Dental Health Professional Information Packet

Updated November 2011

Outline I. II. Introduction3 How to join and help..4 Join a Dental Brigade How to Help: Gather Medication/Supplies How to Help: Donations III. How to prepare for the Brigade6 Basic Travel Needs Accommodations and Daily Needs: Room, Board, Attire Suggested Tools to Bring IV. What to expect on Brigade..9 Typical Brigade Format Student, Dental Student, and Dental Hygienist Involvement Brigade Location and Setup Pediatrics Program Restorative Care Instrument disinfecting protocol Data Informatics Patient Referral Program Community Health Care Workers Testimonial from Dr. Jim V. Appendix...20 Supplies Needed for Brigades & Wish List Contact Information

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Dear Dental Health Care Professionals: It is our honor and privilege to welcome you to Global Brigades the nations largest international student movement. With your time, knowledge, and efforts, you will be changing the world, one brigade at a time. The change you will make in peoples lives is real. The people you will meet will thrive because of your leadership and dedication. The most important step now is the first step to get involved and to make a difference. Global Brigades incorporates hands-on global health initiatives while respecting local culture. This is a unique opportunity to apply your education, intellect and creativity to help the Honduran, Panamanian, and Ghanaian people realize their dream of escaping poverty and experiencing true development. We encourage students, volunteers, and health care professionals to use this time to build skills, networks, friendships, understanding, resumes and a stronger connection to our global community. Thank you for your interest and leadership in Global Brigades. As a student-led movement, this experience and club is exactly what you make it. Ask for more. Share new ideas. Keep the momentum alive. Wherever this experience takes you and your team, were here supporting you, every step of the way! Welcome to the GB family,

Dr. Shital Chauhan Chief Program Officer CEO & Co-founder Global Brigades

Dr. Jenny Najera Medical Director Global Brigades - Honduras

Daniel Truong Dental Brigades Program Lead Global Brigades - Honduras

ARCHITECTURE.BUSINESS.DENTAL.ENVIRONMENTAL.LAW.MEDICAL.MICROFINANCE.PUBLIC HEALTH.WATER

www.globalbrigades.org

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How to Join and Help

Join a Dental Brigade

Every dental brigade consists of dedicated student volunteers, medical and dental professionals, pharmacists, and auxiliary staff providing primary health care to rural communities. The group functions as a mobile medical and dental unit, setting up small clinics to diagnose and treat patients at no cost. If you have any interest in joining one of our university chapters on a brigade, we will connect you with the nearest group whose brigade will coincide with your schedule. Dental professionals return from the trip having not only served underprivileged communities, but also having empowered the next generation of professionals to strive for global access to healthcare. We will provide you with all necessary information to help prepare you for a successful brigade in an environment unique to many existing programs. If you are interested in joining a Dental Brigade, please contact the Dental Brigade Program Advisors, at MDadvising@globalbrigades.org. Once you have joined a brigade, Global Brigades will need to verify that you are a licensed practitioner. In order to do so, you must send us copies of your diploma, valid license and updated passport. For 3rd and 4th year dental students who wish to participate, please see the Dental Student Involvement section on this packet for more information. Please scan all documents and submit them to hcpdocuments@globalbrigades.org no later than one month before your departure date. Without these documents, health professionals will not be allowed to practice in Honduras. Please note that the local law requires an in-country dentist to accompany all dental brigades, and that this in-country dentist will assume all medical liability for treatment received on brigades. We will provide an in-country dentist to join your brigade; it is not your responsibility to recruit them.

Help to Gather Medications/Supplies If you cannot attend the dental brigade itself, you can still contribute to our efforts and make a tangible difference by equipping students with the right tools for their brigade. In order for this trip to be a success, we ask for the support of

Dental Brigades Health Professional Packet | 5 dental professionals in all fields; it is essential that we have enough medications, anesthesia, and supplies in order to effectively treat as many people as possible. As our programs expand, the focus and scope of brigades may begin to differ, and thus certain brigades may require different supplies. These may be sought from hospitals, pharmacies, supply houses, pharmaceutical companies, and individuals. Donations of any kind or questions may be directed to the student group you are sponsoring. If you are able to donate any medication or supplies, please ensure that they are non-expired. For a complete list of needed medication and supply donations, please see the Appendix.

Donate Whether or not you are able to accompany us, we appreciate donations. Without donations from members of the medical community, our brigades would not be possible. Global Brigades is a non-profit organization, and as such, all donations are tax deductible. Be a sponsor o Global Brigades has recently launched a new online fundraising platform, Empowered.org, where donations can be made to individuals or groups. Step 1: Enter the name of the group or individual into the search bar Step 2: Select the appropriate brigade you wish to donate towards and click DONATE Step 3: After making a donation, you will automatically be emailed a receipt. Donate or assist in gathering health-related dental supplies (see appendix below) Assist in pre-trip education, motivational talks at the nearest chapter university

Please see the Appendix for an additional donation wish list.

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How to prepare for the Brigade

Throughout the preparation process, please feel free to contact the Dental Brigade Advising Team with any questions.

Basic Travel Needs General list of necessities prior to traveling: Valid Passport which must not expire within 6 months of departure from the US For brigades to Ghana, all volunteers are required to have a Ghanaian visa. Please visit the Ghanaian embassy website for visa application instructions and fees: http://www.ghanaembassy.org/index.php?page=visas Required vaccination Ghana: For brigades to Ghana, proof the yellow fever vaccine is required. Recommended vaccinations Central America: Hepatitis A, typhoid fever, up-to-date standard vaccinations (e.g. Hepatitis B and tetanus), and Yellow fever (Panama only Recommended zone). Please visit the CDC website for current information on vaccinations: http://wwwnc.cdc.gov/travel/destinations/honduras.htm#vaccines Malaria prophylaxis to be taken 1-2 weeks prior to departure and as directed by your local travel clinic. Travel clinicians will recommend the type of prophylaxis best suited for your personal and travel needs. Any prescription medication currently taken $38.00 exit fee to depart Honduras and about $50-$100 for souvenirs A cell phone is not necessary. Please contact your cell phone provider for details for international service. Emergency contact information: Upon your arrival to Honduras, Panama, or Ghana, Global Brigades will send an email to your emergency contact, notifying them that you have arrived safely. This information will be collected via your club president before your departure.

Accommodations and Daily Needs: Arrival, Room, Board, Attire Welcome to Global Brigades! Upon your arrival you will be met by a Brigade Coordinator at the airport who will guide you to your bus, organize your luggage, help you to exchange money and get you on your way to our accommodations.

Dental Brigades Health Professional Packet | 7 Our accommodations are about one to three hour away from the airport depending on your brigade country. Once you arrive, you will participate in an afternoon activity. After dinner, we will begin an introduction to the country your program is in and address any questions you may have at that point. We will always try to provide health care professionals with quarters that are separate from students, however during busy brigade seasons this may not always be possible and therefore we ask that you be flexible. When possible, health care professionals will be placed with other health care professionals. A twin bed including sheets and a pillow will be provided along with a towel. If you require any additional items, please bring them with you. Running water is available in all accommodation sites, but it is often cold and has low pressure. Bottled water for drinking will be provided. Breakfast and dinner will be communal and served buffet style at the compound where you will be staying. Packed lunches will be provided in the community at the brigade site. If you have any special dietary needs or restrictions, please inform your group leader in order for our in-country staff to plan accordingly. Your brigade will travel to the brigade sites each morning and return before nightfall. All traveling is done as a group in buses or trucks. Global Brigades ensures that each compound is safely secured by providing armed security around the clock. Honduran and Panamanian climate is characterized by two distinct seasons - dry and rainy. The dry season lasts from November through April and the rainy season from May through October. Suggested attire is light, airy clothing that can be worn in layers, as the temperature can vary greatly depending on altitude. Some rain gear is also suggested. Most health care professionals also bring hospital scrubs to wear during the brigade. Bring attire that you will be comfortable wearing in warm weather. Laundry services are also available daily at no additional cost.

Suggested Extractions Tools To Bring Dentists are required to bring their own tools on brigades. Here is a list of suggested tools that are typically used. Dentists are free to bring any other tools they find more comfortable using. Also, please label your tool set with a colored label to distinguish from other dentists tool sets. Upper Straight elevators 150, 150S central, laterals, canines and premolars 18R, 18L, 88R, 88L for molars 10H for impacted teeth (third molars if completely erupted) 10AS upper molars and wisdom teeth 65 for roots #1 forceps for incisors and canines 99c incisors, canines, and pre-molars Lowers Flags and Curved elevators 151, 151S, 137 central, laterals, canines and premolars 16, 17, 23 for molars Others Absorbable sutures, Hemostats, and Surgical scissors Osteotomo Curette Bone file Disposable plastic syringes & saline solution Bite block if needed 3-4 syringe of sealant material & portable light cure Restorative Care (currently only offered in Honduras) Burs (cylindrical cutters, round and conical of different sizes) Phosphoric acid and bonding with applicators Matrix bonds Vitre bonds for base Composite & Temporary fillings Surgical burs Amalgam capsule Amalgamator or amalgam tablets

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What to expect on Brigade

Typical Brigade Format Dental Brigades has treated thousands of patients in hundreds of different communities in Honduras, Panama, and Ghana. Since most of the people we treat do not have access to clean water, toothbrushes, toothpaste, or regular visits with dentist, the services we provide are priceless. In an effort to become more invested in the long-term health of our communities, we have teamed up with the Medical Brigades program to provide a more holistic approach to our communities. In order to be able to provide a larger range of services and more focused on education, we visit the same community three or four days in a row for each brigade. Because we will be visiting each community multiple times rather than seeing all of the patients in a single day, each patient will spend more time during his or her consultation with a physician and more time for dental procedures and education as well. With your help, the community members now will have access to more dental services, including fillings to help restore teeth that otherwise would be extracted. Also, dentists are able to provide patients with referrals to nearby clinics. Community nurses will follow-up on the care for these patients. Please see Community Health Workers for more information. Also within our program, patients will receive education in basic hygiene and other specific topics, as the smaller volume of patients will allow for more time to conduct presentations and small educational activities. As part of the brigade, we input patient information into Open MRS, the patient management program that we use in our Data Informatics System (DI System). This information will not only enable us to provide follow-up care, but can also be used as an assessment tool for analyzing the health of communities as a whole and for measuring our impact in a given community over time. Patients typically arrive at a brigade in families. Many of these patients will want to come see a dentist for a variety of reason. The primary complaint is pain, which is typically the result of severe dental caries and periodontal disease. The majority of these patients want to receive an extraction; however, we want to offer them fillings for teeth that can be restored.

Dental Health Care Professional | 10 Restorative care is one of our initiatives for improving the dental status in our communities overtime. For patients, primarily children, who may not need or want to see a dentist, we offer fluoride treatments along with a dental education program prepared by brigade volunteers.

Student Involvement It is important to remember that our highest priorities are the health of the community and the experience of our students. It is important that students not only enjoy their in-country experience, but also gain knowledge in the process. In addition to providing care to our patients, you will act as a teacher to our students. If you have questions or are unsure how to prepare for this role, we will be more than happy to offer guidance. As a professional participant, you will have an amazing opportunity to interact with students and guide young aspiring professionals. During brigades, unlicensed volunteers cannot perform any procedures or unload syringes but will have a chance to observe and learn from licensed dentists. These precautions ensure that neither the volunteers nor the patients will be at risk.

Dental Students Involvement 1st and 2nd year dental students are able to provide fluoride treatments, cleanings and education for the children within the community. This pediatric element is an important and sustainable aspect of our program. Student volunteers also may assist in this process. 3rd and 4th year students may only partake in providing extractions, fillings, scaling, and applying sealants if they submit a letter from the professor or dean of their dental school stating that he or she has passed the course involving extraction and fillings. Please scan this document and send it along with the dental students passport to HCPdocuments@globalbrigades.org no later than a month before your brigade.

Dental Health Care Professional | 11 Dental Hygienist Involvement Dental Hygienist will be able to work side by side with the dentist and help assist them in the procedure they are performing. The can also help with scaling for those patients who dont need fillings or extraction, provide fluoride treatments, and most importantly, dental education for the children.

Brigade Location and Setup The physical site of the dental brigade and details of setup will vary depending on the community and available resources. Most often, the site will be a school or church in the community. Spatial areas or different rooms will be designated for distinct functions, includes the Dental Brigade and the other Medical Brigade stations. Below is the patient flow chart of a typical brigade format:

For Dental Brigades, a room will be designated where we will create a makeshift dental clinic using the materials in the schools, our restorative unit, and our other supplies. Within the room, there will be specific areas where extraction tools, supplies for fillings, and solution for cleaning instruments will be arranged. The rest of the brigade operates similarly to a traditional hospital. Patients will transition from intake to triage to medical consultation to a dental consultation (if necessary) and ultimately the pharmacy. While waiting for their prescriptions

Dental Health Care Professional | 12 to be filled in the pharmacy, adult patients will attend a public health education workshop while pediatric patients will partake in a dental education program. During this, children will receive a fluoride treatment along with materials and demonstrations for proper teeth brushing and dental hygiene. After receiving their medication, all patients will turn in their patient sheet to students entering the information into the database. Dental Brigades is currently working to create and encourage a more sustainable level of care for our communities. Before being treated, each patient is given a form that records demographic information, vital signs, complaints, diagnoses, and prescription information. Intake: The first station passed through is intake. Volunteers from the community will be responsible for operating this station and filling out the basic information in the section of the patient intake sheet shown below:

*Please note that the patient sheet travels with the patient until after they have received their medication.

Triage: After intake, patients pass to triage, where they relay their symptoms/ ailments to volunteers who:

Take blood pressure for all patients Weigh children under 12 Take temperature of children under 12 and those who complain of a fever Gather information about medication and current health conditions

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Consultation: This station is comprised of health care professionals, and interpreters when necessary. Health care professionals consult, diagnose, and then prescribe medication best suited for each individual patient. Please note that local law requires an in-country doctor to accompany all medical brigades, and that this In-country doctor will assume all medical liability for treatment received on brigades. We will provide an in-country doctor to join your brigade; it is not your responsibility to recruit them. Dental Room: This station is comprised of dental health care professionals who attend to patients who wish to receive dental services. The dentist will perform a routine consultation to determine which procedure the patient should receive: extraction(s), filling(s), scaling, and/or sealant. Working alongside volunteering dentist will be a local dentist. The local law requires a local dentist to accompany all dental brigades; this in-country dentist will assume all medical and dental liability for treatments received on brigades.

Each dentist will also have 2-3 volunteers assisting with instrument cleaning and handling as needed. Volunteering dentists have the amazing opportunity to share

Dental Health Care Professional | 14 their knowledge and educate both patients and students throughout the whole process. Once a proper history is taken, the dentist may begin necessary procedures and prescribe medication as they feel necessary. Please note: ONLY dentists are allowed to mark on this part of the sheet:

Public Health Education Workshop (Charla): We realize that education is absolutely essential in order to truly change the health of any community. To this end, we have begun to develop a number of presentations on such things as basic hygiene, dental hygiene, first aid, and nutrition. The patients will be seated in front of the presenter to facilitate an educational discussion, while their prescriptions are being filled in the pharmacy. Hygiene packs will also be passed out at this station (bags of soap, toothbrushes, floss, etc.) Many of the topics covered in the charla are adult orientated. Because many patients are children, students will have the opportunity to prepare and present dental educational skits, activities, and games for children. During the charla, each child will learn how to properly brush his or her teeth and will receive a fluoride treatment. Pharmacy: In this station, prescriptions are filled with the medicine students have collected for their brigade. A pharmacist oversees this station and answers any questions that students or patients might have.

Pediatrics Program As you know, the dental status of a community is really based on many different kinds of preventative measures from the availability of a toothbrush to education. Many of the communities we serve are stuck in the same cycle of unhealthy diets as children, continual spreading of dental caries, which then leads to the need of teeth extractions as when they are adults. What we attempt to do with this

Dental Health Care Professional | 15 program is break this cycle and provide preventative service and education for the future generation. Step 1: Sealants Generally are applied before fluoridation. The process is simple. We first dry the tooth, and then apply the phosphoric acid for 15 seconds. We then apply the sealant, and dry with the light cure. On a normal brigade, we will recruit patients that need or want sealants and apply the solution to newly erupted back molars that currently have no decay. Sealant materials are on the list of supplies Dental Health Care Professionals should bring. If you can help provide these materials, please notify the chapter presidents. Step 2: Dental Education and Activities Volunteers will put on a group activity that will allow the community kids to be involved, engaged, and interested in various dental hygiene topics. Step 3: Teeth Cleanings After education, volunteers will continually interact with the children and teach them how to properly brush and floss their teeth. Volunteers can make this fun and engaging for the participants Step 4: Fluoridation Once the childs teeth have all been cleaned, the child will then dry his or her teeth and fluoride will be applied via fluoride trays to make his or her teeth stronger and more protected. Generally, the Reyes Irena girls will provide this treatment. Students are able to do this under the supervision of a licensed dentist. Step 5: Data Informatics Input To follow the current dental status of the communities we serve, we will be utilizing the DI system which will help us keep track of our pediatrics patients and analyzing the trends over time.

Restorative Care It is important to focus on the long-term goals of sustainable dental health through restoration and dental education. Fillings are important to community members because it allows them to maintain their teeth rather than extracting them. Patients who come to a brigade for fillings know that maintaining and taking care of their teeth is important to their health. While extractions may

Dental Health Care Professional | 16 alleviate acute pain that they have had to endure since they last saw a dentist, this cycle continues as dental caries spread to the patients other teeth. This will eventually lead to severe tooth decay and the toothache will reoccur. To break this cycle, we must begin to encourage restoration and maintenance of healthy teeth so that eventually we will see a decline in extractions and an increase in both restoration and routine cleanings. In an effort to bring about these changes, we hope to offer the restorative portable unit to all groups on at least one day every brigade. Note that this service is only available to groups going to Honduras. We are currently still collecting donations to purchase units in Panama and Ghana. If you are interested in making a donation to help support this project, please contact the Dental Brigades Program Lead, Daniel Truong (danieltruong@globalbrigades.org). Below are the specificities of the unit in Honduras: DHD-130 Deluxe Portable Dental Unit 4-hole/2-hold instrument hose 2 pc 3-way syringe 1 pc Low volume evacuation 1 set Self contained water supply 1 set Self contained oil-less Compressor (580 watts) 1 set 110 Volt or 220 Volt 7 L tank capacity High Speed Hand-piece Light Cure Patient Dental Chair Generator for communities with no power and also in an event of a blackout NOTE: Suction works on the majority of units but can overheat the unit when using the high-speed piece at the same time. Therefore, the use of suction is possible, but may be compromised during brigades.

Instrument Disinfecting Protocol In the dental station, it is important to disinfect all instruments that are used after procedures. Unfortunately, we do not have the supplies to auto-clave the tools used; instead, we use a set of solution for disinfecting instruments.

Dental Health Care Professional | 17 Instruments are submerged in Sporox (7.5% hydrogen peroxide solution without glutaraldehyde), bleach, and water for 5-7 minutes in each solution, respectively. It is recommended that each dentist bring his or her preferred tools to increase instrument availability.

Data Informatics December 2011 marks the beginning of a new chapter for Dental Brigades. Our electronic medical record system, which has been implemented on all medical brigades since December 2010, is now fully functional for Dental Brigades and will be incorporated on each from here on out. The benefits of Data Informatics are numerous - not only will we be able to analyze health trends within our communities, but we will have the ability to track patients over time, to follow-up on previous conditions and offer better, more personalized dental care. We have adapted the OpenMRS system, designed by Partners in Health, to function with our brigade model. Currently, we are using student computers to collect information primarily in the exam room with the students working alongside providers as data-entry clerks. Your role as a provider will be to work with the patient as well as the student to make sure that information is entered as accurately as possible. Paper forms will still be used for the time being as a back up in case of system glitches and are still the only records used in the pharmacy (OpenMRS does not yet have a pharmacy module that is compatible with our brigade model). If you have any questions about the Data Informatics System or would like more information, please contact the Data Informatics Program Lead, Kimberly Hanson (Kimberly@globalbrigades.org).

Patient Referral System A commonly asked question of many Dental brigaders is in regards to the process of follow-up care after a patient leaves the brigade. Global Brigades Patient Referral System helps to ensure that patients who require additional medical attention are cared for after a brigade. While on a brigade, an in-country physician identifies a patient who needs some kind of follow-up care and writes a referral for that patient to visit their nearby health center or hospital. With this referral sheet, the patient is guaranteed to be seen and is advised to go seek the medical attention within a couple weeks after the brigade. A full-time staff member is dedicated to facilitating the referral

Dental Health Care Professional | 18 system process, and checking in with patients after their initial visits to the health centers. All referrals are entered into the data informatics system providing us with the ability to track and monitor the patient. In addition, accompanying each medical and dental brigade is a staff member responsible for responding to emergency cases. If there is an emergency case on a brigade, the patient is transported from the brigade site to the appropriate location to receive the necessary care. Funding for the Patient Referral System is provided by the Community Investment Fund (CIF), which is included in each volunteers program donation. However, many costs exceed the current funds allocated by the CIF. We actively seek student involvement to fundraise and solicit donations for these patients to bring them the care they need. The additional care provided by the referral system promotes a more sustainable health care system for our patients. The referral process will be discussed further with health care professionals upon arrival in country. Note: the in-country doctor and dentist is the only professional who can write a referral. If you have specific questions, ideas, or concerns, about the referral program please contact Referral Program Lead: Jennifer Grasso (Jennifer@globalbrigades.org).

Community Health Workers Program Global Brigades also sponsors the Community Health Workers (CHW) Program, known as Guaridanes de Salud. The CHW Program currently partners with communities in Honduras to provide intensive health worker training to elected community leaders. The program was created to empower local leaders to perpetuate a consistent level of health care and improve access to medical and dental services inside rural communities. The program also provides CHWs with the knowledge to provide adequate follow-up care between medical brigades and prevent potential health complications. The CHWs are trained through a 3-month course featuring a health promoters curriculum based on the well-known training books, Where There Is No Doctor, and Helping Health Workers Learn. Supplemental information for these trainings is taken from the Honduran Ministry of Health. Topics of the course include first aid, tropical diseases, STDs, family planning and nutrition. The CHWs learn how to track the health status of community members and to teach them about preventive health measures. Each member is taught how to give basic

Dental Health Care Professional | 19 treatment for acute diseases, to manage medication for chronic illnesses, and to refer complicated cases to the next level of care. This program has shown the capacity and importance of having trained CHWs in the communities. This program is currently looking to implement a dental aspect within the curriculum and is currently developing this initiative. The CHW Program is a way to bring more sustainability to the communities in which we work through educating community members on how to maintain a consistent level of health care. It helps to ensure the good we are doing during Medical Brigades is being perpetuated after we leave by promoting the prevention of future health complications and for the follow-up care of chronic patients. For more information about the Community Health Workers Program please contact the Program Coordinator, Jennifer Grasso at Jennifer@globalbrigades.org.

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Appendix
Testimonial from Dr. Bruce Chan My trip to Honduras I just got back from a mission to Honduras with the Global Brigades--the largest student run health organization in the world. If you want to do something that makes you feel good about the future of the planet, the young people and yourself, you may want to support or participate in this organization--check out their website. Several months ago, by daughter who is at USC, asked if I wanted to go as part of the team and I immediately said yes. The team evolved into 50 students, one internist, one ENT doctor, and me. The students had funded themselves individually, and amassed a huge supply of medical goods and clothing and toys. We flew into Honduras the day after New Years and were taken by bus to a compound with dorms and meeting areas, along with separate quarters for the docs. An orphanage of around 150 children was adjacent, and the students went over with toys and were immediately surrounded by children starving for attention--clinging to legs and throwing themselves into the arms of the students. Most of the orphans lived in groups of 12 with one nanny and were unlikely to ever be adopted. The next day, after a hearty breakfast of eggs and beans and juice, we were taken by armed caravan to a mountain village, where another brigade of engineer, architecture and public health students designated a home to have a concrete floor placed, to help control parasitic disease. The students set about leveling the floor, mixing concrete and pouring. At the end of the day, the threeroom house was done, and the exhausted students were taken back for a dinner of fried chicken. In the evenings, the students would pack and organize medications and all the donated goods, and then socialize. We three docs retired to our porch and relaxed. All in all, the conditions were clean and comfortable and basic. And very secure with government soldiers surrounding the camp. The weather was very mild and very little bugs. The next four days, we went by caravan to a small village school. On arrival, we were greeted by long lines of patients, some of who had been walking with their children for over 4 hours to get here. We divided into teams for triage, medicine,

Dental Health Care Professional | 21 dentistry and finally pharmacy--the final stop where medications and clothing and toys were distributed, according to need. We also had two Honduran physicians and one Honduran dentist. We set up chairs and tables as best we could, and set out our donated instruments and supplies and went to work with the brigade students helping. We had long lines that seemed never ending and began limiting the care to one extraction per patient, generally the one causing them pain. Those that needed more would sometimes walk home for hours and return the next day. The patients were very appreciative and very stoic. We were amazed at how the children would come in on their own, point to the tooth they wanted out and sit quietly while we numbed them, and they did the work. We thought they were very mature for their age and had a very tough existence. I generally only had time for a 20-minute lunch, as we were trying to get as many people seen as possible. The Honduran dentist was remarkable, very committed, very fast and very modern. The Brigade hired him and one of the physicians. The other physician was doing his mandatory year of community service. This went on for three more days, and we became more and more efficient as the brigade caught on. The docs were pretty sore at the end of each day and really enjoyed the porch after dinner. These fellow docs were great guys. We were all about the same age and instantly connected. On one night, a folkloric was presented and we were taken to another compound. I was astounded by the amount of students gathered here--from five universities across the United States. After the cultural event in this huge tent, they bought out the dance music and lights and the kids partied with much dancing and school chants. These were great kids I met, unbelievably bright, passionate and committed. I got to know many of them and was impressed at the kind of young people this country is putting out there. On the flight home, I sat next to a executive from a local news channel, and I told him that every day of every week their are thousands of young people trying to make the world a better place, and this was the untold story. He agreed, but said that sort of news did not sell.

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I think it might. Good start to a good year. Brian Chung D.M.D. Oral and Maxillary Surgeon USC January 2011 Brigade

Dental Health Care Professional | 23 Supplies Needed for Dental Brigades Below is a list of supplies that are needed in order to run a successful brigade. Dental professionals are encouraged to help student volunteers obtain these supplies, especially the ones that require a dental professional to obtain.
Amount for three brigade days with one local dentist 6 boxes 3 boxes 300 300 6 tubes 2 bottles 6 bottles 600 (~200 each size) 1 box of 10 10 2-3 syringes 1 bottle 1 box 1 big or 2 little 10-12 sleeves 1 box of 50 400 2 tubes 900 900 900 6 pairs 6 300 1 2 boxes 2 rolls 3 bottles 3 boxes 3 boxes 3 boxes 3 boxes Per additional dentist 1 box 1 box

Supplies (* need dentist to obtain) Lidocaine 2% or Septocaine 4%* Non-epinephrine injection 3%* Short dental infiltration needles (30G)* Long dental infiltration needles (27G)* Prophy paste or large tubes of toothpaste Topical analgesic with cotton-tipped applicators* Fluoride gel/foam 1.23%* Fluoride trays (size XS, S, M) Absorbable sutures* Disposable scalpels* Sealant Material* Hydrogen peroxide Alcohol swabs or alcohol with cotton balls Sharps container Gauze sleeve (2x2 non-sterile) Surgical masks (ear-loops preferable) Dental bibs Sterilizing spray or wipes (Cavi wipes, Lysol, etc.) Toothbrushes Tubes of toothpaste (small) Dental floss Goggles Large surgical drapes Ziplocs prepackaged with 4 gauze pads Dental puppet/mouth to demonstrate Box of tissues Duct tape Hand sanitizer Small gloves Medium gloves Nitrile gloves Large gloves

2 additional

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Heavy duty gloves (dishwashing) Scrub brush (dishwashing scrubber) Extraction tools, including hemostats and scissors BP cuff and stethoscope 3 pairs 3 brushes As available 1 set

Extra Donations and Wish List Dental Brigades is continually trying to expand the program in many ways, and if you have some items that you wish to donate, or know someone or a company that may be of help please let us know! Below is a list of things we are consistently trying to gather. Composite Phosphoric acid Bonding Amalgamators Amalgam Portable Curing lights Portable x-ray panoramic Pressure pots for sterilization Sterilizing liquids Extraction tools Syringes Burs (especially diamond) Goggles (or other eye protection) Headlamps or overhead lamps Extension cords Power strips Portable dental chairs Portable units & compressors Suction pumps Larger mirrors (for looking at restorations) Spanish educational posters/pamphlets/videos

Dental Health Care Professional | 25 Contact Information Honduras Program Lead Daniel Truong danieltruong@globalbrigades.org In-country Lead Dentist Dr. Fernando Estrada drfernando@globalbrigades.org Program Adviser Nicole Coalson nicole.coalson@globalbrigades.org Brianna Clarke brianna.clarke@globalbrigades.org Erin Rudegeair erin.rudegeair@globalbrigades.org Kathleen Schmitt kathleen@globalbrigades.org Brigades Coordinator Karla Platzer karla.platzer@globalbrigades.org Elizabeth Sophy elizabeth.sophy@globalbrigades.org Data Informatics Program Lead Kimberly Hanson kimberly@globalbrigades.org Patient Referral Program Lead Jennifer Grasso jennifer@globalbrigades.org Community Healthcare Worker Program Lead Dr. Bruce Flores Jennifer Grasso jennifer@globalbrigades.org Panama Program Lead Oscar Valencia oscar@globalbrigades.org Program Adviser Jeff Thompson jeff.thompson@globalbrigades.org Ghana Program Adviser Solomiya Teterichko solomiya.teterichko@globalbrigades.org