Pearly Whites

I have had some requests to share more about the work I’m doing here.  Yes, I am going to work.  There is just so much daylight here that there is plenty of time for other things, too.  Here at Maniilaq Dental, there are two full time dentists and one that is here two weeks each month.  The one that is here half time is a prosthodontist, so the other dentists usually save all the crown, bridge, and denture stuff for him to do while he is here.  The closest lab is in Anchorage, but he is from Seattle, so he uses a lab there.  The cost of postage and time it takes is about the same, and he knows their work.  Because the lab is far away, he does a lot of his own lab work in order to minimize the number of appointments and back-and-forth between the clinic and the lab.  This means that he does not have the luxury of teeth try-ins.  He said he would love to be able to do that, but it’s just not possible in this setting and the lab does just fine without the extra steps.  For those of you who are wondering, he most certainly does NOT set his own denture teeth or carve wax crowns.

The other dentists do a menagerie of other procedures.  There is a minority of patients here that come in for regular exams.  These people usually need a filling of some kind.  They do amalgams here, but they also do a lot more posterior composites than I expected.  They are big on using Fuji liners, cavity conditioners, and Fuji IX for fills in conjunction with composites. 

The majority of patients, however, do not come to the dentist unless they are in pain.  This means a lot of root canals and extractions.  Some people can only afford to come in when they are in pain, because they are from out in the villages.  And, flights here are pretty expensive.  Most of the native people qualify for Medicaid, which does pay for their travel, but only if it is essential, aka causing them pain.  Other people simply ignore their oral health and assume that all their teeth will eventually have to come out, because that is how it has been for generations.  Most people here also smoke, which does not help their oral health status.

The kids’ teeth are not much better.  People here drink a LOT of “soda pop.”  It kind of baffles me because it costs like $15 for a 12-pack.  That’s an expensive habit.  I really don’t think parents know what it does to their kids’ teeth, or at least, I like to think they don’t know.  But kids come in with teeth that just have to be pulled because they have washed them away with Shasta and BubbleYum.

It is so interesting to me, because the clinic here is so nice.  It is clean and up-to-date.  The staff is accommodating and the dentists are knowledgeable and skilled.  There are small mini-clinics in the villages that offer simple oral health services.  I’m not sure why more people don’t take advantage of what is available here.  I really think it all stems from a lack of oral health education, a lack of understanding and appreciation for what they have been blessed with and how to care for themselves.