My Experience at RAM

For those of you who missed it, Remote Area Medical (RAM) is a non-profit organization that travels from city to city providing free medical and dental care to any and everyone who is willing to wait in line for it. People can get x-rays, vision care, triage, dentistry, and medical screening. They have come to Sacramento in the past but this was my first experience volunteering with them and I want to share details about how fantastic it was. So, if you're interested, please read on and also visit the RAM California website at

Cynthia and I arrived at Cal Expo on Sunday morning a little after 6am. It was still dark outside and as we walked into the large exposition building we passed a long line of patients waiting outside, most of whom arrived the night before.  We checked in and it was off to work right away. The entire floor was filled with an array of dental chairs, tables stacked with disposables and materials, x-ray machines, and sterilization equipment. It was also filled with tired patients, many in pain, and eager dentists, hygienists, surgeons, and assistants. "Let's get going", Cynthia and I said as we gathered materials and our first patient.

As you can see in this picture, there were tables and dental chairs set up and behind them were the groups of patients waiting to be seen. We walked up and asked for the next person in line, introduced ourselves, found out what was bothering them most and treated 1 or 2 teeth before starting again. We learned that our patients had already been in line for hours and had sat through screening, received pertinent x-rays, and waited again to see a doctor. For a few, they were already at RAM the day before to get medical care and had returned again to have their mouth looked at. Most of our patients had jobs but no benefits. I could tell that they were grateful for the free care but also scared and reluctant, just as most patients are about getting anesthetic and being poked and prodded by someone they just met moments ago. They knew nothing about my credentials, where I went to school, how many years I've been in practice, or how good I am at my job. They put all of their faith in me solely because this was their one shot to get out of pain, remove infection, or rebuild a broken tooth. Come Monday, the clinic would move on and it will be several months before it returns.

I was amazed at the diversity in the nine patients I treated that day. Among them were a young landscaper, a property manager, and single father of five children, a woman who was laid off and is now returning to nursing school, and a 23 year old mother with two young children she's working to support. After doing a filling on Jesse, a 22 year old man I strongly encouraged him to get right back in line to remove three broken down and infected teeth in his upper right quadrant. He politely declined, saying that he had to work the next day and wasn't prepared to be in pain. In fact, the floor director walked by and said they already tried to put him in the surgery line but he doesn't want to. But I wasn't ready to give up. I explained the infection that was visible on his x-ray and what kind of pain he could expect to feel in the near future. "And then what will you do?", I asked. "The care is FREE!", I emphasized. "I know you are so tired and you've been in line for a day. But there are excellent doctors here. You will see a surgeon who is ready to take on these teeth and make you feel better." I am happy to report that Jesse stuck it out and got back in line. And I knew we had done the right thing by not giving up on him.

The mere chance to talk with these patients while they were getting numb would have made the day worth it on its own. Many dental problems are preventable with proper nutrition and home care, which we are all aware is not always well-practiced in the U.S. My mission was to make sure every patient knew what could have caused their problems and how they could prevent their return. If they left with those tools and followed through with them, then our time was well spent. Our young mother of two Erika, has a 3 year old and an 8 month old. I felt such relief having the chance to tell her how she should be caring for her kids' mouths, and educating her on the correct way to give juice and a balanced diet. Just a few small tips can go such a long way. Informing her that tooth decay is caused by bacteria that she can transfer to them through straws and spoons may make her think twice before sharing what's been in her mouth with them. She seemed so grateful for the advise and I felt good thinking her children can avoid the same problems she's having.

Debbie, seen in the picture to the right, hopped in our chair and pointed to her front teeth, saying "Fix these please".  Most of her upper teeth were broken down from decay and she said she could no longer stand to look in the mirror. As she got numb, I asked her if she regularly drinks sodas, energy drinks, or juice. She said no but I went ahead and discussed how those items typically cause decay on the front teeth as they pass through. I made the recommendation that she limit those beverages but also drink them through a straw so they bypass the teeth and go straight to the back of the mouth. I also explained to her that my cosmetic materials were limited in this setting so she may not look like a "supermodel" when I'm done but I would do my very best. Debbie dozed off during the procedure and when she awoke I assured her she hadn't snored. Naturally, she wanted to look in the mirror but I couldn't locate one. So, we pulled out the trusty cell phone and took a picture of her teeth to show her. Well, she may not be a supermodel but she felt enough like a model to tell me she had lied to me and she does drink a lot of soda. She was so grateful for having her teeth fixed that she vowed to cut it off so that she could take care of the work we had done. That moment is one of the best I've had as a dentist.

Cynthia also went out of her way to make our patients at ease. She translated everything I said for our Spanish speaking patients so that they could truly understand what was happening and what to expect. And as the day came to a close, she made sure one patient got a signature from the head dentist to return the following morning and go to the front of the line to complete here care. This didn't surprise me at all, of course, because this is what I see from her everyday. But it made me so happy that these people weren't just getting their teeth fixed. Rather, they were being cared for. They could tell they were in good hands and that really put them at ease. 

When all was said and done 12 hours after we had arrived, I felt I had been given a gift by being allowed this experience. Sure, I was exhausted and my body was hurting. Cynthia had stood on her feet all day because she didn't have an assistant's chair. But we had zero complaints. All I had to do was show up and provide my services. Anyone can volunteer but not everyone is a dentist, doctor, nurse, hygienist, or medical assistant. These people needed care and it is part of our profession to help others. That is, after all, what I wrote on my dental school application. I want to help people and I really felt I did on this day. But they also helped me. And when RAM returns to Sacramento you bet you will find me there.

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