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.

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.

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.