April 24, 2024

Dental students experience oral health abroad

While some hit the slopes over spring break, six dental students from the University of Colorado School of Dental Medicine (CU SDM) embarked on transformative service-learning trips to Brazil and Honduras. The school is new Global health initiatives The goal is to teach students about oral health disparities, the burden of oral health diseases, and equal access to dental care.

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Zach Zylstra (left), Ryan Utsey (center) and Melina Tseng (right) learn about oral health care systems in Honduras at Clinica Esperanza Roatán.

In Honduras, third-year dental students Melina Tseng, Ryan Utsey and Zach Zylstra were welcomed with a music festival and fire show on the beach: Hundreds of people attended the largest fundraiser of the year in support of Clinica Esperanza Roatán, a nonprofit health center that serves 38,000 people annually operates with only 22 full-time employees. “The local community is rallying behind this clinic,” says Utsey. “It’s not just for those who can’t afford care; everyone on the island can go there, so everyone tries to support his mission.”

The students, joined by CU SDM alumni John Raabe, DDS ’90, and Cori Morris, DDS ’21, spent time at Clinica Esperanza, a local elementary school, and in a remote village. They have experienced firsthand what healthcare is like in a very different part of the world than what they know at home.

“For many of the children we saw, this was their first interaction with a dentist. I saw it as an opportunity to build trust instead of the unnecessary trauma that often accompanies dentistry and has affected so many generations to date,” said Utsey.

The team provided dental exams, fluoride varnish and oral hygiene instructions to more than 100 children between the village and the primary school. Utsey said it was difficult to see the extent of the decline in some children, especially at such young ages.

He said: “This experience confirmed that dentistry is the right calling for me. I know I can make a difference in people’s lives with the skills I learn here at CU.”

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At an elementary school in Roatán, Honduras, Ryan Utsey examines a student and provides him with fluoride varnish to help prevent tooth decay.

Promoting confidence in varied patient care

In addition to providing preventive services to local youth, Tseng, Utsey and Zylstra also had the opportunity to perform dental procedures on patients of all ages at Clinica Esperanza. As third-year students, they have been seeing patients under faculty supervision in the CU Dental clinics for just over a year.

Zylstra said: “This experience strengthened my confidence that I could make an assessment and treatment plan on the spot. With every patient I saw, it was up to me to figure out how to help them within about five minutes of meeting them, and without any information other than their name. He emphasized that there were many differences between Clinica Esperanza and the CU Dental clinics. “We had to do the best we could with fewer resources than we are used to.”

Morris said the highlight of the trip for her was seeing the students become more confident and skilled over the course of the week: “On the last day I felt like they knew what they were doing, and they did it well. I hope that the students will gain a better understanding of how to treat patients from different backgrounds and cultures.” Morris owns a family dental practice in Littleton, Colorado, and is an instructor for the CU SDM Advanced Clinical Training and Service (ACTS) Program at the Worthmore Clinic in Aurora, which serves refugees from around the world. She and Raabe have worked with Clinica Esperanza through the Denver Cherry Creek Rotary Club and were instrumental in launching this initiative with the CU SDM.

Broadening perspectives in public health

More than 6,000 kilometers away, in Vitória, Brazil, third-year students Abel Gaytan, Cassidy Hoyt, and Jennifer Ringsdorf joined other dental students at the Universidade Federal do Espírito Santo (UFES) to learn about public health care systems and dental education structures.

The service-learning trip to Brazil was led by Bruce Dye, DDS, MPH, CU SDM Professor, chair of the Department of Community Dentistry and Population Health and Delta Dental of Colorado Foundation Chair in Oral Health Equity. He explained that the trip to Honduras is more about direct clinical systems of care, while the trip to Brazil is intended to teach broader global health concepts, disparities in public health systems and training, and provide opportunities for observational learning.

“This trip provided a wonderful opportunity for students to observe and learn how dental education is similar and different compared to their experiences at the University of Colorado,” Dye said. “Additionally, seeing how dental care is integrated into Brazil’s national healthcare system provides valuable insight into how healthcare systems work differently to ensure people receive care.”

The team was also able to see how a nonprofit clinic partners with the surrounding underserved community to provide a variety of high-quality health care services, including dental care, similar to how a Federally Qualified Health Center operates in the United States.

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Cassidy Hoyt (left), Abel Gaytan (center) and Jennifer Ringsdorf (right) capture the view outside the clinic after a day of observational learning in Vitória, Brazil.

Ringsdorf recalled the most unique observational experience she and her classmates witnessed: “We got to observe some hospital dentistry that we would not normally get to see during dental school. In the surgery we observed, the doctors took a bone graft from the hip to use in jaw reconstruction, which was amazing. That was my favorite day because it was so unexpected.”

Ringsdorf is part of the Doctor of Dental Surgery (DDS) and Master of Public Health (MPH) Dual Degree Program, which gives dental students the unique opportunity to earn the MPH degree asynchronously. Because global health is not a recognized specialty for dentists, those interested in global concepts may choose to study public health and move on from there.

“This week has put a lot into perspective for me personally,” said Ringsdorf. “I am very grateful to have received my degree here at Anschutz Medical Campus and to be able to practice dentistry here in the US”

Hoyt was most grateful for the people she met in Brazil: “As we immersed ourselves in their practices and methodologies, we also formed lifelong bonds with fellow students and physicians, creating a strong network of friends and professional contacts. These connections not only enriched our experience, but also provided valuable networking opportunities for future collaborations and learning exchanges in global health.”

She said this experience broadened her perspective and provided valuable lessons in understanding the complexities of healthcare in diverse cultural contexts.

Get involved: Global oral health initiatives at CU Dental

“Anyone interested in global oral health can find a way to get involved,” Morris said. “You have to be service-oriented and find opportunities to give back, to network with dentists from other countries and to make those connections worldwide.”

In addition to these international service learning trips for dental students, CU SDM offers two new didactic courses: Introduction to Global Health, Policy, Humanitarianism and Introduction to One Health and Oral Health. The first is a foundational course taught by Clinical Associate Professor Elizabeth Shick, DDS, MPH. Shick was recently elected to the FDI World Dental Federation (FDI) Public Health Committee, which is committed to improving oral and general health in underserved communities. She was also selected as a member of the 2024 American Dental Association (ADA) delegation to the annual session of the FDI World Dental Congress. With this title and a grant from the ADA, she helped create a self-paced online course, The Challenge of Oral Disease: A Call for Global Action, which will be embedded into the CU SDM- course and students will receive a certificate of completion.

“This is the first time since 2019 that the school has been able to offer global health activities,” Shick said. Before the coronavirus pandemic, she led the school’s Guatemala Smiles global health program. Both Tseng and Zylstra cited that program as a competitive factor in their decision to apply to CU.

Born in Argentina to parents from Taiwan, Tseng has always had an affinity with world travel. She earned her U.S. citizenship through military service – four years in the Army – and then applied to dental school. She said: ‘I’m so happy that I can finally go on this journey. I love traveling, meeting new people and having new experiences.”

Zylstra grew up in a family that taught global service at a young age, and made many service trips at home and abroad. He said: “This experience focused my love for dentistry and community health in particular. I have come to realize that dentistry has much more to offer than school can ever teach you.”

For students interested in future service learning trips, please email sdm-globalhealth@cuanschutz.edu. Visit the Global Health Initiatives webpage for participation information and more details. For faculty and alumni interested in supporting these initiatives, the CU SDM Global Health Giving Fund helps offset student costs for airfare, lodging and travel insurance.

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