• What is the best toothpaste?

We get asked this a lot!  What really matters here is that your child likes the toothpaste, will use it appropriately and the toothpaste bears the ADA seal of approval.  Toothpaste has to meet strict criteria to get that seal.  Look for it on the packaging.  If your child is 6 years or older, and has  a high risk for dental decay, we will often prescribe a  5000 ppm Fluoride toothpaste.  The kind we are currently endorsing is Clinpro 5000 with Tri-calcium Phosphate made by 3M.  Also, if your child suffers from a lot of canker sores use a toothpaste without Sodium Laurel Sulfate.  The is the ingredient that makes toothpaste foam and basically is a soap.  If you want a “whitening” toothpaste, look for one that has carbide peroxide in it.  Rembrandt makes a good one called Rembrandt Whitening Plus.

• When should I start brushing my child’s teeth and what should I use?

We recommend parents start a “brushing program” even before the baby teeth appear.  Use a soft baby’s washcloth on your finger and massage the gums.  This starts patterning your child to have you putting something in the mouth which you will change over to a small brush like device that slips over your finger and then to a toothbrush.  Introduce toothpaste when teeth appear.  Remember to just put a small amount on the brush.  Toothbrushes should always be soft or extra soft and even when the teeth erupt gently scrub the gum line!  Introduce floss at around age two when both of the baby molars are visible.

• What should I do if a tooth is knocked out?

The first thing to do is stay calm and don’t panic.  Verify that the whole tooth came out!  If you can find it  and it is intact, it is possible to re-implant the tooth back into the socket, but time is the critical factor.  The tooth needs to be put back into the socket within 30 minutes.  Establish the time of the injury.  If you can get to our office within the time frame, all the better.  Emergency rooms are not always that helpful and the likelihood to be seen and the Physician knowing what to do is not always reliable.  More than likely, you will do a better service to put the tooth in the socket yourself.  Before you do, carefully remove any visible debris from the root service.  DO NOT SCRUB THE ROOT!!  This damages the microscopic cells that are vital for the tooth to reattach.  Those cells start to die after 30 minutes of being outside of a biocompatible medium.  A quick rinse of the tooth with water or contact lens solution or even your own saliva can help clean it.  Do not soak it in water!  Once you have removed the “visible” debris, orient the tooth, hold your child’s head and place it back into the blood filled socket.  Instruct your child to bite down as best as he or she can and get to our office.  Now if you are not able to re-implant the tooth and you have to transport your child and the tooth for us to  replace it, then you must transport the tooth in a medium that is “isotonic” (a fancy word for a solution that won’t harm the living cells attached on the outside of the root).  Some acceptable solutions that could be readily available would be saline solution , milk or saliva.  placing ice on the face over the injury is good as well.

• What should I do if a tooth is chipped or broken?

Again, don’t panic!  Most of the time there is no immediate “get to the dentist within minutes” need.   The gums may bleed, lips may be split or swollen and the tooth will feel sharp and jagged.  First, establish any other injuries that may need to be seen by a physician.  If the lip is badly split, it may need stitches which we can usually fix.  Contact our office and let us know about the injury.  If a large part of the tooth broke off and you found it…. keep it moist and bring it with you to the office.  Sometimes we can use the piece and reattach it.  If there are no pieces to be found, don’t worry, we can use composite or porcelain.  The tooth may be sensitive to temperature so baby it!  If you see a small red spot in the middle of the tooth, then the pulp or nerve of the tooth may be exposed.  This will need more immediate treatment since it will be more painful and an entry point for infection.

• What if a tooth has been knocked loose?

The good news here is that most of the time it was knocked a little loose and will eventually tighten back up.  Make sure your child can bite together OK and call the office to let us know what happened.  We will want to eventually take an x-ray to make sure the root did not fracture.

• What if my child’s gums are swollen around a tooth?

Swelling is always something to pay attention to.  Swelling is a component of inflammation.  Inflammation can be caused by infection and trauma.  The mouth is full of bacteria so swelling in the mouth usually means infection.  As soon as you notice the swelling, contact our office even if your child doesn’t have pain.  We will definitely want to see your child soon because usually pain will eventually arrive on the scene.

• What if my child complains of a toothache at night or after hours?

Usually alternating children’s Tylenol and Children’s Advil every 2 to 3 hours is the best over the counter remedy for pain relief.  Children also generally do well with codeine.  Our office after-hours message will contain Dr. Couch and Dr. Hammond’s personal cell phone numbers.  We do this so that you can call us for advice or to set up an after hours visit for your child at the office.  We know that tooth pain can sometimes be very unbearable at inconvenient times.  We give you those phone numbers because if you must call it is usually a genuine emergency.  Sometimes a tooth has to be opened and infection drained before relief will come.

• All the other kids are loosing teeth but my child hasn’t…. is that normal?

There are so many different variations of tooth eruption patterns and timing.  It is very hard to say what is normal.  Generally the lower front two teeth are the first to loosen and fall out.  Look for this in Kindergarten or first grade.  The first permanent molars come in around age 6.  We call those molars the six-year molars.  The second permanent molars come in around age twelve.  Some mom’s have asked if because their child’s teeth came in later than other children’s does that mean the child will be developmentally delayed in other physical aspects?  There has never been shown a correlation between tooth eruption patterns and other areas of development either physically or mentally.  Teeth tend to erupt when they just plain feel like it!

• My child has cavities!! What am I doing wrong?

Decay happens when bacteria eventually gets past the protective enamel covering of the tooth.  The enamel weakens and breaks down because of acid.  Bacteria produces acid as it metabolizes the food particles left around our teeth after we eat.  Most of the bacteria that gets left undisturbed  (acid then builds up) are found in the pits and fissures of our teeth and in between our teeth.  Brushing and flossing is intended to fluff the bacteria and keep the acid attack from building up.  Some enamel is more resistant to acid than others.  Fluoride strengthens enamel.  Also,not all bacteria is created equal.  Some stains of bacteria produce more acid.  So you can see decay is not just a simple formula.  Brushing, flossing, sealants and fluoride are the best weapons against decay.

• I have heard that fluoride is bad for your bones and is rat poison…. Why should I be giving this to my child?

Yes Sodium Fluoride is a rat poison.  At rat poison doses you would have to drink a bathtub plus full of fluoridated water to receive a potentially fatal dose.  Fluoride can and will get incorporated into the bones and toxic levels can make bones brittle.  Fluoride however gets also taken up into our enamel and makes the enamel really strong.  Fluoride as a supplement to help strengthen teeth, has been studied extensively.  Fluoride can be delivered to our developing teeth through either the drinking water or a chewable daily pill that a pediatrician or dentist prescribes.  Birth to age six is the optimal time to get fluoride into the enamel.  After age 12, the benefit reduces significantly.

• Is the water in this area fluoridated?  Who should I get a fluoride RX from?

The State of California passed a law years ago that mandated all public drinking water to be fluoridated.  However, they failed to provide funding.  Most local municipalities have not found the funding to accomplish the mandate.  EID at the present does not fluoridate our water in El Dorado County.  The city of Placerville, however, has a fluoridated water supply.  Most well water in this area does not have any natural occurring fluoride.  Supplemental fluoride table RX’s can be dispensed by pediatricians or our office.  Just ask if you need one for your child.

• I have heard that there is mercury in dental fillings….Should I be concerned?

Yes, there is mercury in silver dental fillings.  These fillings are called amalgam and the main metals are silver, tin and mercury.  Amalgam fillings have been extensively researched over the years and the American Dental Association has found amalgam to still be an acceptable dental finning material.  Many countries have banned the use of amalgam.  The safety of amalgam in our mouths remains a heated debate.  At Couch and Hammond dentistry we have chosen to not offer amalgam as a choice of filling materials in the office.  We feel that amalgam has served the public well for many years, but in this day and age there is no need for it especially in our young patients with developing nervous systems.  We recommend placing either composite or glass ionomer fillings.  For more information about the different types of filling materials just ask our office staff.

• What is the best way to protect my child’s teeth while playing sports?

Hands down, a professionally made mouth guard is the best.  The drawback is that because it is such a custom fitted appliance it may not fit over a long period of time because your child’s mouth may still be growing and changing.  The over-the-counter “boil and bite” mouth guards can be acceptable if they are fitted correctly.  Professional mouth guards have also been shown to reduce the severity and frequency of concussions.

• At night, I hear my child grinding his teeth in his sleep.  What can be done about this?

A lot of kids will grind their teeth.  Usually as the six-year molars erupt and the bite stabilizes, this habit goes away.  If we see that the permanent teeth are showing signs of early wear then a night guard would be appropriate.

• I always had nitrous oxide for dental work when I was young.  Could we do the same thing for my child?

Yes… but!  First thing to consider is that dentistry has changed a lot since we were kids.  I can remember crying my eyes out at age nine in the dentist chair for no good reason.  Most of our young patients do just fine without nitrous oxide and they are establishing a confident easier way to be treated as an adult.  Our advice is to give us and your young one a try first without the nitrous.  We can always use it if necessary.

• When should we start looking at braces?

Some kids will need early intervention orthodontically.  We have seen that to be as early as age 8.  Many orthodontists can get the bones orthopedically moved and aligned and then at age 13 or 14 the full braces can go on.  It’s never too early to get an orthodontic opinion.

• My child’s permanent teeth are coming in really yellow!  When can we bleach them?

Adult teeth are always yellower than the brighter, whiter baby teeth.  When we see them next to the baby teeth we think they are just plain yellow.  It is sort of an optical illusion.  Wait until all of the adult teeth are in… usually by age 14 and then we can evaluate really how yellow they are.  If you want us to whiten your child’s teeth we can usually start that after age 14 or 15.  Just ask us for a menu of whitening services.

• When should my child start seeing the dentist?

The Academy of Pediatric Dentist’s recommends that children start seeing a dentist when the first teeth erupt.  We feel that is good advice, but we like to throw in a little practicality and common sense to the mix.  We tell our mom’s to bring the kids with them to  their appointments.  The infants will get a lot of attention from our staff and the toddlers usually do great with some entertainment we can provide while mom or dad are getting their teeth cleaned.  We can easily do a complimentary check of the child’s mouth and make recommendations.  We feel that around age three, your child can be comfortable with us and a full exam and cleaning can be scheduled.  Every child is different but we like to be seeing the child regularly by age four.

We hope that these commonly asked questions and their answers are helpful to you and your family.  If you have any other questions, please never hesitate to give our office and call.  We love children and want you to be confident that you are prepared for all dental emergency situations and are well equipped to keep your child’s smile healthy and beautiful for a long time.

Be a Happy Denture Wearer with Couch and Hammond Dentistry

One of the most difficult situations we have faced for a long time in dentistry was how to stabilize a loose and ill-fitting denture.  Fortunately, we can confidently recommend a solution and provide a great fitting and stable  denture with mini dental implants.

We have seen many patients suffer with the discomfort, inconvenience and embarrassment of a poorly stabilized denture.  Probably many of us know a friend or family member that must adapt their diets, social lives and daily habits to accommodate the limitations of their dentures.  Thousands of dollars are spent over time on relines, and over the counter adhesives.

At Couch and Hammond Dentistry, we have been placing mini dental implants to stabilize dentures for several years now.  It has been extremely rewarding to see the immediate impact of this simple, affordable, same day procedure.

We typically place 4 mini implants into the jaw.  No incisions or stitches are required.  Most of the time, we can immediately anchor the patient’s existing lower or upper denture into the implants.

If you, or a friend, or family member are tired of the embarrassing and uncomfortable loose or ill-fitting dentures, call and ask us how mini dental implants can change life forever.  These are the same implants you hear frequently advertised on t.v. and the radio.

Let us give you or your loved one a more personalized experience.

Couch and Hammond Dentistry

530-677-0723

www.couchandhammonddentistry.com

So how do you tell someone that they have bad breath? How many times have you wondered about your own breath?

Halitosis is a hard conversation topic & uncomfortable critique for someone to either give or receive. I can’t give you advice on how to be the social conversationalist about the subject, but I can arm you with knowledge on ways to eliminate it in your own life.

First let’s discuss the science behind bad breath. Odors in our breath come from different sources. A common source is the metabolites of the food we eat that are exhaled through our lungs. An example includes the garlic breath that occurs 24 hrs after eating dinner at “ The Stinkin Rose” restaurant in San Francisco. A restaurant famous for everything garlic! Or, the distinct breath of someone on a high protein diet or the diabetic in ketoacidosis. Most mouth odors however, come from the by-products of bacteria feeding on the same food we eat. Bacteria are found on our gums, teeth, throat, nasal passages, and especially our tongue.

These bacteria produce compounds called VSC’s (volatile sulphur compounds) These cause the offensive odors. Some of the names of these VSC’s are :
Hydrogen Sulfide: Rotten Egg Smell
Methylmercaptan: Present in Feces
Putrescine: Decaying Meat
Isovaleric Acid: Smelly Feet

80% of these VSC producing bacteria are found on the tongue, especially the far back side you can’t see unless you stick your tongue out & look in the mirror.

So, now you know the science and are aware of the possibility that these VSC’s could be lurking in your mouth, making you want to brush & floss 5 times a day. What can you do about it?????

metabolite odors from the food you eat – water, water, water…. Just flush it from the system. For the other metabolite odors you may need to see your doctor, or dietician.

The volatile sulphur compound odors are best treated from a systematic approach of reducing the bacteria count and breaking apart the VSC’s they produce.

Get yourself to the dentist & hygienist to have your teeth/gums cleaned professionally
Drink plenty of water and avoid things that dry your mouth out such as alcohol. Chew gum with xylitol (a non-fermentable sugar)
Scrape your tongue, tongue scraping is the single most impactful habit you can start today. Ask for a tongue scraper at your next cleaning, we’ll give you one free, or just stop by & ask for one. Tongue scrapers work a lot better than just brushing your tongue with your toothbrush.
If you like using a mouthwash use one that
does not have alcohol
has chlorine dioxide in it, ie; ClosysII, chlorine dioxide rips apart VSC’s (www.closys.com) we carry ClosysII products
has zinc chloride, ie; Breath RX
Listerine just came out with Listerine Zero- we have found it pleasant tasting, minus the dry puckering effect of the alcohol.

Well there you have it, maybe you can bring up the topic with that fetid breath co-worker or loved one by saying you read this great email from your dentist. We hope this information is helpful and just maybe they will get the message and take action!

Hopefully you learned something from this email in the process.We will be  producing these educational articles from time to time, simply to raise awareness of dental issues and to educate our patients.  If you have a topic that you would like to learn more about, simply comment on this post or drop us an email at candhdentistry@yahoo.com    We would love to hear from you!

Dr. Couch and Dr. Hammond your El Dorado County family dentists!

Happy Tongue Scraping!

Football time!

At Couch and Hammond Dentistry,we want kids in sports to be protected from unnecessary mouth injuries and head trauma. Did you know that sports mouthguards can help in this? Not only do they protect your child’s teeth from injury but they can also help prevent concussions from head trauma. We make custom mouthguards for all athletes. Give us a call to help you protect your child from unneccessary injury.

We need your help!!! We have several computers in our office that we have had to replace because of drive space that we would love to donate locally. If you know of a need for these computers we would love to hear from you! Please call our office at 530-677-0723

Did you know that we have a August and September special that we are running in our office right now? Check it out at our website at http://couchandhammonddentistry.com/.   If you are in need of dental products, now is the time to pick them up!

BIG NEWS!!! We have produced a Music Video!!Yes, you read that correctly! A MUSIC VIDEO!

It has just been released on you tube and you don’t want to miss it! It has some of our patients, our staff and office family in it!  It is so much fun! Check it out now on our website at http://couchandhammonddentistry.com/   by scrolling to the end of the introduction video and clicking on the ”I Smile Parody Video” link.  Or click on this link…http://youtu.be/mNzxcKc8bN0  So much fun! Are you smiling?

We have a newsletter that will be hitting the press soon! The first one is on “halitosis” (bad breath)! Yikes! Our patients will be receiving it via email, or you can read it here on our blog soon!

Are you getting enough SMILEAGE out of your office visits? Do you know all of the services that our office offers? You might be surprised! Check out our menu of services below……

SMILEAGE MENU

This is just a sample of the services we provide. If there is something you don’t see – please ask!

Cosmetic Services

Tooth-colored fillings

Tooth-colored inlays and onlays

Metal-free crowns and bridges made of porcelain and/or ceramic. Ask us which is best for you!

Porcelain veneers

Smile makeovers without braces

Cosmetic bonding

Cosmetic tooth reshaping

Laser dentistry with Biolase lasers

Scalpel-free gum surgery

Needle-free drill-free fillings

Preventive services

Brushing and flossing instruction with video

Preventive cleanings

Oral cancer screening

Sealants to prevent cavities

Fluoride treatments for children and adults

Athletic mouth guards

Dental photography

Implant Dentistry

Placement of implants, including “mini-implants”

Implant-anchored dentures

Implant-anchored crowns and bridges

Financing made simple with CareCredit

Tooth Whitening

In office treatment

Take home custom-made trays

Orthodontics

Invisalign “retainer” treatment

“Six-Month Smiles”

Periodontal (gum) Services

Non-surgical gum treatment

Antibiotic gum therapy

Scalpel-free laser gum surgery

Traditional gum therapy

NTI Device

Laser Biostimulation for TMJ pain

Mouthguards and therapeutic splints

Dentures

Full dentures

Partial dentures

Metal- free partial dentures

Denture repairs/relines/adjustments

Children’s Dentistry

Complete dental treatment for all ages

Special children’s play area – we love kids!

Seven Day Emergency Care

For your safety, we use DEXIS Digital X-ray. Digital x-rays help us see your teeth and surrounding structures more accurately AND produce up to 90% less radiation!

Our office just completed our CPR re-certification! We always have a good time together, even when we are working! Not only is it mandatory but it makes us happy that we know that we are ready in the event of an emergency!

Lastly, Look for our new sign on Cameron Park Drive. Coming soon! We are excited about our sign that will help all of our patients locate our office easily.

We love this community and serving you, your family and friends. We are always accepting new patients so please let your friends know that we are here to help them create a beautiful smile or keep the one that they already have for years to come!

What an amazing experience this was!

TORREY HAMMOND, DDS, William Couch, DMD, Jared Roberts and Hal Young, left to right, show a display of the photographs taken on their work trip to Nicaragua. Democrat photo by Pat Dollins
Practicing dentistry in a Tommy Bahama beach chair, making deals with the local “Godfather” and performing magic tricks in the jungle are not the things they teach in dental school, but they’re good things to know if you’re providing dental services in Nicaragua.
Drs. William Couch and Torrey Hammond of Cameron Park, seven pre-dental students from Brigham Young University, dental school applicant Jared Roberts and University of California, San Francisco, dental student Jason Couch, paired with Hal Young, president and founder of the Worldwide Child Relief Foundation, to offer dental services to 100 orphans at the Venganos Tu Reino children’s orphanage near Leon, Nicaragua.
In two days, dentists and students saw more than 80 patients and performed 145 operations.
Roberts, the team leader, waded through the regulations of two countries while organizing the student volunteers and travel plans.
Hammond, 38, set up the dental clinic in an orphanage dorm room.
Couch, 53, was in charge of the oral hygiene presentations.
Young, 62, and his foundation, sponsored the team and interfaced with the surrounding village.
Student volunteers, David Stafford, Chad Christiansen, Dustin Peterson, Spencer DeSanti, Ryan Leininger and Kasey Hendricks, assisted the dentists.
They brought laptops to digitize x-rays for diagnosis, Tommy Bahama chairs from a discount store to use as dental chairs, dental tools, a compressor to run the drills, cards and pictures for the orphans from Couch and Hammond’s younger patients and a lot of goodwill.
The first morning started with a challenge.
“We were all set up in an empty dorm room at the orphanage within an hour,” said Couch. “But the compressor we brought blew up.”
There was no place in the impoverished village to buy a replacement, so while Couch dazzled the children with an oral hygiene presentation, complete with magic tricks, Young contacted the local godfather in the area.
The man, notorious for being difficult to work with, refused to loan his compressor until he was made to realize the benefits to his own children. Free dental work, which the visiting dentists were happy to perform, secured the compressor and the game was on.
“The kids were laughing and having a lot of fun during the oral hygiene presentation,” said Roberts. Using a puppet with huge teeth, children were shown how to brush. They put on pillowcases to be teeth while dentists pulled ropes between the “teeth” to illustrate how to floss.
“They were excited about our being there, but once they got into the chair, they were a little apprehensive,” said Hammond. “But everyone got up with a smile — I think they were surprised that it wasn’t what they expected. They were amazing — grateful and no complaining.”
“We won them over with the magic tricks and then we numbed them,” joked Couch.
Most of the preadolescent and adolescent girls in the orphanage had never seen a dentist and had no idea what to expect. Children from the village near the orphanage and some adults were also treated.
“There was a lot of decay, especially on front teeth, so we did a lot of extractions on hopeless teeth and put sealants on molars,” said Couch. “It was really rewarding to save their smiles.”
Seventy-five percent of the work they did was to save teeth with only 25 percent being extractions.
While the dentists and student volunteers worked with their young patients, Young, and his assistant Mark Crawford, were busy building a soccer field for the students, putting up basketball standards, giving out 250 notebooks and school supplies at the local high school and going house to house handing out dental hygiene kits. Young set up a program with a man from Leon to teach English to the students twice a week.
“Hal doesn’t speak a word of Spanish, either,” said Bill Couch.
The team had an opportunity through their Nicaraguan liaison, pharmacist Mario Rivas, to visit a dental school in Leon. Dental students in Nicaragua go directly from high school to dental school, so the ready-to-graduate were younger than the American pre-dental students.
“They worked with us the last day and the dean of the school offered their facilities so we wouldn’t have to bring so much equipment next time,” said Roberts.
And there will be a next time.
“Torrey worked on a little girl and he wanted her to come back the next day. I carried her out to her grandfather to ask if they could come back. He had tears in his eyes and he was so grateful. That was the most powerful moment for me,” said Roberts.”This trip exceeded my expectations. Our pre-dental volunteers said they liked the hands-on experience and would do it again.”
“I have a deeper appreciation of what we have in America and of what I do as a dentist,” said Couch.
“I came home feeling that I received more than I gave,” said Hammond. “I saw a different way of living — people who are happy living without all our conveniences and who appreciate what little they have.”
Young is a former educator in the Mother Lode School District and a retired investment advisor. He and his family began visiting the orphans at Venganos Tu Reino in 2005, taking them supplies. Many of the orphans lost parents during the floods after Hurricane Mitch in 1996.
In 2006, the Young family formed the Worldwide Child Relief Foundation to benefit the orphans and the surrounding village. This is the first dental team the foundation was able to bring to Nicaragua.
“I really look forward to coming here,” said Young. “I have so much energy when I’m here. It brought tears to my eyes to finally be able to do this. We want to bring a dental team every two years and next year we want to bring in a team of orthopedic surgeons for children because there is a great need.”
Young is currently looking for orthopedic surgeons to make up next year’s team and funding to keep the enterprise going.
For information about the Worldwide Child Relief Foundation or to see photos of the dental team’s mission visit the Website at wwcrf.org or couchandhammonddentistry.com.

One of our patients even made a hat out of paper and asked me to give it to one of the kids at the orphanage. I gave the hat to one of the boys and he wouldn’t take it off all day. Check out the smile on his face…..

One of the kids in Nicaragua had the best smile. This is Franklin with our tooth brushing demo lion…

Congratulations again to Krissie…..She won a 25$ gift card to In N Out and two movie tickets.

Locals awaiting our arrival

We got straight to work pulling teeth and doing restorative dental fillings. We saw more adult patients today and therefore more acute dental needs.

Soaking it all in

David Stafford

Chad Christiansen

Dustin Peterson and Spencer Desanti

Ryan Leininger

Kasey Hendricks

Spencer Desanti

Jared Roberts

We especially want to thank Jared Roberts who did most of the organizing, planning and leg-work to make this such a successful and memorable dental mission! We also want to thank Hal Young, president of the Worldwide Child Relief Foundation for sponsoring and having the vision to make this happen!

A big thank you from some of the orphange kids! What a fantastic group of kids!

Our parting memory of Nicaragua was fantastic as we spent the evening on the beach reminiscing about our most memorable moments of the trip.

Dr. Hammond (nicknamed "El Che" aka The Man) picking his souvenirs.

A great way to end the day!

Adios Nicaragua! Esperamos regresar un dia en el futuro.

We all jumped in the van and headed back out to the orphanage with a prayer in our hearts that the new compressor would work. We moved the “mobile clinic” into one of the classrooms where we felt we had better crowd control. The compressor was there but it also didn’t function. Apparently an air compressor pulls too much electricity and their power supply is too weak. We sent Hal Young, the president of the Worldwide Child Relief Foundation out to get a generator! Hal was able to come through after pleading his case to the local “Godfather” of the community. So by 11:00am we were up and running!

All of us set to go!

"What's going on in there?"

The kids we were able to do dentistry on were awesome! Almost all of them needed extractions and fillings. Not one of them cried or complained. They kept thanking us all day long.

Our mobile clinic

Dr. Couch and Dr. Hammond hard at work

The pre-dental students finally got their hands-on dental experience that they were looking for. All of them got to extract teeth, drill out cavities and help place fillings! We did a lot of work today! Jason Couch (a current 3rd year dental student at UCSF) did as much operative dentistry and oral surgery today than the last 3 months of school clinic time combined!

Towards the end of the day we were asked to treat some of the adult staff of the school next to the orphanage as well. On one adult alone we did ten fillings!

The day was exhausting but very rewarding! Tomorrow will bring similar opportunities to serve the orphans and local Nicaraguans.

After long flights on Wednesday, we arrived in Managua, Nicaragua at around 10pm. We loaded a large van full of luggage and dental equipment and headed north to Leon.

Arriving in Managua

We woke up early this morning and it was still hot! LOL! We picked up an old industrial air compressor and drove another hour northeast to the middle of no-where. After passing many volcanos (some smoking others threatening), goats, horse-drawn carts, cows crossing the road, and many humble “casitas” we arrived at Venga tu Reino orphange. We set up shop, got organized and were ready to go when the air compressor that we rented blew! We tried to fix it ourselves, the local handyman tried to fix it but it was all to no avail. So we made the most of the situation by taking x-rays and doing exams on about 40 kids, placed sealants and did a fabulous dental hygiene presentation with magic tricks and crowd participation that rivaled Vegas!

Dr. Couch teaching the kids how to brush and floss!

One of the cute local girls

We love these kids!

Dr. Hammond placing sealants on Franklin

Dr. Couch treating 9 yr old Anna

Dr. Hammond in the "zone"

Jason Couch with his new girlfriends...

Taking X-Rays and treatment planning

We’re now going to take a nice cold shower, pump the A/C and hit the sack!

Adios muchachos!

Daryl Lambert, Jenna Lambert, Denise Lambert

We have had the blessing of knowing Jenna for several years and have been able to see her participate in Ponderosa High School Athletics, Community Service Projects, Extra Curricular activities and School Activities, not to mention that she maintains a 4.0 gpa. She is truly an exceptional young woman and we are thrilled to be able to present her with this years Scholarship award.

At Couch and Hammond dentistry, we value the youth in our community. We recognize the importance of education, community service, leadership and extra curricular activities and appreciate how hard Jenna and so many other youth in our community work to excel in all of these areas.

We see a bright future in our community because of so many young adults like Jenna that live in this area. We commend and congratulate all 2011 graduating Seniors. Good luck and keep up the great work!
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