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Where is the NOMAD?

Where in the world is the 10K NOMAD?
Following the 10K NOMAD in its travels across the globe on medical mission trips with Global Health Outreach.

University of Louisville Dental School Mission Trip to Haiti
Dr. David Maddy led a team of dental students from the University Of Louisville School of Dentistry to Haiti for a week of medical missions work in March 2013. They were part of a GHO team of 42 people including physicians, dentists, pharmacists and students from pharmacy, medical and physical therapy schools. They worked in the city of Jeremie and had more than 1,500 patient visits.

The 16 members of the dental team were aided by the use of the NOMAD dental x-ray machine. A laptop with a digital Kodak sensor and Kodak software was used to capture the radiographic images. Having led more than 20 mission trips, this was his first trip using the radiographic equipment.

The clinic was set up with two dental chairs for cleanings, two chairs for fillings, two chairs for extractions, a sterilization area and a triage station. The NOMAD was utilized in the triage station by Dr. Maddy and his colleague Dr. Tim Daugherty. The patient started in the triage area where the chief complaint was identified, and then the patient was directed to the dental treatment area for evaluation.

Having access to the NOMAD proved to be very valuable. It was easy to use, fast and efficient, as well as consistently providing image readability. Its best use was in determining if a tooth could be filled rather than extracted. After evaluating the radiograph the size of the decay could be determined and teeth could be identified that did not have probable carious pulp exposures. On a trip with a training focus for students, this helped students as they gained more experience doing drilling procedures. The possibility of intending to fill a tooth, spending the time preparing the cavity, and then having to extract the tooth because of an unknown carious exposure was eliminated.

Another beneficial use was in evaluating the chief complaint. There were a few circumstances that the patient was complaining of pain and no area of decay could be visualized. There was heavy calculus, and without the use of the NOMAD, one could have easily assumed that the pain was periodontal in origin. The radiograph revealed very large exposures of the pulp and teeth were extracted, thus providing the most appropriate treatment.

Another potential use fortunately not needed was to identify broken remains of roots after extraction of a tooth. The skilled hands of our dental surgeon and his oversight of the students accounted for all parts of the teeth without need for x-ray location and/or verification. The NOMAD proved to be a valuable tool in the dental setting of a medical mission trip and will be utilized by Dr. Maddy in the future.

Nicaragua Trip Testimony
All I can say is WOW! The NOMAD is definitely a “game-changer” for CMDA mission teams! We set up clinic in the very small mountain town of Rodeo Grande, Nicaragua. On the first day, Dr. Todd Blevins of Mullins, South Carolina was able to do a root canal for a teenage girl on a central incisor. In the past, our only option would have been an extraction, and the young lady would have spent a lifetime without her front tooth.

One of the biggest challenges on trips is deciding if a tooth is restorable. We would start a restoration only to find out that the prognosis is hopeless and then ultimately remove the tooth. With a good radiographic exam, we were able to predetermine what treatment is needed and act accordingly. We were blessed to have two talented oral surgeons on our team, Dr. Keith Blevins and Dr. Jason Sheikh. With the NOMAD, we were able to send patients straight over to oral surgery, greatly increasing our overall efficiency as well as accuracy. And many times we were able to diagnose and treat decay that would have gone completely unnoticed on previous trips.

The NOMAD was an awesome gift to CMDA that will keep on giving for years to come! I have been on many trips without the NOMAD, but I must say…I am officially spoiled. Thanks so much to the team that designed and produced this incredible tool for dentists in the mission field.

Gregory M. Griffin, DMD
Lincolnton, Georgia

Camb*dia February 2013
Global Health Outreach served in rural Camb*dia in February 2013 on their fourth annual trip to serve the Khm*r people. Michael O'Callaghan, DDS was the team leader and was assisted by 24 other GHO team members, as well as 30 fellow Cambod*ans. The GHO team included four U.S. dentists. We also were assisted by three Cambod*an dentists for part of the time. In addition, we worked with 25 different dental students who served as our assistants and translators. In eight busy clinic days, our team treated 4,441 patients including 788 dental patients. We provided sonic scalings, restorative dentistry and extractions. The NOMAD was a useful tool to have in the toolbox. It will be far superior (quicker, more diagnostic) with the digital sensor. But we took about 12 to 15 periapical dental radiographs over the entire trip. The NOMAD helped to rule out dental problems as the cause of a key local pastor’s recurring facial pain. It also allowed me to determine that we could proceed with removing some third molars (wisdom teeth). In another case, it revealed that it would be unwise to provide such care. On the last clinic day we saw two patients with oral-facial infections where we could not provide definitive care. Using the NOMAD, we were able to make an accurate assessment of the complexity and refer to a local dentist for follow-up care. The dental student translators were impressed that we have such capability.

Michael O'Callaghan, DDS