Sunday, June 21, 2009

Dr. Wise Shares Moving Experiences Of His Work With The Smiles Foundation


Dr. Wise works with the Texas Dental Association Smiles Foundation. Here is what he says about his work:

My participation in TDASF has been one of the most meaningful of my professional career. By giving back our special talents, we can help others who are greatly in need. And the more we give, the more we get back. It’s a great thing. Most dental providers who volunteer their time are amazed at how much they get back from their patients. The love and deep caring that is shared is truly remarkable.

Check out the short about a patient we treated at a TMOM in Laredo. The story appeared in a 2008 version of Orthodontic Products Magazine.


As an orthodontist at a TMOM, they don’t let us do too much. The program leaders try to keep the needles and sharp instruments out of our hands. Instead, we are many times asked to help triage patients, act as runners, interpret dental code, or remove the occasional periodontally involved tooth with cotton gauze. Imagine my surprise when I was asked to head up the removable prosthesis department at the Laredo TMOM this past Spring. I think my experience grinding on plastic retainers and delivering orthodontic appliances swayed them over. WOW! I was in charge of an entire department at one of the most anticipated TMOM’s in TDA history. (Later I found out that I was the only possible choice since no one else wanted to do it).

On the Thursday before the event, I was charged to set up the lab area. Like any good planner, I wanted to see what my assets and challenges were. I knew that a few folks would be having front teeth removed, and I wanted to be ready to make them a beautiful replacement that would last them for many years. I was shown the lab equipment consisting of a Dremel from home depot, a few alginate and stone mixing bowls, 2 wax spatulas, different acrylic choices (mostly reline material for dentures), some separating medium and about 50 plastic teeth- but only 3 color choices. Turns out, my assets were my challenges!

So I went to work setting up the lab, knowing that the next day would be very busy. Opening boxes and organizing the work area, I found what I needed to make things functional. All I needed was some electricity to make my Dremel go. Thank goodness Dr. Richard Smith from Amarillo had a long extension cord and some duct tape. We made it work.

Friday opened with a bang. Things were a little crazy since we had a shortage of doctors, but no shortage of patients. The local Catholic and Methodist churches had made sure that we were going to be busy. So instead of making flippers, I was sent to a chair to remove some teeth. I told them, “only the really easy ones”. I was rewarded with a young woman who was experienced in having teeth removed, and her decayed and thankfully mobile teeth came out fairly easily. We made friends, shared a hug and parted after only one and a half hour in the clinic. By now, some more docs were arriving so they kindly asked me to go to the lab where I could start making the flippers.

Several alginate impressions had already shown up, and I was ready to go. That’s when I realized that my partner for the day would be none other than Dr. Richard Black from El Paso. Rick is also an orthodontist and at that time our TDA President. I was indeed in good company. And what made it better was that he had done this job before. He had made flippers in Burnett back in the Fall with a local lab technician. Remembering him from that Hill Country TMOM, all covered with acrylic dust and pumice, I began to realize why the orthodontists were asked to be “lab guys” . PAYBACK!

But no worries- we went to work pouring up models and making them ready for replacement teeth. One of my first cases was some teeth with Lupita’s name attached. Apparently Lupita had to have her two front teeth removed (that’s numbers 8 and 9 to those of you who are following along). I very carefully selected the teeth from my supply. Thankfully we had a color that the treating dentist thought would match- shade 1 of our 3 choices. We had a couple of teeth that required some grinding and reshaping to make fit. After a few minutes and several chances to chase down a spinning and out-of-control plastic tooth on the clinic floor (“Did anyone see where that tooth went?”), I was able to set the tooth in the arch and I started adding acrylic. And adding, and adding, and adding. Apparently, the acrylic I had was not ideally suited for what we were doing here. But within a few minutes we had what looked like a nice stable appliance- even though it looked a little thick to me.

I set the stone model and plastic flipper aside and started on my next set of teeth. After several minutes, I checked to see how the acrylic on Lupita’s model was doing. Still kind of soft. More time passed. Still soft. Uh oh. This may take a while. After about 2 ½ hours, we had a firm set to the plastic and I started trying to remove it from the model. Anyone who has ever made one of these things knows that the weak spot is right where the teeth are. You must be really careful to make sure that your artwork doesn’t break while trying to separate it from the model. Now, please remember my assets. It’s tough to separate a ¼ inch thick acrylic flipper from a model with only a wax spatula and a Dremel. A few nerve racking minutes later (“Was that cracking sound my flipper or was it the stone model?”), I had it loose and started polishing it. With my Dremel from home depot. And no pumice. And only the “polishing wheels” that come from Home Depot. Challenges and assets!

The flipper finally was finished. And because of its thickness, I think it will last this Lupita until the next decade. Still not having met my patient I asked the treating dentist why Lupita had to have the teeth removed. The rest of her teeth looked pretty good as far as I could tell from the model. No cavities visible, no major issues. He let me know that the teeth had been cracked and were discoloring badly and causing her great pain. Oh well, Lupita would return on Saturday and we would see what was going on. I just knew that my “Home Depot Special” flipper would have to “make do”.

Saturday morning arrived and the clinic started to fill up. More and more patients had heard about TMOM from friends. “Free dental care” to all who cared to come out was probably the buzz in Laredo. We eventually treated over 750 people that weekend. We met part of a tremendous need in an area of the state that I had never before experienced. These were some of the kindest people I had ever met. Appreciative to a fault, but very little English was being spoken. And I still had not met Lupita.

Now, I mentioned earlier that the Catholic church had helped us get the word out about our Laredo TMOM. The day before, I had the pleasure of meeting Sister Rosemary and many of her co-workers. They were on site all weekend lending a hand and watching us care for the throngs. Sister Rosemary had an infectious smile with lots of gold showing in the back, a dark tan covering her freckled face, a wiry build and a few wrinkles displaying her years of service to her adopted community. She was clearly not of hispanic descent. But this was her home, and these were her people. Think “Mother Teresa” of Laredo. That’s Sister Rosemary.

Sometime before noon, I started noticing a young family. A mid-thirties hispanic woman, two young boys with dazzling smiles and lots of energy, and a young man standing off to the side. Turns out, that was Lupita, her husband and boys. They had returned to get her flipper. Well, I was ready. I seated her in my “dental” chair (actually a regular chair from the local civic center), removed the flipper from its Ziploc package and admired it in my hands. What a beautiful flipper! The boys were very curious. They were looking at Lupita’s new teeth with great interest, and concern. Lupita was trying to smile, but not really. She was covering her mouth with her hand and looking away most of the time. I could notice some left-over healing going on from the previous day’s surgery on her two front teeth. A large, dark hole was present in the middle of her “smile”. Something had been taken away from Lupita.

Sister Rosemary was close by and helping me with instructions and communicating with Lupita. She spoke very little English. With Sister Rosemary’s help, I was able to introduce Lupita to her new front teeth. Her boys were still watching closely- very concerned. As the flipper went in her mouth for the first time, I asked Lupita to check for rough areas and sharp spots. The teeth had excellent retention (probably because it was so thick!), and man did it look great. The treating dentist had matched the color perfectly, and the shape and size of the teeth seemed to fit beautifully in her mouth. As I handed Lupita the mirror for the first time, I could see her boys’ eyes light up. They could see, too, how great that flipper looked. Lupita stared into the mirror and then the smile broke out across her face. A few words in Spanish came flowing out, and I stood back and admired my work. And the tears began to come. Lupita was crying and smiling at the same time. Her boys were laughing again. Lupita’s smile was back! The husband stood to the side with his arms crossed and showing very little interest.

Lupita made her way to the check out area where she could receive some more basic instructions as well as some dental care supplies- toothpaste, brushes, floss, etc. Sister Rosemary was there helping with the Spanish-English interpretation. And then, the two of them came back to my lab area. Sister Rosemary told me that Lupita wanted to thank me personally. And better yet, she wanted to thank me in English. Apparently, Lupita was trying very hard to learn some English phrases, and she wanted to use them today. So, with Sister Rosemary’s arm around her shoulder, Lupita began telling me how much she appreciated my being there to help her and how much she thought of all of the dentists who came to her town. It was all spoken in broken English and a halting tempo, but a more heartfelt and beautiful “thanks” I have never received. When she was done, she reached for my neck to give me a hug. With more tears flowing- mine and hers- she whispered in my ear “Thank you” and kissed my cheek before she left.

I watched her walk away and wondered what her life must be like. What sort of happiness can she find in this world? Sister Rosemary was there next to me, and she began to tell me Lupita’s story. When Lupita had returned from TMOM the night before, her boys had been very upset in seeing their mom’s smile in ruin. The bright and shining smile that I had witnessed only minutes before had disappeared. Lupita’s boys were very concerned. Lupita knew that some sort of help was coming today, but she did not completely understand what it would be. So in seeing her smile return, Lupita and her boys were absolutely thrilled.

And the broken and cracked front teeth? Well in addition to helping at TMOMs, Sister Rosemary is also a counselor at a local women’s shelter. She and Lupita had met months before after Lupita’s husband had once again lashed out in anger at her. The young man standing to the side showing little interest in Lupita’s new smile was her abusing husband and those were their children. Lupita was at our TMOM to restore her smile, but she was also on the road to restoring her life. With Sister Rosemary’s help, the abusing, disinterested husband would be removed from Lupita’s life. And very soon.

On hearing this story and more clearly understanding Lupita’s life, I was speechless, and choked up. The tears were coming again, and Sister Rosemary looked at me- right in the eye- and told me, “Thank you. Your special gift and the talent of all of these dentists has changed Lupita’s life and affected the lives of hundreds like her here in Laredo. Thank you.” And after that, drained and speechless, I returned to my acrylic and began polishing the next flipper for the next Lupita. And in my mind I said, “Thank you, Sister Rosemary and the city of Laredo. And may God Bless Lupita.”


**Texas Missions of Mercy (TMOM’s) are supported by charitable donations made to the Texas Dental Association Smiles Foundation. Supported by 100% of TDA members in our state, “The Smiles Foundation” reaches out to communities in need by bringing dental and local volunteers together a few times a year to change people’s lives- one smile at a time. Please support “The Smiles Foundation” with your time, your treasure, your passion, or your special gifts. Thank you.

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