In Guatemala dental clinic, tears and thanks

Editor’s note: The Tri-City Herald and Northwest Public Radio/Television spent a week in Guatemala with Kennewick dentist Bart Roach as he led a volunteer dental clinic. Read the Herald’s full report in Sunday’s Depth section, check out a video at tricityherald.com/video or on Northwest Public Television and listen for a radio story at 89.1 FM.

Nancy Ruano walked up to Floris Hartman tentatively, with worry on her face.

The 7-year-old girl from a remote part of Guatemala had only been to the dentist once before, when she was a toddler.

And Hartman had funny glasses around his neck and a tray of scary-looking tools.

She wasn’t sure what she was in for.

Nancy had been feeling pain in her mouth for a few days, so her father brought her to the temporary clinic in El Paredon, where Hartman and several other dentists were seeing patients over Thanksgiving week.

The group was led by Dr. Bart Roach of Three Rivers Dental in Kennewick, who’s become — in the last year — the de facto dentist of the small fishing village.

Nancy sat down in Hartman’s chair.

She needed a filling in a badly decayed tooth, and a second tooth — one causing a painful abscess — needed to come out.

Hartman got to work.

He’s a dentist based in Amsterdam, and he heard about Roach’s Thanksgiving volunteer trip through a friend.

As he started on Nancy’s filling, Yesenia Lopez held the little girl’s hand.

Lopez grew up in Wapato and taught elementary school in Pasco before taking time off to travel. She pitched in during the weeklong clinic as a chairside assistant and interpreter.

If something hurts, Lopez told Nancy in Spanish, lift your hand into the air.

Before long, Nancy’s hand shot up.

It hurts? Yesenia asked in Spanish.

Yes, Nancy said.

It didn’t actually hurt. Nancy’s mouth was numb — Roach, who was doing initial exams, gave her a shot before she got to Hartman’s chair, and Hartman followed up with more when Nancy said she could still feel the sticks and pokes.

But the 7-year-old didn’t like the pressure, the unfamiliar sensation.

She was scared.

In the Netherlands, people don’t necessarily like going to the dentist — trepidation is passed down to kids from their parents, Hartman said. But they also start going early.

It’s the same in the U.S., where people generally start visiting the dentist as children and issues are caught early, before they become problems.

But El Paredon doesn’t have its own dentist. The nearest one is miles and miles away and too expensive for most in the village.

Limited access to clean water and diets high in sugar also contribute to mounting dental problems, along with lack of literacy in proper oral hygiene.

As a result, “there are a lot of cavities everywhere, infections, abscesses,” said Dr. Revenda Bebawi, an Army dentist serving in Germany who volunteered for the Guatemala clinic on her own time. “There’s a lot going on in their mouths.”

In Hartman’s chair, Nancy squirmed a bit as he finished the filling. When he started the extraction, the 7-year-old started to cry.

Tears rolled down her cheeks.

Lopez stroked the girl’s hands. “It’s OK, it’s OK,” she said soothingly. “Todo está bien. No pasa nada.”

After a while, the bad tooth was finally out.

Hartman wanted to remove a second one as well — he started working on it. But Nancy was too upset, it was too much.

Instead, he put a layer of filling material on the tooth to provide extra protection. Lopez helped Nancy sit up.

The team had fixed the 7-year-old’s cavity and removed a tooth causing angry, painful inflammation. It was a win.

Nancy walked over to her dad and wrapped her arms around his waist. He pulled her in for a hug. They talked for a moment.

Would the dentists be coming back again? Ruben Ruano asked in Spanish.

Yes, a bit down the road, one of the volunteers said.

The father nodded. He’d bring Nancy back when they did.

The volunteer dental clinic is a good option for the community, he said in Spanish. He’s grateful.

This story was originally published December 3, 2016 at 8:00 PM with the headline "In Guatemala dental clinic, tears and thanks."