The majority of international healthcare missions are service-oriented programs. The majority of areas served are in desperate need of health care and the work of volunteer clinicians tends to center on oral surgery and/or exodontia to provide relief for infection and pain.
The Dominican Dental Mission Project (DDMP)
The Dominican Dental Mission Project (DDMP) is a service-oriented project conducted under the auspices of the Catholic Medical Mission Board, Inc., of New York (see www.cmmb.org). The project, which is one of the most durable projects in the country, has been in continuous operation for 33 years (as of 2014). The DDMP was started in 1982 with one volunteer who spent four weeks providing care in mountain villages in the Dominican Republic. With rudimentary supplies, the volunteer performed exodontia in village homes, and limited restorative dentistry services (i.e., amalgams and auto polymerized composite resin restorations) were delivered in the local hospital dental clinic. Except for a dental unit with a creaky high-speed handpiece, equipment was lacking. A mortar and pestle and a squeeze cloth were used to mix amalgam. The volunteer returned from that first trip wondering whether he had done more for the Dominicans or whether they had done more for him.
After the initial trip, several dental students learned about the project and expressed an interest in participating, so the mission board and local missionaries, who were approached about that offer, thought the students could be accommodated. A portable dental unit and compressor, along with more supplies, were purchased. In 1983, one dentist, one hygienist, and three dental students participated. Since that time, with the assistance of the local Dominican community, Catholic missionaries, as well as interested volunteers, the project has expanded to as many as 40 participants working at three different sites in the Dominican Republic annually.
The project has become completely mobile, so that each day volunteers leave the mission compound for remote villages high in the mountains. Preventive services, exodontia, operative dentistry (i.e., amalgams and light-cured composites), endodontic, pediatric (pulpotomies and stainless steel crowns) and prosthetic services (e.g., transitional dentures to replace maxillary anterior teeth and complete dentures using denture templates and monoplane teeth) are delivered in schoolrooms that have been converted into dental clinics for the day. The project incorporates a variety of portable units, compressors, generators, chairs, and other equipment to make the services a reality, and all of the dentistry is done in villages with no consistent source of electricity or running water. The local health committee of the town’s development association and local missionaries are responsible for scheduling the villages that will be visited, recruiting and organizing volunteers to help with registering patients, assisting dentists, cleaning instruments, cooking, and providing transportation.
After having treated about 250 people that first year, the first volunteer felt his efforts seemed like only a grain of sand on the beach. However, 33 years later, more than 60,000 people have received approximately US$18 million worth of dental services through the project. Eight Dominicans who originally worked as helpers have gone to dental school and have been partially supported by the project. Several of these dentists continue to work with the project. Preventive programs, including placement of sealants and administering fluoride, are in place in most of the local elementary schools, where each classroom has a toothbrush rack.
As the project evolved, some communities no longer had a great need for the visiting dental teams because Dominican trained dentists have been able to provide the necessary services. As some villages became more self-supporting, new villages were added to the itinerary. As the initial leaders of the project stepped away and then returned, other project veterans stepped forward to continue the work. In addition, several Americans who had volunteered for that project have subsequently developed projects of their own in other countries.