It was toward the end of the week — Thanksgiving morning, maybe — when the little girl sat down in the plastic chair.
She was wearing jeans and a red-and-white shirt, her hair pulled into a ponytail.
She wasn’t crying, like some of the other kids who’d occupied the same spot in the hours and days before. But she was scared.
Bart Roach took notice. He set down the small mirror and dental explorer that are the tools of his trade.
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He folded his tall frame so he could look her in the eyes. He smiled.
He was, most likely, the first dentist she had ever met.
In and around El Paredon — the poor fishing village on the Pacific Coast of Guatemala where Roach spent his holiday week — dental care isn’t exactly a priority.
For the most part, people go without.
Their teeth rot, become infected. They learn to bear the pain. They suffer.
Or at least they did, until Roach came along.
When we get in there, it looks like people maybe haven’t brushed their teeth in 10, 15 years.
Volunteer Katie Rodgers, a dental hygienist from Arizona
The 32-year-old Kennewick dentist has raised thousands of dollars, amassed a collection of portable equipment and recruited colleagues to join him for weeklong stints treating cavities, pulling teeth and teaching the basics of oral hygiene.
He’s become the dentist of El Paredon.
He wears the role well.
Roach charmed the little girl in the red-and-white shirt, getting her to relax as he spoke gently to her in Spanish.
He motioned for her to open her mouth. She did, letting him get a look.
‘A beautiful community’
El Paredon is home to anywhere from 700 to 1,500 people, depending on who you ask.
Santos Corado Centeno puts its population at 1,300. He’s a village leader.
For years, the community’s main industry was fishing, and some still get by that way, he said.
But recently, tourism has grown as word of the beach’s stellar surfing spreads. Hotels and hostels have gone in — like The Driftwood Surfer, which helps coordinate Roach’s dental clinics and plays host to his volunteer teams.
Still, El Paredon remains relatively secluded.
It’s a beautiful place, almost from another time. Kids in bare feet yelp in delight as they set off fireworks between brightly colored buildings; a checkers game played with bottle caps draws a crowd at a tienda; chickens, pigs and dogs wander free; the volcano Fuego smokes in the distance.
While it’s rich in color and vibrancy, El Paredon lacks some critical resources.
“Unlike some of the towns that have a little bit more medical knowledge — there’s some sort of doctor or dentist — there’s nothing here. Nothing at all,” said Brant Early, co-owner of The Driftwood Surfer.
Limited access to clean water and diets high in sugar make dental issues a particular problem.
So does lack of knowledge about proper oral care.
“When we get in there, it looks like people maybe haven’t brushed their teeth in 10, 15 years. There’s a lot of inflammation, a lot of buildup,” said Katie Rodgers, a dental hygienist from Arizona who joined Roach on the trip. “They’re tough people, but I don’t know how they deal with the pain sometimes.”
In El Paredon, it’s a part of life.
For Centeno, the community leader, Roach and his friends represent relief.
“He says he’s very thankful because a lot of people here don’t have the money to go see a (dentist regularly),” an interpreter said, as Centeno spoke in Spanish. “It’s very helpful for everybody in this community. He says he’s very, very thankful.”
‘He wouldn’t let us’
Roach owns Three Rivers Dental in Kennewick and is co-founder of the nonprofit Sonrisa Immaculata. An avid traveler, he’s visited more than two dozen countries, including multiple trips to Guatemala.
He started his work in El Paredon in January, making a scouting trip and handing out toothbrushes.
He returned in April with four dentist friends, two dental assistants and other volunteers. In a week, they treated about 400 people, mostly kids.
During the Thanksgiving trip, Roach brought a crew of about 12. They saw fewer patients — 247 total — but most were adults, and that meant more complicated cases.
The conditions were tough.
The community building that housed the temporary clinic was run down, with yellowed walls and a dirty floor.
It was hot and sticky inside, and the dentists and volunteers sat on hard wooden chairs that made their backs hurt.
Outside, a massive trash pile attracted all kinds of animals, and sometimes they wandered in. At least twice, Early had to chase out a chicken skittering between the dental chairs.
It was difficult emotionally, too. Patients were uneasy and tense in the unfamiliar world of dentistry.
While most of the patients were adults, some were kids. There were tears.
Late in the afternoon on the first day, Nate Green — a dentist from Denver — shepherded a little boy in a bright red T-shirt to his chair.
The boy, named Gabriel, had an infected baby tooth.
At first, he seemed fine. But before Green could do much, Gabriel panicked.
He cried, even though his mouth was numb and he was feeling no pain. He hollered and flailed.
Green works exclusively with kids back home, and he’s great with them. But Gabriel could not be calmed.
His cries were so loud the rest of the clinic went quiet.
Green had to let him go.
“We couldn’t take (the tooth) out because he wouldn’t let us do it,” the dentist said later.
Luckily, “it’s the good kind of tooth infection — the kind that doesn’t cause pain. He’s going to lose that tooth very soon (anyway),” Green said.
Still, it would have been best to take it out.
As the clinic shut down for the day, Green found the boy outside. He gave him a fist bump. He found a basketball and the pair shot around for a while. They parted with smiles.
Green hoped Gabriel would come back to the clinic later in the week, to try that tooth again.
He watched for him every day. But Gabriel never showed up.
‘That was the best’
The Thanksgiving week clinic saw plenty of triumphs.
Roach and his team pulled 285 teeth and placed about 500 fillings — relieving pain and making for healthier mouths.
Children who came through also got fluoride treatments, toothbrushes and instructions on how to use them.
We had a patient yesterday who just laughed. No matter what you said to her, she just laughed.
Nate Green, dentist from Denver
There were smiles, laughs and high-fives. Personal connections were made.
“We had a patient yesterday who just laughed. No matter what you said to her, she just laughed,” Green said on the last day. “I had Rosario (one of the volunteer interpreters) ask her in Spanish what makes her so happy. She just basically said that she lives with her kids and she just laughs all the time.”
Leslie Green, Nate’s wife and chairside assistant during the trip, nodded at the memory.
“We actually saw her right outside of our chair today, in that little market (that was set up for the morning). She was looking at things. And Nate looked at me and goes, ‘Hey Leelee, I’m going to make her laugh.’ And he stood up and said, ‘Hola!’ and she just burst out laughing. It was so cute.”
Yesenia Lopez was touched when a patient brought her Gatorade as a thank you. A Pasco teacher who’s taking time off to travel, Lopez spent the week helping the dentists and interpreting.
With the fruit punch drink, “(the patient) answered my prayers, I was so hot and thirsty,” Lopez said later, in a message.
For Roach, the best moment was looking up mid-week and seeing the clinic buzzing.
“Seeing 15 people with their heads (bent) over a patient, working,” he said.
“It’s always on Day 3 when you start feeling that fatigue and you’re not as excited about coming in here and sweating and working, and you just want to hang out and enjoy this beautiful country,” Roach said.
“I’m very impressed with the team and how well they’ve been able to put up with the conditions and work through it and get everybody treated without complaining or quitting. And they’re always wanting to do more.”
‘A great blessing’
While the other dentists treated patients in chairs set up along a wall, Roach worked from a table in the middle of the room.
He saw every patient first, using his mirror and explorer to find cavities, to diagnose.
If a piece of equipment sputtered, he ran over to help fix it. If a fellow dentist faced a particularly tough extraction, he jumped in to help.
He almost never sat down. Hardly ever even paused for a swig of water.
He can trace the start of the El Paredon clinic to a pair of promises he made in his early 20s.
After his undergraduate studies at Carroll College in Montana, Roach spent four months living in Guatemala.
He’d gone to volunteer, but quit after realizing he had few useful skills to offer. Instead, he worked in a hostel and vowed to return when he did.
Roach made a separate promise as he was taking the dental school admission exam: if he scored high enough to get in, he’d dedicate part of his life to helping the poor.
He scored what he needed and then some.
“I was driving home from Spokane after taking (the test) and it dawned on me that I’d just made this pact and I was going to have to spend a considerable amount of time to live up to it,” Roach told the Herald, standing in the hot El Paredon sun. “But it’s been a great blessing.”
For Roach, the work is exhilarating.
He likes the fast pace, the people, the chance to blend his dental skills and love of travel.
Roach plans to keep coming back to Guatemala. He’ll likely alternate between El Paredon and another remote community.
As he invests more time, he hopes to see systemic changes.
If the kids learn to care for their teeth, they’ll have healthier mouths. And they’ll pass that onto their kids. And so on.
And he’s thinking about sustainability. “Whenever you do these kind of projects in the Third World, you have to think about (that). Because I can’t do this by myself forever,” he said.
So he recruits his dental friends to spend a week alongside him, hoping they’ll catch the bug.
He amasses equipment that’s stored in Guatemala, ready anytime a team — with or without him — can spend a few days fixing teeth in between surf sessions.
He’s the Dentist of El Paredon, but he’s working toward a time when there will be Dentists of El Paredon.
He may already have some takers.
Several on the Thanksgiving team said they’d like to come back.
Nate Green was among them.
“I like the people here. You look around, you see everything we see — the poverty, the trash, the very difficult living conditions. But everybody’s got a smile on their face,” Green said.
“When we drive in the truck, up and down the road, coming in and out of town, everybody you drive by just (has a) big smile, a big wave. That’s what I like about it. It’s so encouraging to see that people are still so happy, even though there’s a lot to be not happy about.”
When Green talked about El Paredon, he looked happy. Like maybe it had found a place in his heart.
The Dentist of El Paredon
It’s in Roach’s heart, no doubt.
Ask him why he does it — all the work, all the effort — and he talks about his two promises.
He talks about his family’s commitment to service.
He talks about his love for Guatemala, about the Driftwood, about the joy of watching his friends heal hurting mouths.
“I don’t really know the right answer to why I’m doing this. Except that it’s fun, it’s a ton of fun,” he said. “When you give of yourself you receive twice as much in the spirit. At the end of the day, I know it’s time well spent.”
So on Thanksgiving morning, the clinic that Roach built buzzed around him.
He saw patient after patient, hardly pausing to sit or even take a sip of water.
He charmed the little girl in the red-and-white shirt. Then another patient took her place — a grown woman.
Roach picked up clean tools. He took a breath. He smiled.
“Abre su boca, por favor,” he told the woman. Open your mouth, please.
Dr. Bart Roach of Three Rivers Dental in Kennewick brought along several other dental professionals and volunteers on his Thanksgiving trip to El Paredon, Guatemala.
The team included dentists Floris Hartman of Amsterdam, Nate Green of Denver, Ted Graham of Federal Way and Revenda Bebawi, an Army dentist serving in Germany. She participated on her own time, taking leave.
Dental hygienists Katie Rodgers and Kirsten Petty of Arizona also took part, along with non-dental volunteers Leslie Green, Joelle Hartke, Yesenia Lopez, Rosario Vargas, Tanguy Conq and Delphine Pédron. Staff of The Driftwood Surfer also pitched in.