	In an open clearing, under the sunlight of Thailand and beneath the shade of a village tree in Burma, Dr. Joseph Whitehouse provided impromptu dental care that he never intended to practice abroad. Finding himself at the right place at the right time, while visiting remote villages in Southeast Asia, he began performing tooth extractions to local villagers that suffered from mild to severe dental complications.

	But it was a vacation in Guatemala and a coincidental encounter with a physician from Idaho, that really got Dr. Whitehouse committed to third world dentistry. While reading under a canopy in Lake Atitlan, similar to the U.S.’s Lake Tahoe, Whitehouse and friends began talking to a Physician from Idaho that had set up a medical clinic in the area. Whitehouse remembers, “I said to him, how would you like a dental clinic? And that was probably about five or six years ago. We have not only set up a clinic in the Mayan village where he has his clinic, but there are now four other dental chairs. Three at lake level and two way up in the mountains.”

	With the success of his clinics, dentists can go volunteer down in Guatemala and branch off into each of the villages where a dental chair has been set up. “The dental chairs are there, slowly we will get lights in all of them, couple of them now have the lights and slowly get compressors in each one of them and then we can go ahead and actually do dental care.”

	Whitehouse recalled, “Each time I didn’t originally go to do any dentistry. I took along instruments because the person leading the tour in Thailand had built a place for us to stay in a Mong village. Then it turned out to be appropriate, the day we were going to walk out of there, to line up and shoot up nine people, let them get back in line and by the time I shot up the ninth one, the first person was numb and I could take one tooth out of each person. In other words, that was something that was appropriate for them, it was pretty easy to do and that was the first time I had done anything like that.”

	His next encounter, while getting ready to leave a remote village in Burma, was with a man suffering from an extreme draining abscess. “It didn’t seem appropriate to do anything, but on the way out, there was a man and down at the bottom corner of his mouth, below his ear, he had a draining abscess coming out. And I thought this guy could die, I’ve never seen anything like it. So we got him under a tree, where I still had sunlight, and determined that there were two molars that were very very loose and they were the cause of the infection probably. But he probably never even knew what a dentist was.” With the help of three translators, Whitehouse was able to remove the two molars successfully. Watching this procedure from afar, Whitehouse was then approached by a woman wearing an elaborate silver coin headdress that also wanted a tooth removed. He treated her and would have treated others, but the sunlight was going down, diminishing visibility.

	Since starting his clinics the dental school in Guatemala City, approximately two hours away, has agreed to send one of their senior students down to the main clinic for eight months out of the year. So now a village of about 3,000 people basically has a dentist about eight months a year. “This has changed everything for them” said Whitehouse. “They can perform basic fillings, extractions and cleanings..."

	With continued support and success, Dr. Joseph Whitehouse plans to continue his work in Guatemala and will someday share his story in totality.

Articles

 In an open clearing, under the sunlight of Thailand and beneath the shade of a village tree in Burma, Dr. Joseph Whitehouse provided impromptu dental care that he never intended to practice abroad. Finding himself at the right place at the right time, while visiting remote villages in Southeast Asia, he began performing tooth extractions to local villagers that suffered from mild to severe dental complications.

Third World dentistry, first class care

	Sandy Smith, a dental hygienist in Ohio, felt she had no other option last August but to quit the part-time job she had held for 22 years, and liked doing. She left because she had learned that the dentist with whom she worked had become addicted to narcotics.

	"We did IV sedations,” she said. “So there was access to Valium and Demerol and that’s pretty much what he was using.”
	
	Dentists have more access to drugs than the general population and that may fuel speculation that use of drugs and alcohol is more prevalent among them than the general population, but a recent study has shown that isn’t the case.
	
	“There is little evidence that dentists are at a greater risk of developing alcohol-or other drug-use problems than is the general public,” concludes a study co-authored in 2005 by George Kenna, which analyzed the prevalence of alcohol, illicit drug and cigarette use among 113 dentists.
	
	As Smith’s story shows, however, drug addiction can surface in a dental practice and become a potentially devastating issue not only for the dentist, but staff and patients.
	
	Smith, whose name has been changed to protect her privacy, said the dentist’s addiction, and the way the situation was handled, is still distressing for her nearly a year later.
	
	“It turned my life upside down,” she said. “I wasn’t prepared for it.”  
	
	Kenna, a professor of psychiatry and human behavior at Brown University, agreed there is no easy way for an employee to handle such a difficult situation.
	
	“You feel like you’re going to get fired if you confront the person, but you end of getting fired anyway if the practice is harmed,” he said.   
	
	In her case, Smith said she went to work one day last summer and learned that the dentist had collapsed the day before, and paramedics had been called.
	
	“That was when things came to a head,” she said. “I went in and I was greeted with “We don’t have a doctor today.’”  
	
	Because she worked part-time and didn’t have frequent interaction with the dentist, Smith said she was surprised to find out that he had become addicted to painkillers.
	
	She said other employees discovered the evidence in his office.  
	
	“They found a tourniquet and syringes in his private bathroom and there would be no reason for those to be there,” she said. “They also found an open bottle of Demerol and a shipment of Demerol in his office.”
	
	Because the dentist had always displayed a somewhat moody personality, she said any drug-related changes in his personality had gone unnoticed. He also had always been an upstanding member of the community.
	
	“He could fly off the handle,” she said.  “But he was the last person I’d ever would have thought would do this. That’s why none of us suspected.”
	
	When the dentist returned a couple days after collapsing to resume his practice, Smith said she had a choice to make.  She didn’t think she could work there anymore and her husband, a police detective, agreed.
	
	“He said, ‘You can’t work there anymore. You’ll never trust him.’”  
	
	Though it may be because her husband is on the police force, Smith said she also felt deeply hurt by other hygienists who she believed froze her out, and didn’t want to tell her about the dentist’s problem.
	
	She recalled that one person approached her the day after the collapse  to tell her about the discovery of the dentist’s addiction and said, “I’m not supposed to tell you this but I am going to because I wouldn’t want something to happen to your  (dental hygiene) license.”
	
	Smith believes that informing the dentist that she was quitting and that she planned to cite the reason as his addiction when she applied for unemployment frightened him and forced him to take action. He voluntarily contacted the state dental board and told them about his problem, and went into 30-day rehab.
	
	Kenna, whose wife is a dental hygienist, said he does not believe Smith was in jeopardy of losing her license “unless she was complicit in the act (of using drugs).” The Ohio State Dental Board did not return calls for comment.
	
	Unfortunately, other than leaving the job, Kenna said there may be few options for people who find themselves in a situation like Smith’s.
	
	“The best way to handle the problem is to start looking for another job,” he said. “But the brave thing to do is to bring it to the dentist’s attention.”
	
	Months after making her decision to quit, Smith has found another part-time job, but she said it was difficult to land one in this slow economy. She also that the dentist she worked for has returned to practice, and has brought another dentist into the business.
	
	Her former boss, however, has not contacted her.  She feels an apology from him would help her move on emotionally.
	
	“I’m struggling to try to forgive him. I’m kind of in limbo,” she said.  
	
	Though other hygienists continued to work in the practice even after the addiction became known, Smith said she thinks she did the right thing, and her decision to quit forced the dentist to get help.
	
	“If my quitting pushed him to get help then I’m glad I did it,” she said.
	
	“She should be proud of what she did,” added Kenna. 

  Sandy Smith, a dental hygienist in Ohio, felt she had no other option last August but to quit the part-time job she had held for 22 years, and liked doing. She left because she had learned that the dentist with whom she worked had become addicted to narcotics.

dentalproductsreport.com-2011-05-01

Third World dentistry, first class care

Do you work with a drug addict?