February 13, 2020
by Irene Iancu, BSc, RDH, CDTP
Crosscheck complete. Ready for departure from one of the most remarkable adventures I’ve had the privilege of embarking on. I’m faced with the incredibly challenging task of describing what seems to be an indescribable dream; a blur of circumstances sous vide in emotions that I had forgotten I was capable of feeling.
Hold your hands out, palms up, and take a moment to appreciate those beautiful, meticulous, perfectly trained and wildly experienced hands. Thirty-four muscles and 27 bones combined in each hand to make the most delicate movements. Slow and soft index and thumb rotations with an endodontic dental file, gently maneuvering fine suture around delicate gingival tissues, then in a split second, firm luxation with a strong and dominating grasp in a full mouth extraction case. Our hands are gifted and with those gifts come the social responsibility to use them for every opportunity we have to do some good in the world.
As dental professionals, we have three gifts. Our gifts stem from our formal education, however, they far exceed the simple intricacies between our thumb and fulcrum finger. These gifts include our ability to change someone’s future, save someone’s today, and give someone their smile back. We may forget this while living in the reality that dentistry is a business; a profitable endeavour we are constantly trying to hone, develop, grow and propagate into bigger and more productive practices. Raise your hand if you’re guilty of a sliver of that. I raise my hand here as well, and can reassure you that simply put, you’re only human.
WHERE IT ALL BEGAN
Dr. Jonathan Levine, a New York Prosthodontist who wears many entrepreneurial hats began his philanthropic endeavours after returning from a mission trip in Rwanda in 2012, which was hosted by Foundation Rwanda. They helped women get back on their feet after the devastating 1994 genocide; a much needed undertaking considering the population of 14 million people only had access to seven dental offices while living in poverty. The Levine family returned home to their New York life feeling empowered and did what we all do when we come home from any adventure: we share the stories with our patients. Dr. Levine did just that.
The only difference in this story was who Dr. Levine shared his story with. As a respected clinician, his clientele is unique and who he shared his story with was Lenny Kravitz.
Lenny posed a request to the “Doc” as we all call him. He wanted to know if a similar mission could be brought to his home in the Bahamas, specifically Eleuthera, an area with very limited access to dental care. The Levine family immediately flew to Eleuthera to explore this potential initiative and they felt an instant connection. They were convinced these were the people that they needed to help.
LOCATION: 25°23’35.6″N 76°33’23.4″W
On December 10th, 2019, I departed for the fifth mission to Eleuthera. This was my third (Honduras 2008, East Africa 2013) dental mission in my 10 plus years of practice, and it couldn’t have come at a more perfectly imperfect time.
Considering my new practice build is in full swing, I’m constantly making tough decisions daily that could change how I operate my dental practice for the rest of my career. It’s also post-Black Friday shopping season and holiday online sale chaos with my Toothlife brand, and benchmark days at the dental hygiene school with chart audits stacking up. I was well aware of the sacrifices I would have to make in my busy life but then again, I’m no different than the nearly 100 other volunteers, some whom have busier lives than I do.
Dental professionals with roots in every continent flew into Eleuthera over a two-week period to the Let Love Rule + GloGood Foundation + Twice mission. Some of us were first timers and others have been attending this mission since its infancy. These amazing individuals showed up and have proven that humanity and skilled dentistry adjoined bring a special kind of energy to an event like the one I’m about to describe.
Dr. Levine and his two sons, Cody and Julian, sat down with me in a huddle to record a podcast episode in front of triage to the clinic, as an afternoon tropical storm quickly blew through the small town. The golden dust kicked up by the wind and rain looked like sparkles as the sun peeked through the storm clouds, sending sunlight beams scattered among the patients nearby waiting to be seen. The setting was surreal; the vibrations of the bass from our music resonated through the wooden boards beneath our feet and even with my fancy noise cancelling recording headphones, you could hear the laughter of children playing in the rain with Mrs. Stacey Levine, or Mamma Bear as they called her on the podcast. Our very own honorary tooth fairy.
Among the organized chaos of the clinic with patients streaming in and out, we felt it was the perfect place to capture the moment and share their enlightening history with the world. To listen to the full story of how they made this happen, visit the link at the bottom of this article to tune in to episode 29 of my podcast that dropped on December 19th.
To call these people remarkable humans is a significant understatement but then again, I’m faced with this task of describing the indescribable. Their stories will give you goosebumps. There are so many inspiring stories for me to share with you, not one being more profound than the other.
• A brave woman who escaped domestic abuse on a neighbouring island.
• A single mother with three children – her youngest son had rampant decay and multiple broken teeth, who by far was the best patient of the week at only five years old.
• Ancilla, a mother of two who traveled to the clinic in the hopes her children could be seen, putting aside her desperate need for treatment. We managed to see her as well but sadly, we were only able to complete part of her treatment. She covered her mouth to hide her deeply cavitated anterior tooth decay when speaking and she mentioned that she hadn’t smiled in years. She departed with only part of her treatment completed and left us all feeling hopeless when she said she wouldn’t be able to return.
• A 23-year-old diabetic patient with generalized profound edematous tissue and severe bone loss, so painful that she could barely eat.
My eyes filled with tears beneath my loupes that dripped down my cheeks and under my mask as I tried to comprehend how and why life is so different for some of us. Repeating under my breath, “This is so unfair”.
• An elderly man that hitched a ride in a truck for two hours, who gave me a surprise high-five and leaned in for a hug and kiss as I took off his bib. His parting words to me were, “Thank you for giving me my smile back”.
Lastly, the patient that had the greatest impact on me.
A 27-year-old female with only 10 remaining teeth, no posterior occlusion, no dentures, M3 mobility on all lower anteriors, and a bridge of calculus unlike anything I’ve seen in my life. I had a very amazing assistant by my side; a fellow high school classmate whom I haven’t seen in over a decade, with no dental experience. Nina was invested in this case just as much as I was and stood by my side suctioning and packing gauze while Julian carefully picked up 8 mm pieces of calculus chunks with cotton pliers to the very end.
I scaled those 10 teeth for over an hour and a half. The moment I tore my gloves off of my sweating and trembling hands, I instantly burst into tears and it felt like I just called “time of death” to a patient for the first time. I knew that I did the best that I could under the circumstances but in my heart, I knew it likely wouldn’t be enough to save her remaining teeth to see her 30th birthday or daughter’s graduation.
Seeing these beautiful people living in so much pain yet bringing so much happiness with them into the clinic was mind and heart opening to me, being someone who (before my last mission) would get upset when Starbucks ran out of blonde americano. My own worries felt so trivial.
The best books you can read and movies you can see elicit your core human emotions. The last day of clinic did just that. Tears of happiness and sadness poured out at the same time; gut-wrenching feelings of panic that there just wasn’t enough time, the pressure in your chest in moments of overwhelming heartbreak, followed by newfound motivation and passion for treating patients.
Throughout the week, our clinic had progressively closed later and later in the evenings, simply to accommodate and treat more patients. Many team members chose not to take a break or lunch. On the final day, our clinic stayed open three hours later than scheduled.
Ancilla, the patient who had been seen three days prior but hadn’t been able to complete her treatment, unexpectedly returned when we all feared we wouldn’t see her again. She had been treated for broken teeth that were filled and extractions, however, she returned to see if we could give her the ability to smile again.
Despite her arrival during the hectic time where the clinic was no longer able to triage any new patients, the triage team was able to make her dream come true.
Emi, the dental hygienist who saw her a few days prior, built a strong bond and truly advocated for her to come back and get the rest of her smile restored. When Ancilla told her that she couldn’t return, our very own RDH superhero was heartbroken and visibly devastated. We had encouraged her that she did the best she could do but deep down, Emi was heartbroken and couldn’t stop thinking about her. Now the look on her face when Ancilla returned was priceless. Ancilla was seated with Dr. Sandra Garcia Martin and truly I have never seen someone as happy as I saw Emi that afternoon.
THE FINAL STRETCH: 7:30PM 1.5 HOURS AFTER CLOSE
While our last two patients were being treated, the unexpected happened. The clinic and town suffered a massive power outage and our last remaining generator was powering our speaker system. We didn’t need hand pieces or suctions; all we needed was the finesse of our clinicians, and the expert DJ services provided by Julian Levine to play us to the finish line.
Queen, Michael Jackson, Aretha Franklin and Gloria Gaynor shook the converted community centre and gave our team the much-needed energy to power through the final treatments and to pack up the equipment. We lit the clinic with loupe lights, cellphones and flashlights to give us the light needed to navigate to the end of the day.
Both remaining patients had extremely complex cases and were anxiously awaiting the sight of their smiles for the first time. In one chair, Dr. Levine, Dr. Mehy Lo Presti (London) and three assistants, Jamie, Rafaela (a dentist from Brazil working for Dr. Levine as his assistant in NYC) and myself finished up the anterior endos, restos and final denture insert among the other restorations and extractions that preceded the finishing touches.
Meanwhile, in the back corner of the clinic, Dr. Sandra and Nasim finished the last anterior restorations for Ancilla. Utilizing advanced restoration techniques, they reconstructed the teeth prior to removing decay to recreate her tooth anatomy in its ideal shape. Taking a silicon index from the lingual surface of the teeth, followed by utilization of matrix bands and wedges to contour interproximal surfaces, and then using a layering technique to minimize the finishing line between composite and natural tooth structure. Like an artist, Dr. Sandra hand-painted the restorations with her own restorative kit she brought with her from London, finishing the case with polishing to give these restorations a perfect aesthetic.
Everyone else danced and cheered for us and for our patients. Of the two last standing teams, Dr. Mehy, with complete relief and exhilaration, jumped out of his chair, raised his hands in the air and exclaimed, “I’m done!” – immediately followed by Dr. Levine rushing in to insert the final denture he had been modifying in the background to culminate this makeover.
Within the next 15 minutes, the power came back on almost at the same time that Dr. Sandra completed Ancilla’s transformation. She too arose from her chair with a very stiff back and said, “I’m done, too!”
Appropriately enough, Dr. Sandra and Dr. Mehy both reside in London, and they are best friends. What a perfect way to complete their adventure here in Eleuthera together.
Cheering, dancing and singing became louder and finally after years of insecurity, our much-loved patient held a mirror in her unsteady hands and smiled for the first time. Not a dry eye was left in the room as the embraces began. Emi and Nasim comforted Ancilla and shared in her ecstasy of having her smile back.
REFLECTIONS FROM SEAT 18A
I went into this mission blindly, not knowing what to expect and how much of an impact I would make being an RDH. Now, I realize that a title and credentials, however important, are not the driver of the impact one can make. We all have talents; some clinical, some emotional and some organizational. I think of Angela, Jessica and Alejandra running around with their clipboards organizing treatment. Our sterilization and equipment team who held it all together. Because of this team, we all came together to make this trip as impactful as it was.
Now, look down at your hands again, holding the magazine or phone you’re reading this article on. You’ve worked hard to be able to provide the treatment you do for your patients. Maybe one day, if you haven’t already, you may share your gifts with someone in need, in a place you haven’t yet visited. And maybe one day, you’ll write an article like this one and share your stories of how you have changed someone’s life with those two hands, each consisting of the same 34 muscles and 27 bones.
To find out more about Twice and the GloGood Foundation, visit:
About the Author
Irene Iancu, BSc, RDH, CDTP has worked in various specialties including Paedo, Perio, General Practice and Orthodontics. Her goal in her current holistic practice is preventing and maintaining an optimal mind, mouth and body. Irene connects the systemic effects of oral conditions to her clients, while making a change for overall health and wellness. As a Peer and Quality Assurance Mentor contacted by the CDHO, a Clinical and Theoretical Dental Hygiene instructor at Oxford College, and a practicing dental hygienist in Toronto, Irene shares her passion for education with us today in the hopes we can change the lives of our clients and their loved ones. Irene can be contacted at Irene@toothlifestudios.ca, www. toothlifestudio.ca, IG: @ToothLife.Irene, @Toothlife, @Toothordare.podcast.