International Volunteer Dentistry: ICD Impact Around the World

International Volunteer Dentistry: ICD Impact Around the World

A Presentation of the International College of Dentists USA Section 2024 Annual Convocation

Francis G. Serio, DMD, MS, MBA, Dr. Pub Service (Hon.), FACD, FICD, FADI (Hon.) Founder and Director Emeritus Dominican Dental Mission Project 2023 USA-ICD Humanitarian Award recipient 2015 ADA Humanitarian Award Recipient 2004 AAP Humanitarian Award Recipient Diplomate, American Board of Periodontology

In Memory of Dr. Michael Perry, 1973-2016

Commercial Disclaimer

Why is the ICD interested in these activities?

Why is the ICD interested?  College motto is “Recognizing Service and the

Opportunity to Serve.”  “Get the word out” to more locales- regional meetings.  Complimentary to the efforts of the ADA and Health Volunteers Overseas.  Become a go-to resource for those interested in getting involved but do not know where to start.

Leverage the experience of Fellows of the College.

The Course  Who is in the room?  The questionnaire  A few words about conditions around the

world  Sample projects  Volunteer opportunities  Q&A  Party time!

Who is in the room?

Let’s get startedoral health conditions around the globe…

http://issuu.com/myriadeditions/docs/flipbook_oral_health

http://www.fdiworldental.org/media/77552/complete_oh_atlas.pdf

Reorienting our paradigm: Shifting thinking to the local context.

Other fluoride sources  Topical fluorides- gel, varnishes, rinses.

Need personnel.  Fluoridated water- expensive. Where to the locals get their water?  Fluoridated salt- inexpensive, effective, controversial.  Remember- it’s context!

Cultural effects of facial deformities.

Cultural effects of facial deformities.

Major surgical efforts  Global Health Outreach  Operation Smile  Smile Train  Others

Annual US dental care expenditures: $142.2 billion in 2020

Why Volunteer?  The reasons are as varied as the volunteers are.

 Desire to give something back….or pay forward.

 Realization that there is more than going to work,

driving the kids to soccer practice, catching that trophy striper, or lowering that golf handicap.  Be part of the solution, not just part of the problem.  Interest in traveling to new places, meet new people, and do something worthwhile at the same time.

Why Volunteer?  Support a church mission or humanitarian

service organization.  An interest in sharing knowledge, skills, and experience with international colleagues.  The desire to participate based on experiences related by someone with volunteer experience.  It’s just a fun thing to do!!!!

“From everyone who has been given much, much will be demanded; and from the one who has been entrusted with much, much more will be asked.”

Luke 12:48

The Nature of Volunteer Activities  Traveling vs. touring.  Having a lasting positive impact on the

community, whether at home (e.g. Habitat for Humanity, Missions of Mercy) or abroad.  “We” projects vs. “us and them” projects.  Engage the locals in any project. Key to sustainability.

Brocher Declaration

Brocher Declaration

Brocher Declaration

Brocher Declaration- Principles  Mutual partnership with bidirectional input and

learning  Empowered host country and community define needs and activities  Sustainable programs and capacity building  Compliance with applicable laws, ethical standards, and code of conduct  Humility, cultural sensitivity, and respect for all involved  Accountability for actions

Brocher Declaration

The nature of the volunteer  Leave some of who you are at home- your

ego, your impatience, you know what to leave in the airport parking lot!!!!  Remember that it isn’t the first rodeo for many team members and locals, even if you are on a horse for the first time.  Preparation- easy to be prepared for the project, more difficult to be prepared for the location.

Qualities of Dental Volunteers Culturally sensitive- remember, it’s context.  Flexible- be prepared for the what if’s….  What if the power goes out?  What if conditions are not as advertised?  What if the equipment does not arrive or does not work?  Patience.  Able to relax.  Think creatively.  Willing to share knowledge, skills, and experience with others.  A sense of humility.  Start young. 

The nature of volunteering- understand the context you are in, not the context from which you came.

“….sometimes simply being a role model is the most important part of a volunteer assignment.”

From HVO’s Volunteering Effectively document (www.hvousa.org)

Challenges on the home front  Preparing your practice for the project.  Make the project part of your practice.  Roles for staff members.  Preparing your family for the project.  It is your idea but the rest of the family

has to be on board.  Could make it a family affair.  Being home but not present.

Get The Family Committed

Challenges on the home front  Returning from a project.  No one will mistake you for Mother

Teresa. Plenty of others have done what you have even if it is your first time.  Don’t be disappointed if people aren’t as interested in your adventures as you expect or you think that they should be.

Those most interested are those who have walked in your shoes.

Cross-Cultural Issues

Cultural Knowledge and Sensitivity  Cultural Similarities and

cultural Differences  Cultural Values  Cultural Beliefs  Cultural Learning  Cultural Behavior  How do they see you and your culture?

Culture Shock  Initial euphoria at being in and functioning in an

alien environment.  Irritation and hostility at the situation and conditions. This can be especially pronounced when tired or sick.  Gradual adjustment and comfort with the local situation.  Adaptation, or biculturalism, after having come to an understanding of the situation on local terms, not the volunteer’s terms.

Cross-Cultural Issues  Know something about the culture you are

entering.  Avoid the “Ugly American” persona.  Bafa Bafa cross cultural training.  Lonely Planet Guidebooks.

Types of Projects  Service  Teaching- collaborative  Combination

“Give a person a fish, feed him for a day, Teach him to fish, feed him for a lifetime.” …but there is a caveat…

The idea of sustainable projects.

What Can Be Accomplished?  Direct provision of care.  Teaching.  Making new friends.  Breaking down barriers…..in both

directions.  Having a great time.

The Dominican Dental Mission Project Serving the dental needs of the poor of the Dominican Republic since 1982 42nd Anniversary 1982-2024 www.ddmp.org

Meeting the needs of the community  Being mobile.  Preventive, pediatric, periodontal, restorative,

surgical, and prosthetic services.  Support of the local dentists.  Sustainability, repeatedly visiting the same locations until the needs are met. Increasing the oral health awareness of local communities.

Services provided Exodontia.  Restorative- composites, amalgams.  Prosthetic- transitional partial dentures, complete dentures.  www.benchmarkdenture.com  Preventive and periodontal services, including scaling and root planing, sealants, and SDF. Includes OHI and toothbrush distribution.  Pediatric services- pulpotomies, stainless steel crowns.  Occasional endodontic services. 

Impact?

“We know that because the dentists come back every year that God has not forgotten us.”

The People of Hondo Valle

42 Years of the DDMP Over 67,500 poor Dominicans treated. Approximately $22 million in dental care

provided. ***Supported 8 young Dominicans to become dentists and take care of their own people.  This is the answer to development and

sustainability. This project has evolved from being the only dental option to supporting the local dental care system.

42 Years of the DDMP Approximately 900 American volunteers and

countless Dominican volunteers- dentists, dental students, community members. 1991 President’s Volunteer Action Award, 2001 Points of Light Award, 2004 AAP Humanitarian Award, 2015 ADA Humanitarian Award, 2018 UMSOD Distinguished Alumnus Award, 2021 Honorary Doctorate, UMB, 2023 USA-ICD Humanitarian Award.

The concept of succession planningkey to real long-term sustainability.

DDMP Board of Directors  Dr. Christin Mobley- Director, new ICD

Fellow  Dr. Aaron Nicholas- Assistant Director, new ICD Fellow  Drs. Mark Costes, Olga Gil, Ryan Harris, Tiffany Harris, Shannon Minges

Dr. Christin Mobley

Dr. Aaron Nicholas

Training and Education Projects

www.hvousa.org

Dr. Steve Mackler in Moldova

Dr. Frank Serio in Vietnam

Matching the training needs to the local site.

How to prepare for teaching: • Re-read current textbooks and pertinent articles • Seek experienced teachers for help, advice and even materials • As much as possible: • Encourage active participation • Give demonstrations • Give digestible amounts of information • Follow logical steps • Communicate the “What?” and the “Why?” • Make it personal and interactive

H ow to get startedJumping off the cliff and landing softly !

How to get started  Jumping off the cliff and landing softly  Decide what type of project- teaching or

service, where you would like to work, how long you would like to go, and how much work you want to do preparing for the project.  Look around this room, do some networking before you leave.  Plugging into an existing program.

internationalvolunteer.ada.org

Selecting a Site  What is the political and social climate of

the site? For example, is the location politically and socially stable? Is it friendly to Americans?  Can the country be reached by reliable commercial transportation?

Selecting a Site  Are special licenses, registrations, or work permits

needed? For example, Jamaica requires all entering volunteers to have a temporary work permit issued by the Jamaican Ministry of Health. That requires the submission of professional credentials well in advance of arrival in the country. Treating patients without official permits falls outside the law, so a volunteer could be subject to criminal sanctions.

Remember, volunteers are subject to local laws; the U.S. Embassy may not be able to assist if laws have been broken.

Selecting a Site  Are there appropriate logistics such as

ground transportation, housing, ability to communicate with home via cell phones, Internet access, and food for the volunteers?  What health alerts or restrictions are there and what vaccinations are needed?

Selecting a Site  Has the dental project been developed?

Have the specific dental needs been defined? It can be frustrating to prepare for a surgical project only to arrive on-site to find out that restorative services are the primary need.  Are dental materials and equipment available on-site, or does everything have to be brought in?

Selecting a Site  What are the customs restrictions regarding

the transport of dental supplies into the country? How might materials be shipped before volunteers arrive in the country?  Is there a suitable facility in which to work?

Will patients or professional colleagues be available at appropriate times?

Assembling the Team  Do not overreach.  One person is ultimately in charge.  Delegate when possible.  You cannot talk anyone into going. The

decision to go must be personal and independent.  Remember- you want “we” projects, not “us” and “them” projects.

Assembling the Team- Using Locals  Organizing and registering patients. Crowd

control. COVID screening  Assisting with restorative procedures and giving post extraction instructions to patients.  Washing, disinfecting, and sterilizing instruments.  Interpreting, cooking, and performing other tasks as needs arise.

Equipping the Project  Service vs. teaching- some needs are the

same, some entirely different.  Checklists, checklists, checklists.  Electricity- 110, 220, something else? Plug configurations. Reliability.  Water- potable sources?  Transportation- roads, vehicles. Safety first, second, and third.

Equipping the Project  Portable equipment- what do you need?

Where can you get it?  Supplies- checklists, checklists, checklists.  Where to get them.  How to pay for it all?  Private donations.  Foundations.  Government grants.  Other.

Aseptico

Nomad-Pro

Do not be surprised to encounter “donor or volunteer fatigue.”

The problem of “YES”

New funding possibilities

ICD and Henry Schein

ICD and Henry Schein

http://www.osap.org/?page=ICOralHCMissions

Pressure Cooker Sterilizer See Christian Dental Society Info

http://www.cdc.gov/travel/

Immunizations Oh no, not that!

Hepatitis A  Hepatitis B  Influenza  Measles, Mumps, Rubella  Tetanus-Diptheria  Poliomyelitis  Yellow Fever  COVID in-country and traveling 

Local First Aid  Ciprofloxacin  Hydroxychloroquine  EpiPen®- other epi forms- easier is better in an

emergency  Diphenhydramine  Percutaneous exposures- HIV primarily  OraQuick®  Isentress®- raltegravir  Truvada®- emtricitabine and tenofovir  COVID testing- BinaxNOW- Abbott, others

Volunteer Opportunities  Word of mouth- professional groups, church

projects, friends.  www.internationalvolunteer.ada.org  Directory of volunteer organizations.  www.hvousa.org  Listings from this presentation.

CDS

Christian Dental Society  www.christiandental.org  Volunteer opportunities.  Equipment rental or purchase.  Clinical instruments.  Portable patient chairs.  Dental Missions Manual.  Volunteer training sessions.

Globaldentalrelief.org Dr. Cunningham

beckyb@globaldentalrelief.org

Flyingdocs.org Dr. Fritz

azdacares.org

Dr. Myers-Fineberg

flyingsamaritans.net Dr. Myers-Fineberg

Somosamigos.org Dr. Castillo

Smile Outreach International

Dr. Mark Costes, Dr. Aaron Nicholas

Smile Outreach International Dr. Aaron Nicholas

Local Opportunities

Why Volunteer Locally?  For those who seek to volunteer, but find it

difficult to travel outside the country, Mission of Mercy “type” opportunities and other smaller scale events are available  Volunteering locally, or within the U.S., affords you the opportunity to address tremendous need in a location that is more accessible

Mission of Mercy Clinics

What is a MOM Clinic?  A MOM Event is hosted by the state dental

society and its foundation in partnership with America’s Dentists Care Foundation, ADCF (The parent organization of Mission of Mercy)  A MOM events consists of up to a 100-chair, portable dental clinic, complete with central compressed air, vacuum & water…instruments and sterilization

What is a MOM Clinic?

Extractions  Fillings  Cleanings  Pedo (which you may be surprised to learn accounts for under 15% of our event patient treatment – Parents will always make sure that their children receive care first and more programs are available to serve children’s needs)  A lab will provide treatment partials and in some states, Benchmark Dentures  Limited Endo  Patient Education/Social Services 

What is a MOM Clinic?  Strong support from the local community

and state and local dental society – for preevent assistance, event assistance and follow-up care, post-event  A 25,000 Sq. Ft. facility to host the event – with adequate parking  An adequate electrical, water, and lighting supply

www.vdaf.org

By volunteering, we combine our desire to give back with our greatest strength: our dental skills!

 Volunteers are most touched by those

patient experiences that conclude with, “ Now I Can Smile.” and/or, “Now I Can Apply for a Job.”

Benefits for the Individual and our Dental Community No surprise, you will experience a remarkable sense of accomplishment.  You are able to volunteer and share your greatest strength – your dental skills.  The opportunity to work closely with your colleagues is exciting and inevitably, a tangible and inspiring Esprit de Corps develops.  An event will draw attention to the importance of dentistry, the contribution that dental professionals make, and recognize all of the good work that dental societies provide.  Bringing hope, perhaps the greatest gift of all. 

Operation: Stand Down  Purpose- to provide for veterans who are needy

and have slipped through the cracks.  Locate the veteran service officer in your countyVFW will know.  Approach local dental association and secure volunteer dentists. This should not be a problem as many have served or are in the reserves or National Guard in many areas.  Posters at VFW and American Legion posts.  Screening at community health center on a Saturday morning.

Operation: Stand Down

 Dentists then reviewed charts and assigned 4-5

veterans to each of the volunteer dentists.  Each dentist saw the vet in their office providing all types of care free of charge.  Veteran eligibility Copy of their DD214 (discharge papers)  Driver’s license to show residency in the county.  Lack of dental insurance.  No current dentist.  Income less than $25,000.  Honor system.

Remote Area Medical www.ramusa.org

Remote Area Medical Clinics http://www.youtube.com/watch?v=Dgef-OTmrWg

Dr. John Osborn

RAM at Southern Virginia University

RAM at Southern Virginia University

Other Resources

www.usa-icd.org

Other Print Resources  Steffes, B, Steffes M. Your Mission: Get ready! Get

Set! GO! www.s3ministries.com. A comprehensive guide to traveling overseas from a Christian perspective. Companion guide to Medical

Missions; Get Ready! Get Set! GO!  Palmer D, Wolf CE. Handbook of Medicine in Developing Countries . Christian Medical and

Dental Associations.  Dental Mission Manual- Christian Dental Society.

Online Resources  www.usa-icd.org  www.internationalvolunteer.ada.org  www.hvousa.org  www.hesperian.org  www.cdc.gov/travel/  http://issuu.com/myriadeditions/docs/flipbook_

oral_health  http://www.worlddentalrelief.com/training.htm  www.christiandental.org

Volunteer- It’s the most fun you’ll ever have working!