3rd World 3rd
In a village setting without electricity, improvisation becomes the rule, headlamps a must, and x-rays only a wish.
Armed with an array of dull, nicked elevators, experienced forceps, cotton “balls” and no suture kit, our third trip to the villages 50 kilometers outside Siem Reap, Cambodia, presented daunting challenges.
Having lived in Saudi Arabia for a year, I have been initiated to hotter climates. The equation changes dramatically when 100% humidity is factored in. Add to that a 30-40 year old female with pericoronitis around a decayed mesio-angular partial soft tissue impaction and you have a real dilemma.
Our initial screening was a firm “no way”. In fact, we decided it was too high risk. Fate however dictated a surprisingly slow patient load that afternoon, and after 5 minutes of witnessing the painful rejection in her eyes, I couldn’t take anymore. We invited her to sit in the foldout aluminum dental chair, complete with a 10 gallon trash can that served as our cuspidor. Administration of the anesthetic was welcomed and the quelling of pain generated a smile, albeit short lived.
The access flap was performed with an elevator selected due to a convenient chip it had near the tip that provided a sharp edge. Four to five repetitive slices actually yielded a clean cut. Bleeding was “controlled” with infiltrations.
My confidence was high, this being the last day of our mission, but short lived when the gut wrenching sound of a “crack”, that delivered only the clinical crown of #32, was heard. The remainder of the tooth was submerged under irregular tissue tags from my previous “clean” cut. The ensuing 20 minutes of working a small apexo around the perio ligament space seem longer that the entire last quarter of clinicals in dental school. Most embarrassing was the sweat dripping from my forearms and head, onto the patient. The stray dog roaming the clinic snatching soiled gloves from the makeshift cuspidor, strangely seemed to compliment the scene.
Aided by my Cambodian nurse assistant and a few of the children fanning me with hand towels, teamed with a dental assistant volunteer from Sweden that robotically blotted the surgical site with cotton balls, we ultimately claimed victory and recovered the fractured roots.
Summed up, I’ve delivered hundreds if not thousands of wisdom teeth in my dental career, but none more exhausting, yet more rewarding than the 3rd World 3rd.
My thanks to Dr. Jennifer Miller who accompanied me on the “village mission trips” portion of Free to Smile. Our synergistic efforts resulted in over 180 completed procedures in 5 days. All of this made possible through the efforts of Dr. Byron Henry and his Free to Smile Foundation
