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International Outreach Program - The Ugandan Clinical Outreach

CEO Build Your Smile Dental Foundation, Toronto, Ontario, Canada
Head - Division of Prosthodontics, Mt. Sinai Hospital, Toronto, Ontario, Canada
Corresponding author: Izchak Barzilay, 2300 Yonge Street, Suite 905, Toronto, Ontario, Canada. E-mail: ibarzilay@buildyoursmile.com
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Outreach is a vital part of the mission and philosophy at Prosthodontic Associates and its founder - Dr. Izchak Barzilay.

As part of Bridge to Health Medical and Dental as well as Kihefo (Ugandan NGO) volunteer team, Prosthodontic Associates participated in a brigade to Uganda. This was the 5th time that Dr. Barzilay and the team had been on an African mission and the 3rd consecutive year since Dr. Barzilay introduced same day denture fabrication.

The main purpose of the mission was to deliver critical dental and medical care to impoverished communities which otherwise lacked access to such services. In addition, sustainable health, dental care, as well as health and dental education was provided to support long-lasting impact on the communities served. Prosthodontics - denture fabrication - played a major role in this mission.

Over the 2-week course of the mission, the team traveled hundreds of miles from Kabale, Uganda to remote villages where they transformed rudimentary school houses and classrooms into makeshift dental centers while the medical team pitched tents on the public lawns. The team utilized a generator to create limited electrical power in the villages since electricity, or running water is scarce or non existent in these remote locations. Bottled water, dental equipment, and supplies were carried to each location and set up daily. Patients were triaged and then assigned to treatment appropriate for their needs. Separate areas were assembled daily for extractions, restorative, preventive and hygiene services, and functioned for approximately 6 h, before being dismantled only to be set up the next day in another location. Simultaneously, treatment was being administered on the medical end of the brigade.

With the support of multiple donors, the team was able to expand services to offer same day denture fabrication and insertion. The prosthodontic team served a steady stream of patients; many lined up in advance of the team’s arrival to ensure their immediate dental needs could be addressed. Dr. Barzilay and the team, over the course of the fifth Brigade, fabricated upward of 66 partial and complete dentures using light cured materials (Triad) combined with high-end denture teeth (Genios). This extraordinarily rare treatment to the Ugandan villagers quickly became one of the most popular services offered. The team witnessed not only physical but also emotional transformations, as patients were boasting full smiles by the end of each clinical day. Partial or complete edentulism, which may have been a stigma and a hindrance to getting a job or finding a partner, was treated to the sounds of joy, laughter, and applause.

The team expected to see many more complete edentulous patients and was surprised to see very few. When asked why there were so few, the team was told that “the people without any teeth die becasue they cannot eat.” This gave the team a very different perspective of the key role outreach missions play in these communities.

Over the course of the 2 weeks in Uganda, the dental team cared for several thousand patients. Oral cancer screening was performed as well as minor treatment performed in the field. Major treatment was referred out to urban dental centers. The medical team saw thousands of patients and treated a myriad of medical conditions.

A very difficult part of the job was the prosthodontic triage process. All patients who needed extraction and pain management were seen; however, there were many patients needing prosthodontic services that had to be prioritized. The toughest part for the team of the 2018 mission was turning people away at triage, as the denture program was at capacity for that day. Resources were limited, as was time. The patients who were rejected did not complain; they just started walking to the next village where we would be the next day with the hope that they could be seen. These walks could take all night, but their want and need for treatment overpowered the discomforts of “on foot travel” (often barefoot). Preparations for the coming year’s program have, therefore, taken on a different form with increased personnel as well as increased abilities to provide prosthodontic services.

A unique pilot project was also undertaken in 2018, where two dental implants were placed in the field. This treatment, unheard of in this part of the world, allowed for two patients to avoid partial edentulism. At this time, the implant treatment is being expanded to include more patients and a larger number of implants. Implant education is being given to the local dental officers and full handson training is being planned.

Dr. Izchak Barzilay, Build Your Smile Dental Foundation, and the entire Prosthodontic Associates Team remain committed to helping those less fortunate and very much look forward to future outreach programs - both internationally and locally.

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