November 2017 Volume LIII Number 6

 
 
 
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The Bresler Family is on a Mission

November 2017 Volume LII Number 6

AAPD Members Drs. Josh Bresler, Jason Bresler and Rachel Bresler Lead Temple University’s Maurice H. Kornberg School of Dentistry’s Haiti Club on Annual Missions Providing Dental Care for Underserved Haitian Children

NEARLY 1,200 PATIENTS TREATED AND 5,000 TEETH EXTRACTED BY UNIVERSITY AND HAITI CLUB DOCTORS

In May of this year, Drs. Josh and Rachel Bresler, brother and sister, returned from their yearly volunteer mission to the Caribbean island of Haiti, along with the Temple University Maurice H. Kornberg School of Dentistry’s Haiti Club, where four dentists and 10 dental students treated close to 1,200 patients and extracted nearly 5,000 teeth in makeshift clinics. Villagers have been known to walk for days from their own villages to far locations when hearing of the dentists’ visit seeking dental and oral health care—virtually none is available other than when U.S. doctors make their annual trip.

Temple University’s Maurice H. Kornberg School of Dentistry’s Haiti Club has been dedicated to improving the health condition of the Haitian people since 1997. The Temple Haiti club is run almost entirely by dental stu- dents and faculty. Dr. Josh Bresler, co-owner of Doc Bresler’s Cavity Busters, a Temple University Kornberg School of Dentistry part- time faculty member and club advisor, went on his first Haiti trip in 2002 as a junior dental student, and now travels with the group yearly, assisting with the legal and logistical details, including travel arrangements and commu- nication with the Haitian Health Foundation (HHF), the program partner in Haiti.

Dr. Jason Bresler, co-owner of Doc Bresler’s Cavity Busters has traveled to Haiti every year since 2007, except for the 2017 trip, as he was awaiting the birth of his second child. Next year’s trip is already on his calendar! Dr. Bresler said, "Dental missions like our annual trip to Haiti, are extremely important experiences. They remind us about the primary reason we went into the field of medicine. Helping people! Often students are overwhelmed by tests, procedure requirements or insurance difficulties, as well as general policies and procedures that sometimes get in the way of helping people. On our Haiti mis- sions, this is medicine in its purest form. ‘What hurts? OK, let’s take care of that for you!’ It gives the students a renewed sense of purpose and pride for their chosen field of medicine. It’s a win-win for everyone."

In order to secure the more than $20,000 needed to fund the journey, students and fac- ulty organize a variety of fundraising events throughout the year, and then collect and pack of all the equipment, supplies and food the group will need for the duration of the one week stay in Haiti. The trip is so popular that students and faculty alike vie for the op- portunity to be part of this annual give-back mission.

Although the students don’t receive credit on the trip, there is still a large student turn out every year, but only a few are selected. The faculty selects the 10 dental students based on club participation and a one-page essay on why they want to travel to Haiti.

For seven days each spring, 10 dental stu- dents and four faculty members from Temple University’s Maurice H. Kornberg School of Dentistry, provide free dental care in remote villages outside of the town of Jeremie. This year faculty included: Dr. Josh Bresler, Dr. Ra- chel Bresler, Dr. Cory Johnston, and Dr. Tyler Twiss. Students included: Jacob Kuruvilla, Dr. Miriam Ting, Kieran Mullarney, Michael Santora, Andy Zhou, Jessica Parry, Victoria Castens, Liam Register, Joseph Gallelli, and Carlos Sanchez. Dr. David Bresler, along with Drs. Josh, Jason and Rachel Bresler, have all served as a faculty advisor on numerous trips, as well, before Dr. David Bresler’s passing in March 2013.

The journey to Haiti is not easy, as described by Dr. Josh Bresler:

"To reach their destination, the group trav- els to New York and flies to Port-au-Prince, Haiti, where they then take an eight hour bus ride to the HHF headquarters in Jeremie. Every day, from sun up to sundown, the group embarks on a stomach-churning drive into the mountains, where paved roads are non- existent and dirt paths are often washed-out by torrential spring rains. Broken axles and flat tires are common. The danger involved in this portion of the trip cannot be overstated, as one of the HHF nurses was killed in June of 2009 when her vehicle careened off of a 50-foot embankment, less than three months after working with the Temple Haiti Club."

The goal for each Haiti trip to is to provide the highest quality of dental care to as many Haitian people as conditions will allow. Students and faculty begin their day by setting up a makeshift clinic. Instruments are autoclaved in the U.S. and then cold sterilized between uses. There is no electricity, running water, or suction availability, which makes treating patients even more difficult. Students typically work outside under the shade of a tree, although at some villages, there may be a small building or thatch roofed hut that can be utilized in inclement weather. Hundreds of patients are seen each day in portable dental chairs. Often, complex extractions and other surgical procedures are performed in the field. The team brings an extensive armamentarium of antibiotics and pain medications for distri- bution to patients after treatment.

Only since 2008 have diagnoses been able to be made with radiographs (X-rays) due to a generous sponsor donation. Now the Haiti club has a hand-held X-ray unit that makes diagnosis more accurate and reduces patient risks. According to the World Health Organi- zation (WHO), more than 50 percent of the Haitian population survives on less than $1 per day, and more than 45 percent are considered undernourished. There is less than one dentist and only eight hospital beds per 10,000 people, so conditions like odontogenic (tooth) infec- tions can rapidly become life-threatening.

Under faculty supervision, students are able to perform procedures. Extractions are the main treatment modality due to rampant caries, but it is not uncommon for students to suture lacerations or drain infections. Since hand pieces are not available, the students learn how to section teeth with a chisel and mallet. Because of this, student’s oral surgery skills quickly improve. By the second day most students are performing the extractions with limited help. Haitian translators work with the group to review medical histories and give post-operative instructions, and students quick- ly learn the important words. Before long, most of the group can speak enough Creole to treat patients without a translator by their side. A new graduate Haitian dentist accompanies the group each year to improve his or her skills, as well. The dentist who accompanied the group last year, was hired by the HHF to provide care to patients in between visits, thanks to the help of donations collected by Temple students.

Day and Night in Haiti

Bresler diligently blogged about each day and sent back his entries to the U.S. every night of the trip.

DAY ONE WAS A SUCCESS!
Our team split up into two groups and traveled one hour into the mountains to visit different villages. Each group saw close to 100 patients, and each team doctor extracted an average of 40 teeth—almost 800 teeth that will not be keeping people up in pain tonight! We treated a few major oral infections and removed a large pyogenic granuloma (gingival growth that can bleed) from a patient who prior to this procedure, was embarrassed to smile. The students did great and have already drastically improved their skills and confidence. Looking forward to tomorrow!

ANOTHER SUCCESSFUL DAY IN HAITI!
We split up into two groups again today and traveled a little further into the mountains. Each group saw over 100 patients with no complications. Many abscessed teeth (infections accom- panied by swelling and inflammation, frequently caused by bacteria) today! We did quite a few I&Ds (incision and drainage) to reduce facial swelling. One five-year old boy’s face was so swol- len, he could barely open his eyes. In the U.S., this patient would have gone straight to the OR for immediate surgery, and then would have spent two days on IV antibiotics. He was a tough little guy who let us do the work he needed, without any sedation. The other group of doctors removed a large cyst from a patient’s cheek, relieving her pain and ‘malformation’. We finished working around 6 p.m., and then played soccer for a while with many of the patients! Looking forward to tomorrow!

DAY THREE
Another successful day in Haiti! The students were awesome. Their oral surgery skills have dramatically improved since day One. We saw almost 250 patients today, until we had to stop early because of bad weather.

A pretty significant thunderstorm came in and since we were only working under tarps, we all got pretty wet while finishing up our last patients. We removed another large tumor from a patient’s face today, along with hundreds of abscessed teeth and impacted 3rd molars. Tomor- row our group is all working together, and we expect a very busy day!

DAY FOUR
Another successful day in Haiti! We traveled two hours to the town of Abricots, today, and we saw 150 patients by 2 p.m. Lots of abscessed teeth and impactions, and we did a lingual frenectomy on a teenager with severe tongue-tie, who’s suffered a speech impairment her entire life. Since we finished early, we stopped at the beach for an hour and played soccer with some of the local kids, and went swimming in our scrubs! Can’t believe tomorrow is our last day.

OUR LAST TWO DAYS
Yesterday was a long and successful final clinical day! We split up into two groups and seven of us traveled to the village of Castillon, two hours on bumpy roads to the top of the mountain.

Over 100 patients were seen—this is the only dental visit in the village until we return next year. The other group traveled one hour to a very busy post where over 160 patients were seen.

Founded in 1982, by Dr. David Bresler, Doc Bresler’s Cavity Busters has seven locations throughout Phila- delphia and the suburbs, Red Lion Surgicenter and Special Touch Dentistry, providing experienced, warm and friendly pediatric dentistry to infants, children, teens, and adults with special health needs.

Visit www.cavitybusters.com.

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