The Real Face of Impact

By Paul Fraumeni

When patients visit 101 Elm St., they expect to get their teeth fixed at a price they can afford. Many find a whole lot more, though. Time with a DDS or graduate student eager to engage with patients and perfect their skills. Access to students and instructors who work as a team to develop treatment plans, assess underlying health conditions and help people get well. Compassion and assistance for the cost of dental care. 

With their pain gone and their smile restored, they truly feel the impact of a whole-person approach to dental care. 

All dental care impacts lives. Here are some stories about how the Faculty of Dentistry’s clinics go even further to make a meaningful difference in people’s lives. 

JOSHUA JACKMAN

As a young child, Joshua Jackman’s two front teeth stuck out. Kids at his elementary school taunted him about it, calling him “beaver.” 

“He started talking about committing suicide because he was being bullied. Even in the summer when he went to overnight camp, he’d come home and say he was being bullied there too,” says his great-aunt and guardian, Desiree Trotman. 

It wasn’t just the boy’s appearance that was a problem. He couldn’t completely close his mouth either. 

Jackman, now 13, had already been through so much. He came to Canada from Guyana in 2014. His mother had suffered a horrific acid attack back home that left her visually impaired. On arrival, the six-year-old was malnourished and had pneumonia, leading to an extended hospitalization. With his mother no longer able to care for him, and Jackman about to be put into foster care, Trotman agreed to step in. 

After he enrolled in school, a visiting dentist told Trotman that Jackman’s teeth needed urgent treatment. “I looked around for a dentist but it was quite costly,” says Trotman. She runs her own hairstyling business (the pandemic has dramatically affected her income over the last year) and has no dental coverage for herself and Jackman. 

A customer told her about the U of T Dentistry clinics, so she took the boy in for an assessment. They found out that Jackman was going to need extensive treatment, including four premolars extracted, a headgear, a temporary anchorage device, full fixed braces and, eventually, bonded and removable retainers. 

“They told me how much treatment would cost and I knew this would be hard for me,” says Trotman. She paid for some of the extractions out of pocket but couldn’t afford to pay for everything. David Makar, a first-year orthodontic resident at the time, presented Jackman’s case to the committee that grants funds from the Faculty’s Access to Care Fund in fall 2018. He was able to secure $4,500 for the rest of the boy’s care. 

“He is patient and so nice,” says Trotman of Makar. “One time, they had to put a screw in Joshua’s palate and I was so scared about it. Dr. Makar patiently and kindly explained the procedure to me.” 

Now, with his treatment plan well underway, things have changed for Jackman. The bullying has stopped. He’s now just a young teen who loves spending time on his phone and is building friendships — including with girls. “His whole facial structure has changed. He has a lot of confidence now,” says Trotman. “It’s a real transformation.”

ALICIA PENTZ

Alicia Pentz wanted to leave a difficult past behind her. But as she moved on with her life, she realized that the state of her smile was still holding her back. 

“I had severely damaged teeth,” says Pentz, who is now 27. 

For many years, she lived in an abusive and neglectful situation while dealing with physical limitations, too. She didn’t visit the dentist and didn’t have easy access to regular brushing and flossing. 

As she began rebuilding her life a few years ago, she remembered being treated at the Faculty as a child. “I was and still am trying to get on my feet. I knew I couldn’t afford a regular dentist and that the dental school did really great work and was much more affordable.” 

Pentz also knew that her teeth were in bad shape and would hold back her health and future plans. “I had a lot of work that needed to be done because of damage to my mouth. It was important that I got it done.” 

In the summer and fall of 2019, and then again early in 2020, the team at the Faculty of Dentistry did in-depth cleanings and filled 12 cavities for Pentz. The treatment went so well that many of her teeth were saved from what the team originally thought would have to be root canals. 

As well, DDS student Samantha Stahn 2T0 secured coverage for Pentz through the Access to Care Fund. “If I didn’t have Access to Care or had to go to a regular dentist it would have been close to $50,000 worth of work,” she says. While Pentz is thrilled with the dental work, she is equally grateful for Stahn’s approach to care. 

“She didn’t judge me. That was something I had experienced a lot then, where people would look at my mouth and think badly of me. They didn’t understand that it wasn’t my fault my teeth were this way. Samantha was compassionate toward me, my anxiety and my post-traumatic stress. She made sure I was comfortable. She even helped me get an electric toothbrush.” 

Pentz still needs more work done and plans to go back to the clinic to have her wisdom teeth extracted. With her oral health back on track, her future looks bright. She is taking a funeral pre-planning course online and living with her boyfriend. 

Importantly, the look of her mouth and teeth no longer hold her back. “It definitely made quite the change in me because I was so depressed about my mouth and I didn’t smile and didn’t want people staring at me,” she says. “Now I’m smiling all the time and not ashamed to show my teeth off.”

SCOTT FRASER

It’s 2014. Scott Fraser is in terrible pain. Although he’s just 23, a team at the Faculty is about to extract all of his teeth. 

“I was on the operating table and when I looked up, just before I went out, I realized there were about 30 students around me,” says Fraser, who’s now 29. 

Fraser was born in Toronto and was living with his mother, Laura Rojas, in her native Chile when he first starting having issues with his teeth at around age 12. 

“He had pain from eating. His teeth were starting to rot, cavities everywhere,” Rojas recalls. A student dentist at the University of Chile told them, “If Scott doesn’t get treatment soon, he will lose his teeth by the age of 20.” Other dentists confirmed that he would eventually need dentures. They treated his regularly occurring cavities but the fillings kept falling out. The teen started needing pain medication. 

“I was bullied because of my teeth being yellow,” says Fraser. “People could see the cavities and they just assumed I was using drugs. I didn’t even drink alcohol or smoke.” Rojas faced judgment from dental professionals and others who assumed she was a neglectful parent. 

In 2012, Rojas, Fraser and his sister moved back to Toronto. “Scott was in so much pain that every day he wanted to put his head through the wall,” his mother recalls. 

Rojas took him to U of T Dentistry, where the team confirmed that Fraser had some kind of underlying oral condition. They’d never extracted all the teeth of someone so young, but it was the only way forward. 

While Rojas was able to afford some of her son’s treatment, his implants and dentures would run about $50,000. Prosthodontics master’s student Hooman Mohandesan 1T6 MSc Prostho got a good portion covered through the Faculty’s Access to Care Fund. 

“Dr. Mohandesan was amazing. He was caring and kind, always calling us to tell us what was happening,” says Rojas. 

After getting his dentures, everything changed for Fraser. “Smiling came easier and I felt like I could finally start living my life.” 

Rojas is just as effusive. “After Scott’s new teeth were put in, he brushed away his past. His face changed, his attitude changed, his mental health became so much better. He has more confidence and self-esteem.” 

Today, Fraser has a college diploma and is a published comic book artist. “My life has significantly improved. I’m thankful to everyone who did this work, the people who believed in me and the dentists who kept telling me that everything was going to be fine.”

WENDY MACLELLAN

In September 2020, Wendy MacLellan had her first appointment at the Faculty. DDS3 student Yonit Levin immediately saw that things were not quite right with her patient’s oral health. 

“I noticed this nodular appearance in her mouth, on her palette, tongue, gums and the insides of her cheeks,” says Levin. Concerned, she scheduled a consult with oral and maxillofacial pathology and oral medicine resident Justin Bubola. 

He diagnosed MacLellan, now 71, with the genetic disorder Cowden syndrome, which causes tumor-like growths called hamartomas that usually appear in the mouth and on the skin. The disorder is also associated with an increased risk of developing several kinds of cancer, including breast, thyroid and uterine. 

The diagnosis made sense: MacLellan was diagnosed and treated for uterine cancer in 1997 and has had breast cancer twice since. 

“I wish I had known this in 1988. If I had known I was at risk for cancer, I’d have gone to the doctor more. Cancer treatment isn’t for wimps,” says MacLellan. 

MacLellan, who is doing well now, was impressed that Levin noticed the growths, secured her a quick diagnosis and then referred her to a specialist. Now, her care team at Princess Margaret Hospital is doing genetic testing and researching MacLellan and her family — she has three living sisters, and their mother will turn 99 this year. 

It was financial challenges that led MacLellan to visit the Faculty. Now retired, she’d worked at a hotel call centre and a timeshare exchange company, but doesn’t currently have a dental benefits plan. 

“I’m retired and trying to live on an old-age pension. I knew I needed to keep having dental work but I decided I couldn’t afford $250 every six months if I’m living on $18,000 a year.” MacLellan is impressed with Levin and Mary Shehata, the DDS4 student paired with Levin in the clinic this year. 

“When Yonit didn’t know something, she wanted to know more. She’s diligent and capable,” says MacLellan. She notes that sometimes procedures take longer at the Faculty clinics, as student dentists confer with instructors. “But she kept up a running commentary, explaining what was happening, and that made it a lot easier.” 

Levin says aiding in MacLellan’s diagnosis and treatment has been a special learning opportunity. “I thought it was fascinating to see a direct connection between the mouth and someone’s overall health,” she says. “We learn a lot about that in school, how oral health is total health.”

Photography by Stef & Ethan

Interested in more stories? Read the PDF edition of the U of T Dentistry Magazine Winter/Spring 2021 Issue