The clinic is humming along like a well-oiled machine. Semisi Finau has everything working (keep your fingers crossed, for our poor, tired equipment) and we are enjoying the generosity of Midwestern University School of Dentistry, as well as of Randy Gardner, Matt Coplin, and Rick Ballard, our volunteers who were here in October, December, and January, and Courtney Fisher, who will be here until April. We are using electric handpieces, have high intensity curing lights, and use the Isolite on every patient. Every time I utilize a dental material, I think of them.
We still see patients who break our hearts. It is particularly distressing to see students in Form 6 or 7 who have been at Liahona for 3 or 4 years, who have never been to the clinic. But, we have established a good relationship with the administration, and they are sending students to the clinic every day, 2 or 3 at a time.
With the Isolite system that Matt brought, we can do two quadrants of restorative procedures in one visit. This means we can do 10 or 12 restorations, on one side of the mouth / upper and lower teeth, in one visit. We can finish the treatment on a student in two visits. We are constantly adding to our “Wall of Fame,” that lists the students who have completed treatment.
It may seem hard to believe, but most of our patients actually like coming to the clinic. Many have never been to the dentist and it’s strange to treat a patient who has no pre-conceived ideas about how the appointment should go. This means that they have no idea what to expect from the administration of anesthetic. (We do a lot of nose wiggling and ear pulling, and a lot of patients find this very amusing). They also don’t know how to spit (gets messy sometimes), or tap their teeth together. But they also have a VERY high tolerance for pain, and after doing a dozen restorations, they rarely have post operative discomfort (that they tell us about). They also frequently come back in for their second visit a day or two later. We rarely give them analgesics, and almost never give antibiotics.
For you dental types out there, I use septocaine almost exclusively. This means I can adminsiter anesthetic, and begin preparing a tooth immediately thereafter. Generally, we seat a patient in the chair, and are beginning treatment within a couple of minutes. We don’t waste any time. If we don’t run into problems, we can do ten restorations in an hour. But I do use a lot of sedative base material, because most of their cavities are very deep. We go to great lengths to avoid pulpal exposures, but even teeth that have had very large lesions seem to respond well (not many flaring up and needing root canal treatment). I should write a book on Tongan tooth anatomy. Tongans have 1) large mouths – plenty of room for third molars, 2) deep pits and fissures, 3) intact smooth surfaces (no decay between the teeth, in general), and 4) a high tolerance for pain. They are uncomplaining, and very rarely present with behavioral management issues. (I did have one patient who was needle-phobic, but we got past that quite easily with nose and ear wiggling).
It’s nice to walk through the Liahona campus and see students who are patients in the clinic. They always call out hello (or malo e lelei – but it is an English speaking campus).
It reminds me of when I practiced dentistry in Switzerland, and the little children in the alpine villages would greet me the same way. (Except they would say: “Oh, le piquer! Ca fait mal!).
I’m not sure I have a favorite type of patient, but I do like to ask where the students are from, and what their background is. Many are from very small islands in the South Pacific, where there is no opportunity for oral health care (or medical care, for that matter). I really admire the students from P.N.G. who have made it 1,500 miles to Liahona to go to school for 5 years, away from their families and culture. Many are on scholarships, and after their missions would like to go to B.Y.U. Hawaii.
All of the students have bright eyes, and are alert, and an the girls are vivacious. They have a sweetness about them that is so refreshing. They all love to sing, and it’s very common to hear them day and night, singing in small groups.
F.Y.I. In February we placed 899 composites (fillings), and did 164 extractions. So we are tipping the scales in favor of saving teeth. (It was about even when we first got here).
We are also seeing a lot more students, pre-missionaries, and missionaries (which makes the Presiding Bishopric Office happy). The students returned to Liahona at the end of January, which explains why 1) we didn’t see many in January, and 2) why we saw so many in February.