U of T Dentistry nurtures international partnerships for positive impacts near and far
By Suzanne Bowness
During her third year, Wenxin Miao 2T4 took nearly two weeks out of her hectic schedule and headed for Niigata, Japan. She was joined by fourth-year DDS student Kunyuan Yang 2T3 for a visit to Niigata University’s Faculty of Dentistry, where they toured private clinics, experienced innovative technologies — including virtual reality simulations — attended lectures and went on field trips.
Miao says the visit — which was organized by the Faculty, funded by U of T Dentistry and Niigata University, and offered the two students a course credit — was a highlight of her degree. “It’s a once-in-a-lifetime opportunity to do this in dental school. This experience helped me to be more sensitive when I practise dentistry, learning about how different cultures view dentistry differently.”
Academic institutions have a mandate to generate and share knowledge with a wide scope, which is why the Faculty of Dentistry takes its global role seriously. International student rotations, teaching or lecturing abroad, exchanges and academic partnerships offer numerous benefits to students and faculty, and also the places they go to.
“These programs exemplify U of T Dentistry’s commitment to improving global health and achieving health equity,” says professor Amir Azarpazhooh, who is also the Faculty’s global outreach director.
Globetrotting while furthering dentistry offers an opportunity to build the Faculty’s reputation abroad and create genuine, mutually beneficial partnerships.
A GLOBAL PAST
U of T Dentistry has always had a worldwide scope. Back in 1908, recent grad Ashley Lindsay and his new wife travelled for five months to reach remote Chengdu, China, where he treated patients in great need with few resources — his lab was in a shed with a mud floor.
He helped found the Department of Dentistry of the West China Union University and served as its first dean; it became a separate faculty two years later. He also established a dental hospital and journal, leaving a legacy in China, where he’s still known as the father of modern dentistry.
Having a global footprint, for a dental school, often begins with outreach via service rotations — they serve as remote versions of on-campus clinics, focused on building student skills and supporting those who need care.
Participating in the 1000 Smiles project has been very meaningful for students and faculty. Annually, volunteers visit the likes of Grenada, Turks and Caicos or Jamaica to treat hundreds of patients over a five-day period. The pro- gram is run by Great Shape! Inc., a California-based social service group that organizes dental outreach. It is affiliated with the Sandals Foundation and volunteers stay at the San- dals Resorts.
Clinical instructor Daniel Biner, who has been participating in the work since 2018, lauds the U of T dental class presidents, who help organize the trips. On the ground, treatments include mostly restorative dentistry, extractions and scaling, plus some root canals. Anyone who shows up can access treatments for free. Patients often have an emotional response to their care.
“One guy who worked at a hotel said he can’t smile because his front teeth are broken. We fixed them up. He came to us afterwards, and he was the happiest person. It made such a difference. It’s a blessing for the students and a blessing for the patient,” says Biner of last year’s trip to Grenada.
Beyond the humanitarian aspect, Biner says the students get to experience more autonomy than they do in clinic. “We tell them, ‘This is the first time you’re actually practising as dentists.’ They get more freedom. We watch them carefully, but they’re doing it.”
As students leverage their technical skills, often with access to limited tools and technology, they tap into a deeper level of commitment and professionalism. Biner says in Grenada, the rotation wrapped up with more patients still waiting. “The students refused to go until we saw all of them,” says Biner. In August, 42 students and 11 dentists went to Jamaica, treating more than 700 patients with endodontics, restorative, surgery and periodontics.
Another long-standing program for U of T is an annual operation with the Build Your Smile Dental Foundation to southwestern Uganda. In January 2024, two fourth-year students provided preventive and periodontal care, restorative dentistry, extractions and other treatments to underserved communities. Other programs on hold but slated to restart include collaborations in the Dominican Republic with Bright Island Outreach, and in Honduras and Guatemala with the non-profit Health Outreach.
Students are prepared for these experiences through Azarpazhooh’s Dental Outreach Global Services course. It covers public health and socioeconomic conditions, requiring students to reflect on and document their experiences, as well as the community impact of their work. Students can also take a course called Dental Outreach Community Services, taught by Azarpazhooh, through which students engage in outreach programs based in Toronto and Thunder Bay.
TEACHING ABROAD
A natural extension of service rotation is sharing academic and clinical expertise with an international partner — all to foster better dentistry across the globe. Since 2014, the Faculty has been a part of the Toronto Addis Ababa Academic Collaboration in Ethiopia. The program is led on behalf of the Faculty by assistant professor, teaching stream, Joel Rosen- bloom. He personally developed a passion for providing dental care in Africa after working in Sudan and Mozambique as a newly minted dentist.
Almost every October, Rosenbloom, who is also director of student life, takes a group of students and another faculty member to Addis Ababa University. The instructors teach from their respective specialties, to address gaps in the Ethiopian curriculum. Students also lecture and get to train their peers, plus meet teams from the 11 other U of T faculties that participate in the program. In a country with just 250 dentists, only 11 of whom are specialists, for 120 million people, it’s valuable expertise to share.
The program engages students who want to make a difference. “Students right now have a very high level of motivation to have a social meaning to their career,” says Rosenbloom. Working closely with Ethiopian dental students gives them new insights. “There’s a nice connection that develops between our students and their students, because they can see that these are people who are doing exactly what they’re doing. At the same time, students from Canada come to realize the difference in performing dentistry in a place where the resource differences are vast.”
Rosenbloom and others often come back from abroad and share across the university. His lecture on noma, a severe gangrenous disease of the mouth caused by multiple factors such as malnutrition and poor sanitation, caught the attention of International Dentist Advanced Placement Program (IDAPP) student Benedict Chukwuma.
“That lecture moved me to tears, it really touched me, coming here and seeing that there’s an advocacy group that fights to eliminate this disease,” recalls Chukwuma, who is a trained dentist hailing from Nigeria. He joined the Faculty’s Noma Action Group, which played a role in an international campaign to have noma successfully listed with the World Health Organization as a neglected tropical disease. Chukwuma says the Faculty’s other international and humanitarian efforts provide a meaningful opportunity to learn and give back. “For those that have the interest, they may want to make an impact and do something that will reverberate more than a thousand kilometres away.”
FINDING THE RIGHT PARTNERSHIPS
Schools cannot just buy plane tickets and treat mouths in all corners of the world without the right partners and a two-way understanding of mutual goals. Daniel Haas 7T9, 8T8 PhD, dean of the Faculty of Dentistry from 2012 to 2022, says that when he entered the role, the Faculty had an existing memorandum of understanding with the dental school in Chengdu, but few other international opportunities. He helped develop and implement a new strategic priority to increase global out- reach through research, teaching and student experience. This resulted in the current robust slate of worldwide offerings and a Faculty-wide appetite for starting new initiatives.
Yet while the administration is enthusiastic, they are also careful to ensure that all exchanges and partnerships are a good fit. “Many programs have reached out to us because we have a good reputation,” says Haas. The Faculty only signs when a program is built on mutual respect and equality.
Azarpazhooh says partnerships should address a gap in oral health care plus offer a learning experience aligned with the curriculum. “The program must offer significant educational and clinical value to the students. This includes opportunities for students to gain hands-on experience, enhance their clinical skills and understand the social determinants of health in diverse settings,” he says. The destination must also be safe for students and faculty.
Haas says that the cultural experience provided by global opportunities is invaluable. “A big incentive for us is to give students cultural competency. Dentistry is much more than just a technical skill; it’s treating a person,” says Haas. Students with international experience often continue to pursue such opportunities. That includes a recent graduate Haas spoke to who still goes on outreach excursions. “If that happens, what we’ve done is expose the students, and now they will continue to do it forever because they realize this is a thing that we do as dentists — we give back.”
Chukwuma says that international projects gives students valuable insights into dentistry’s bigger picture. “U of T is producing dentists who will serve the community in the best possible way, who will also be global leaders, and that expo- sure to what is happening beyond Toronto, Canada, North America, will help them to think beyond to a global scale.”
Top illustration: Ryan Garcia
Interested in more stories? Read the PDF edition of the U of T Dentistry Magazine Summer/Fall 2024 Issue