this equipment, and it is essential that you know in advance so you can be of the most use.
Participating in a volunteer trip overseas is no small decision. Before boarding the plane, dentists must engage in a multitude of decisions to ensure the trip is successful — from properly vetting the sponsoring organization to accounting for business losses during the trip to familiarizing themselves with local customs. But, once they are set up and providing care for those who need it most, dentists who go on these trips report no greater sense of satisfaction. AGD Impact asked four dentists who have participated in overseas volunteer trips to share their stories and how these unique experiences changed them.
By Michael L. Johnson, DDS
HCould Dentistry in the Peruvian Jungle Be on Your Bucket List?
ave you ever thought about using your dental skills in a thirdworld country? About 25 years ago, that opportunity came my way.
A good friend of mine was organizing a humanitarian trip to Peru, where one of his projects was to build an additional classroom for an existing grade school. His thought was to include dentistry as an additional project. I received the invitation and gladly accepted. Since I would be needing a dental assistant, my 12-year-old son came to mind and was immediately drafted.
We flew to Lima then took another flight to a remote area in the middle of the Amazon jungle. Later that day, we arrived at the school to set up our temporary dental clinic. The school principal greeted us and gave us a quick tour. Every one of the classrooms was being used, but he recommended that we use the school library. That turned out to be a blessing because we needed the tables for our dental supplies and the chairs for our waiting room.
I brought a portable A-dec dental unit, but I needed to find something that would work as a dental chair. I spoke with one of the school officials and let him know that we could really use a couple of lawn chairs so that we would have something that could recline as we were working on patients. He stated those aren’t common in this jungle town. He offered to drive me around town on his motorcycle to see if we could buy or borrow one. After striking out on all our possibilities, he said he had a friend who made furniture and thought we could ask him.
Upon arrival, I explained our situation to the furniture maker. He said he didn’t have a lawn chair but offered one of his plastic kitchen chairs. I gratefully accepted because it was better suited than the ones in the library. He then asked if I could look at his four-year-old daughter’s teeth. She had been complaining of a toothache for a few weeks and was having a hard time sleeping. I did a quick assessment and observed that all four of her upper incisors were badly infected. I spoke to her dad about the condition of her teeth and recommended that they be extracted. He understood. I invited him to bring her to our clinic first thing in the morning and said that we would take care of her.
The next day, about 30 minutes before we opened the clinic to a line of people patiently waiting outside, we went through our checklist. With our portable dental unit connected to a borrowed two-horsepower compressor, a kitchen chair for our patients and a five-gallon bucket for me to sit on, we were ready to go to work.
When we opened the door, the parents of the four-year-old girl were there with her. Before I brought her back, Mom told me that her husband had a gift for us. He then presented us with an adjustable dental chair that he had made in his furniture shop. I asked her the story behind the chair. She said her husband was so impressed with our volunteer effort that he wanted to help in some way. She went on to say that he spent most of the night designing and making a simple dental chair that could be raised and lowered as needed. Our group was floored by his generosity. We took care of his daughter as well as close to 100 other patients over the next five days.
Upon completion of the work projects, the local mayor organized a huge celebration for us. This jungle village was so grateful for our volunteer service and how much our efforts would make an immediate impact on the community. At the conclusion of our trip, our group was able to visit the ruins at Machu Picchu as well as some of the other local points of interest. Including these experiences makes these humanitarian trips much more meaningful, as we now have a deeper appreciation for the culture.
My son had a great experience being my assistant and being introduced to doing dentistry in a third-world country. His first comment at the conclusion of the trip was, “Wow, Dad, these people don’t hardly have anything, but they are always happy.” I agreed and commented that we can certainly learn a lot from them.
Our mission on these trips is always to try to save as many teeth as possible. The teeth that we could save were restored either with amalgam or composite. For many of our patients, I was the first dentist that they had ever been to. Even though nearly all of our patients really valued their teeth, their biggest obstacle was a lack of resources to pay for even basic dental care.
Since that experience, I have had the opportunity to go on dental humanitarian trips to Guatemala, Honduras and Mexico,
“There always seems to be one constant: After every trip, each one of us is always a better person than we were the week before.“
as well as return trips to the jungle of Peru. Each of my four kids have had the opportunity to go with me. As a dad, I try to include my children on as many trips as possible. Years later, they still talk about the unique experiences they’ve had. There always seems to be one constant: After every trip, each one of us is always a better person than we were the week before.
Currently, I volunteer with the Xela Aid organization in Guatemala. Check out its website at xelaaid.org. We would love to have you come down to Guatemala to share your dental skills. ♦
Michael L. Johnson, DDS, practiced dentistry in Mesa, Arizona, and currently serves as visiting faculty at Spear Education in Scottsdale, Arizona.
Volunteering in Central America and Cambodia: For the Big-Hearted, Not the Faint of Heart
Following is a synopsis of the experiences of Carl D. Werts, DDS, FAGD. To read the full version, visit agd.org/werts.
By Carl D. Werts, DDS, FAGD
Istarted going on mission trips in 2008 after the economy tanked and I faced a downturn in my office. Days with no patients left me with time on my hands, so I looked for ways to make a difference. I visited a patient involved with the homeless community of skid row in Los Angeles, helping them find housing. When I asked about their dental care, he referred me to LA Christian Health Centers. Out of curiosity, I went there and was quickly asked when I could start. Despite not having done extractions in over 30 years, I was thrown into the role, learning on the spot. I quickly found that I enjoyed oral surgery, and, over time, I expanded my skills to do almost everything in dentistry. This led me to volunteer once a month at LA Christian Health Centers for the past 16 years, an experience that has given me perspective on life by working with those less fortunate.
Volunteering in China and Central America
During the time I was volunteering in Los Angeles, I attended a course taught by Dr. Karl Koerner. He mentioned a dental mission he arranges annually to China. Since I had just developed proficiency in oral surgery, I volunteered and was accepted. It was a great experience — I was able to bond with the team, the patients were grateful, and I got to experience China in a unique way, far from the typical tourist path.
A few years later, I joined Los Medicos Voladores (LMV) — “The Flying Doctors” — an organization that primarily works in Baja California, a state in Mexico, but also runs annual missions to Central America. In 2016, I joined a trip to Guatemala, and, since then, I’ve made it an annual mission.
Cambodian Health Professionals Association of America
Through LMV, I met a psychiatrist who invited me to join a 2018 mission to Cambodia with the Cambodian Health Professionals Association of America (CHPAA). The mission was large, with around 125 volunteers from the United States, and we worked alongside a Cambodian team. Cambodia was eye-opening. Many of the people over age 50 had survived the Khmer Rouge regime under brutal dictator Pol Pot in the 1970s, and the founders of CHPAA were medical professionals who had fled to Thailand, trained in the United States, and had returned to help their people. This organization is purely humanitarian, with no political or religious affiliations.
The missions are volunteer-based, and we cover our own expenses — airfare, meals, lodging — while the rest is funded by donations. The amazing people I meet on these trips, both volunteers and patients, make the experience so rewarding. In Cambodia, I began as a volunteer dentist and later helped organize the dental department, eventually growing our team to 25 dentists, hygienists and dental students. Our goal is to teach and share knowledge while also providing treatment, mainly extractions. Since my first trip in 2018, I have returned to Cambodia in 2019, 2023 and 2024, and I will be going again this year.
The sizes of the mission trips I’ve attended have varied. In China, we had 18 volunteers, including a plastic surgeon for cleft palate surgeries, working alongside over 60 local counterparts. Guatemala typically involves 25 people from the United States and support from local medical staff. In Cambodia, the U.S. team is around 125, with another 125–150 local volunteers. We’re also able to recruit local dental students, with more than 100 applying for 15 spots on the upcoming mission.
Local Challenges
I’ve traveled to various locations, each with its own challenges. In Guatemala, we usually meet in Antigua before heading to more remote areas like Quetzaltenango (“Xela”) or Tierra Colorada Baja. These regions are home to indigenous Mayans, who live on a few dollars a day, and their colorful handmade clothes tell stories of their heritage. The conditions in these rural clinics are basic; we often work with makeshift equipment and improvised spaces, like classrooms or small rooms with curtain dividers. We sometimes
“The challenges are part of the experience — the discomfort, the uncertainty and the occasional conflicts within the team. But those who go on these missions are dedicated, selfless people, and the reward is in the difference we make.“
face uncomfortable heat, rain and unpredictable conditions, but the work is rewarding.
One year in El Salvador, changes in the political landscape nearly caused our mission to be canceled, but, after a public outcry, the new administration allowed us to go. This time, we worked out of a school rather than a clinic, and I had to improvise with rented equipment and local dentists. There were challenges like the lack of basic resources, but, despite the discomfort, the patients’ gratitude was overwhelming. After the COVID-19 pandemic, we returned to Guatemala, this time to Retalhuleu, a sugar cane region where poor dental health is rampant due to the local diet. The conditions were again challenging, but the reward of providing care to those in desperate need kept us focused.
In Cambodia, we rotate between provinces each year, providing care to remote villages. The heat and humidity are constant challenges, and working with limited resources requires quick
thinking and flexibility. We bring some equipment, but much of it is purchased locally, and donations help cover the costs. Every mission presents new challenges, but the team’s dedication ensures we can still provide valuable services to those who need them most.
The Drive
What drives me to do this work? After years of mountaineering and personal travel, I found that giving without expecting anything in return is far more rewarding. The mission work has allowed me to develop skills I enjoy while helping those who are often overlooked. The appreciation from the patients and the bond I share with my fellow volunteers makes it all worthwhile. It’s not about the conditions or the challenges — it’s about making a difference, even if in small ways.
The most rewarding experiences come from the deep gratitude patients express. In Guatemala, I was able to treat a clinic worker who had been cleaning the clinic tirelessly. She feared she would lose most of her teeth, but I could tell her rampant decay was the type that was shallow. I restored 13 of her teeth, and, when she saw herself in the mirror, she burst into tears, so thankful for the change.
The challenges are part of the experience — the discomfort, the uncertainty and the occasional conflicts within the team. But those who go on these missions are dedicated, selfless people, and the reward is in the difference we make. The patients may not have much, but their appreciation for the care we provide is more than enough. ♦
Carl
D. Werts, DDS, FAGD, owns a practice in Glendale, California.
By Nicole Smith, DDS, FAGD
I
A Dental Mission Trip to Vanua Levu, Fiji
Providing Life-Changing Care and Building Connections
had the incredible opportunity to join a dental mission trip to the remote island of Vanua Levu in Fiji. The journey was long and arduous, involving two flights, a boat ride and a bus trip, but it was a journey that would leave an indelible mark on my heart and reaffirm my passion for charity work.
The mission trip was to The Mission at Natuvu Creek, a well-established volunteer center that welcomes a diverse array of medical professionals to rotate in weekly and provide critical care to underserved communities in Fiji. In addition to dentists, other volunteer teams that travel to The Mission to donate their time and skills include ophthalmologists, pediatricians, obstetriciansgynecologists, general surgeons, plastic surgeons, cardiologists, nurse practitioners, health educators and nutritionists. Together, those who volunteer work to improve the lives of the Fijian people who otherwise have limited access to medical care.
Our team of four dentists and five dental team members was tasked with providing much-needed dental treatment to residents across Vanua Levu. Over the course of the week, we treated over 170 patients, many of whom had never received dental care or had waited years for treatment. For these individuals, our visit was not just a routine dental appointment — it was a lifeline. The majority of the people we saw never had access to preventive care and were suffering from preventable conditions like tooth decay, gum disease and abscesses. It was humbling to see the immediate relief that a simple extraction or filling could bring to someone who had endured pain for months or even years.
What struck me most was the distance these patients traveled to receive care. Many patients boarded buses before dawn, traveling for hours from remote villages scattered across the island, just to reach our clinic at Natuvu Creek. The commitment of the Fijian people to their health and the profound gratitude they expressed was a powerful reminder of how crucial these outreach missions are.
In addition to the general dental care we provided to adults, we also had the opportunity to spend a day at the Seventh Day School, a primary school where we provided oral hygiene instructions and fluoride treatments to all of the children. This was one of the most rewarding aspects of our trip. The children were eager to learn, and their excitement was contagious. As we taught them about proper brushing techniques and the importance of good oral health, we could see their faces light up with understanding. Afterward, the children sang a beautiful Fijian song for us and proudly showed us their artwork — creative, colorful drawings that highlighted their joy and pride in having us
visit their school. Their enthusiasm was a reminder of the ripple effect that good health education can have on future generations.
The entire experience was deeply rewarding, not only due to the tangible health improvements we helped bring but also in the connections we formed with the Fijian people. It was humbling to realize how much the simplest act of kindness — like taking the time to provide a fluoride treatment or offer a comforting word — can mean to someone who has limited resources. This experience reinforced my belief that charity work is not just about giving medical care; it’s also about showing love and respect to others, especially those in need.
For me, dental mission trips are more than just a professional obligation — they are a calling. It’s easy to take modern healthcare for granted in more developed countries, but traveling to places like Vanua Levu highlights the stark disparities that exist in global health access. It’s incredibly fulfilling to use my skills to help those who would otherwise go without; but, beyond that, these experiences also feed my soul. The smiles on the faces of our patients, the heartfelt gratitude they expressed, the hugs from a nervous patient and the shared moments of cultural exchange are what keep me volunteering.
The people of Fiji are resilient, kind-hearted and incredibly welcoming, and it’s an honor to serve them. While we helped provide critical dental care, the true gift of this mission trip was the connections we made, the lives we touched and the realization that charity work is not just about giving — it’s about growing, learning and sharing in the humanity that unites us all. ♦
Nicole Smith, DDS, FAGD, is a dentist at Huntington Beach Modern Dentistry, Huntington Beach, California.
“Charity work is not just about giving medical care; it’s also about showing love and respect to others, especially those in need.“
Providing Critical Care and Support to Honduras Through Medical Brigades
By Michael V. Unti, DDS, FAGD, FADI, FAES
My mission experience started through my local church, Living Grace Community Church, in Cary, Illinois. At the time, we had been partnering with World Gospel Outreach (WGO) since the early 1990s. WGO is an organization based in Tegucigalpa, Honduras, and its mission is to reach the world with the Christian gospel through medical brigades, starting in Honduras. Honduras is the poorest country in Central America. Anyone partnering with WGO can lead a mission team of 15–30 people. In 2006, I went on my first trip, led by our pastor, along with one of my hygienists. Since then, I have been back five times.
The WGO missions are fairly labor-intensive. We stay in a nice mission house in the surrounding hills of Tegucigalpa. After a cultural assimilation briefing on Sunday, we get up early Monday and load a panel truck with all of the supplies and equipment needed for medical, dental, optometry and pharmacy care, as well as a spiritual brigade, and then drive up to two hours to a local church in an area of need within Tegucigalpa. The church must have enough open area to set up a makeshift clinic. The neighborhood will have been canvassed previously in order to tell people of the clinic. As soon as we set up, the doors open, and 300–500 people will be seen in two days. After the second day, we break everything down and return everything to the mission house. On Wednesday, we brief and either have an opportunity to visit an orphanage that WGO operates or take a short tour of some of the local sights. On Thursday and Friday, we operate another clinic at a different location. On Saturday, we go home.
WGO can be clinically challenging in that the equipment is all portable and often makeshift. There is no radiography equipment and very few provisions to do root canal therapy, unless you can bring your own supplies and work very quickly under the conditions. Consequently, many teeth are extracted that could have
been otherwise saved. Without radiographs and decent suction, extractions can often be difficult.
I have also been to the El Ayudante mission in the foothills outside of Comayagua, Honduras. El Ayudante is a 21-acre compound that has a medical, dental and optometry clinic in a modern 5,000-square-foot building. Along with the clinic, staff interacts in the region by offering after-school study programs for all grades; educational programs for adults about parenting, hygiene and marriage; and various religious programs. They have provided much-needed water filters for the entire area and are now reaching up into the mountain community with filters and a portable medical/dental clinic.
At the main clinic, people come from an area about the size of greater Chicago. The dentistry there is more modern, with real operatories and radiography equipment. There are now three full-time Honduran dentists on staff who are very eager to learn from visiting dentists. Although the clinic setting at El Ayudante is more modern, the equipment is old, and supplies can be limited. Everything is donated, and, as with WGO, you have to use what they have.
Traveling through customs can be tricky. The supplies you bring are often examined, leaving you at the airport for several hours while authorities figure out how to tax you. On our last trip, we waited four hours while they came up with an equivalent of $55 U.S. dollars for a duffel bag full of vitamins.
In general, the experience is very rewarding. Most participants feel like they get more than they put in. The satisfaction of helping a population in need lends itself to much personal introspection and purpose. I highly recommend anyone participate in learning firsthand how some of the rest of the world lives. ♦
Michael V. Unti, DDS, FAGD, FADI, FAES, owns Palatine Complete Dental, in Palatine, Illinois.
“The
satisfaction of helping a population in need lends itself to much personal introspection and purpose.“
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