{"id":30635,"date":"2026-04-28T08:37:41","date_gmt":"2026-04-28T13:37:41","guid":{"rendered":"https:\/\/www.aae.org\/specialty\/?p=30635"},"modified":"2026-04-29T14:52:31","modified_gmt":"2026-04-29T19:52:31","slug":"reach-in-action-expanding-endodontic-care-beyond-borders-in-st-lucia","status":"publish","type":"post","link":"https:\/\/www.aae.org\/specialty\/reach-in-action-expanding-endodontic-care-beyond-borders-in-st-lucia\/","title":{"rendered":"Foundation’s REACH in Action: Expanding Endodontic Care Beyond Borders in St. Lucia"},"content":{"rendered":"

By Dr. Jessica Hwang<\/em><\/p>\n

Dr. Jeremy Sprouse is a second-year resident at University of Texas, Health Science Center at Houston. The Paper Point\u2019s Dr. Jessica Hwang (PGY2, UCLA) spoke with him about his experience volunteering with the AAE Foundation through an international access-to-care trip to St. Lucia. Dr. Sprouse provided endodontic care with his mentor, Dr. Bruce Justman, at clinics in St. Lucia in partnership with Great Shape! Inc. and the Foundation\u2019s Resident Expert Advisory Council (REACH).
\n<\/strong><\/p>\n

1. What initially motivated you to participate in an international access-to-care mission, and can you share how this opportunity to volunteer in St. Lucia and the Foundation arose?<\/strong><\/p>\n

My motivation for participating in this international access-to-care mission is rooted in both my background and my training. Throughout my path in dentistry, I\u2019ve seen how profoundly access, or the lack of it, shapes oral health outcomes. Even within our own communities, patients often present with severe carious lesions simply because they didn\u2019t have the opportunity to seek care earlier or they did not have the funds to pay for the necessary treatment. As an endodontics resident, I\u2019ve been trained to save teeth. But that skillset only has meaning if patients have access to it. This opportunity came through the AAE Foundation, whose commitment to expanding access and supporting outreach efforts made this experience possible. When the chance to serve in St. Lucia arose, it felt like a natural extension of why I chose this specialty, to provide care that preserves function, alleviates pain, and, in many cases, changes the trajectory of a patient\u2019s oral health.<\/p>\n

2. What types of cases were most commonly encountered during the mission, and how did they compare to what you typically see in your residency clinic?<\/strong><\/p>\n

We mostly encountered cases of extremely symptomatic irreversible pulpitis or pulpal necrosis, often in teeth that had been untreated for extended periods. While these diagnoses are familiar from residency, the key difference was in the patient presentation. Many patients came in at a much later stage of disease progression, whereas at UT Health Houston School of Dentistry, some (not an overwhelming majority<\/em>) patients may present at early stages of disease progression.\u00a0 In addition, for some of the St. Lucian patients, this was their first time visiting a dentist, let alone receiving endodontic care. In my residency program, the patients have typically visited their general dentists before and have had one to a few root canals performed in the past. That shift in context changed my approach; I\u2019m not only managing pathology but also intervening at a critical point to preserve teeth that might otherwise be lost. The ministry of health volunteers expressed that only a very small number of providers performed root canals on the island, and often at unaffordable prices. Furthermore, much of our treatment was performed in anterior and premolar teeth, which patients consistently identified as most important. In conversations, many explained that in a hospitality-driven workforce on the island, a person\u2019s smile can significantly influence job prospects, often serving as a gateway to opportunities that might not otherwise be accessible.<\/p>\n

3. Were there any particularly challenging or memorable cases that stood out to you from a clinical or emotional standpoint?<\/strong><\/p>\n

Honestly the entire experience stood out, not really for the clinical complexity of the cases, but for the stories of the patients behind them. I treated patients of all ages, but there was one young patient, in particular who had never been to a dentist before. He approached the experience with a mix of nervousness and curiosity, asking about every instrument before we even began. Another older patient shared how he fractured his anterior teeth in a motorcycle accident, and how he\u2019s been in pain, and limited his employment opportunities, highlighting how closely oral health is tied to quality of life. We performed NSRCT on #7-10 with build ups and he left the clinic smiling, with the support of the entire community behind him. Another impactful moment involved a mother who had spent the entire day at the clinic with multiple generations of her family. After we were able to save teeth that were essential for function, she became emotional and expressed how rarely she has the chance to care for herself. Experiences like these reinforce that behind every diagnosis is a person, a story, and often, a much larger impact than we initially see.<\/p>\n

4. I heard there were some unexpected challenges along the way and that the team adapted despite some unforeseen circumstances\u2014how did limitations in resources, equipment, or time influence your treatment planning and decision-making?<\/strong><\/p>\n

This service trip required a high level of adaptability on different fronts. Working with limited resources, without a microscope, and within a high temperature and high-volume setting, meant that efficiency and sound clinical judgment were essential. Some of our supplies were held at sea for a few days, requiring us to use and do whatever we could to help the patients.\u00a0 Also, this was the first trip that the Sandals and AAE Foundations sponsored in St. Lucia for endodontics, and required logistics early on. The cases only reinforced the importance of fundamentals,\u00a0 access design, tactile awareness, and a strong understanding of root canal anatomy. Without relying on advanced technology such as a Cone Beam Computed Tomography (CBCT), those core principles became even more critical. Treatment planning also required sincere thoughtfulness and attention to the patient\u2019s diagnosis, prognosis, and necessary treatment.. We had to weigh ideal treatment against what was feasible, making decisions that prioritized long-term benefit while respecting the constraints of time and resources.<\/p>\n

5. What endodontic techniques or principles proved especially valuable in a mission-based environment?<\/strong><\/p>\n

The most valuable takeaway was that strong fundamentals and patient management translate across any environment. Careful access, effective irrigation, and efficient instrumentation were essential, particularly in the absence of advanced magnification. The ability to complete treatment in a single visit, when appropriate, also proved highly beneficial given the setting. More broadly, this experience reinforced that successful endodontics is grounded in principles and decision-making, tons of irrigation, not solely in technology.<\/p>\n

6. What was the most rewarding aspect of participating in this mission, both professionally and personally?<\/strong><\/p>\n

Professionally, the most rewarding aspect was applying my training in a setting where the impact was immediate and meaningful. The people of St. Lucia were extremely kind, appreciative, and friendly. It felt nice to give back and I am extremely grateful for the opportunity from the AAE Foundation and certainly look forward to potentially serving as a mentor in the future. Personally, it was the connection with patients and having the opportunity to serve alongside my wife. Many local citizens waited several hours in line, often alongside family members, simply for the opportunity to receive care. Their gratitude, trust, and resilience left a lasting impression. It was a powerful reminder that what we do extends beyond procedures. It directly influences comfort, confidence, and quality of life.<\/p>\n

7. You participated in this mission alongside your wife, who is a general dentist\u2014what was it like working together in this setting?<\/strong><\/p>\n

Working alongside my wife made the experience especially meaningful. We have been incredibly blessed, and we don\u2019t take for granted the opportunity to serve others. It\u2019s a privilege to use our skills in a way that can directly impact patients\u2019 lives, and something we truly cherish. Although we attended dental school together and started our careers in parallel, we don\u2019t often have the opportunity to collaborate clinically in our day-to-day lives as much anymore, so being able to serve together in this setting was unique. She focused on restorative care while I provided endodontic treatment, and we were able to see firsthand how our roles complemented one another. It added another layer of fulfillment to the trip, both professionally and personally.<\/p>\n

8. You also got to work alongside Dr. Justman (mentor). What was a lesson learned from Dr. Justman that you can share with us?<\/strong><\/p>\n

Let me just say, Dr. Justman is a true gem to the profession, and I was happy to be paired up with him. One of the most valuable lessons I took from Dr. Justman was the importance of clarity and composure, particularly in less-than-ideal conditions. He consistently approached the day with focused attention and our cases with emphasizing efficiency and sound decision-making. Dr. Justman was funny, kept the environment light, and ran our radiograph system and headlamps flawlessly. He also gave me and my wife some really great career and life tips. \u00a0He was great in navigating the high-volume, resource-limited environment with consistency reinforced that excellent outcomes are driven by discipline and judgment, not just technology.<\/p>\n

9. What lasting impact do you hope this type of outreach work has\u2014both for the patients served and for the providers involved?<\/strong><\/p>\n

For patients, I hope this type of outreach expands their sense of what is possible, preserving teeth is an option and their oral health is worth investing in. For providers, experiences like this offer perspective. They highlight the reality that access to care is not universal and encourage us to think more broadly about our role in addressing that gap. Ultimately, I hope this work contributes to a continued commitment, both locally and globally, to improving access to care, because the need is significant and the impact is lasting. I see it as a powerful example of stewardship to prioritize access to care and that the AAE Foundation continues to lead with purpose and intention in this area.<\/p>\n

\"\" \"\" \"\" \"\" \"\"<\/p>\n


\nDr. Jessica Hwang is a PGY2 Resident at UCLA Endodontics and a member of the AAE’s Resident and New Practitioner Committee.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

By Dr. Jessica Hwang Dr. Jeremy Sprouse is a second-year resident at University of Texas, Health Science Center at Houston. 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