Generalizations of any sort can be difficult justify but it’s hard to deny that most of the Nicaraguans the CCESP trip met were of the smiling stock. Whether it was the wide unapologetic grin of child who’d just scored a goal on the gringos or the nervous upswing of lips on a patient in our little makeshift clinic rooms, there wasn’t a day in Hormiguero that wasn’t filled with giggles and flashes of pearly whites, sometimes capped with gold. Certainly dental work was available in surrounding area, but it was often expensive and rarely feasible. As a result, when the inevitable patient came in complaining of dolor in their teeth, we had to let them walk out the door with only a pack of ibuprofen in their hands
The work that the “teeth team” (an moniker that stuck for better or for worse) did aimed to prevent situations such as these, especially among the young, when habits can be ingrained for life. The team, consisting of a rotating roster of Dartmouth undergraduates and Bridges to Community translators, was lead by college sophomores Regan Plekenpol ’17 and Lauren Gruffi ’17 and set up separate stations for brushing, flossing and lacquering, stocked with very appreciated donations from Henry Schein. As the patients lined up for the day, an announcement was made to the crowd for the children to gather by the old stairs where teeth care would be demonstrated and practiced. We also put fluoride varnish on the children’s chompers, providing a first line defense against decay. Some of the children were shy and had to be urged on by their siblings and some babies certainly wailed even in their mother’s arms, but the single-minded seriousness with which all the children brushed and rinsed and handed their toothpaste off to their parents made it clear that they may have realized there was something more at stake than that tingly feeling in their mouths.
The Nicaragua CCESP worked in Hormiguero, a village in the Siuna region of Nicaragua and each day new patients from different villages would show up to see the doctors at our clinic. We got to know the local children quite well during our time there as they consistently solicited us for photos and to play soccer in the afternoon. And they certainly ingrained our schedule into their own, as one day before we even began to set up, the local children began sorting the children from the new village into rows and instructed them on the procedures they could expect from the teeth team. Distributing toothbrushes, floss and picking up the garbage as they had seen us do day after day, they were efficient, bossy and most definitely enjoying themselves too much. Maybe it was just another game for them, maybe they thought that if we could wrap up our work earlier it meant we would have more time to play with them, but maybe there’s also more to it. The children seemed to understand how important the work the teeth team did meant to the clinic overall, and I hope that they were able to feel a sense of ownership in the process by spreading the knowledge that they had gained to unfamiliar faces.
The success of projects such these always need to be evaluated, that is without question, over a long period of time. Sustainability is undoubtedly a worry since even though we diligently distributed Henry Schein’s toothbrushes, toothpastes and floss to over twenty communities in the area, the availability of similar products on an everyday basis is a concern. But we’re hoping that it takes small steps to start, that the varnish will offer some holdover protection for a while and that it will be a long time before these children have to come to a clinic that doesn’t have a dentist in the hopes of reversing the course of decay.