International Service Learning: Experiential Medical Education

A Pre-Dental Student Explains What Global Dental Care Really Looks Like

DrH

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The fastest way to understand dentistry isn’t another lecture, it’s sitting chairside in a real clinic where the tools are limited, the need is high, and you have to earn trust before you can help. We’re joined by Nikki, a University of South Carolina pre-dental student, as she reflects on international service learning across the Dominican Republic and Puerto Peñasco, Mexico and what changed when she returned as a student leader.

We talk through the real mechanics of a dental mission trip: how the team sets daily goals, rotates through patient intake, vitals, assisting dentists, and charting, and how students with little dental experience learn instruments and procedures on the fly. Nikki shares what surprised her most in Mexico, including oral hygiene patterns like low floss awareness, the challenge of deep decay you can’t fully treat in a short-term clinic, and system differences such as dentists often working without assistants.

Some of the most powerful moments have nothing to do with fillings. Nikki describes calming scared pediatric patients when language gets in the way, why communication “without words” becomes a clinical skill, and how a visit to a men’s rehabilitation center left a lasting impression. We also dig into a protocol many US clinics don’t use: required glucose checks before treatment, and how that changed the team’s view of safety, prevention, and access to care.

If you’re exploring global health, dental volunteering, or experiential medical education, this conversation offers honest context and practical insight. Subscribe, share this episode with a friend considering service learning, and leave a review with your biggest question about providing care across cultures.

I also want to thank our listeners for joining us as it is our goal to not only share with you our guest’s introduction to international healthcare, but also to share with you how that exposure to international healthcare has shaped their future path in healthcare. As true patient advocates, we should all aspire to be as well rounded as possible in order to meet the needs of our diverse patient populations. 

As a 50+ year nurse that has worked in quite a variety of clinical roles in our healthcare system, taught healthcare courses for the past 20 years at the university level, and has traveled extensively with my students on international service-learning trips, I can easily attest to the fact that healthcare focused students need, and greatly benefit from the opportunity to have hands-on experiential healthcare experiences in an international setting! I have seen the growth of students post travel as their self-confidence in their newly acquired skillsets, both clinical and cultural, facilitates their ability to take advantage of opportunities that previously may not have been available to them. By rendering care internationally, and stepping outside one's comfort zone, many more doors of opportunity will be opened.

Feel free to check out our website at www.islonline.org, follow us on Instagram @ islmedical, and reach out to me @ DrH@islonline.org

 



Welcome And Meet Nikki

Dr. H

Well hey there, I'm Dr. Patrick Hickey, or Dr. H, as many of my students refer to me. I want to welcome you to another episode of the International Service Learning Experiential Medical Education Podcast. During each episode, I will be interviewing healthcare-focused students and faculty from high school to university that have had an opportunity to participate in an international service learning trip. Additionally, I will be discussing the benefits and challenges to international service with healthcare professionals that have served abroad, as well as industry leaders in healthcare, education, study abroad, spirituality, and those living in the countries being served. Well, it's my pleasure today to have Nikki with us. And uh Nikki's a student at the University of South Carolina, bio major, psych minor, member of our honors college, and sophomore, I believe.

Nikki

Junior.

Finding The Pre-Dental Path

Dr. H

Oh, junior, sorry. I apologize. And and again, I believe on the pre-dental path. Is that correct? Yes. Well, Nikki, if you don't mind, just share uh with our uh listening audience a little bit about yourself.

Nikki

Um I'm from Lexington, Kentucky. Uh so I came to the University of South Carolina because my brother actually did, and I came to visit him all the time, and I loved it. So I applied to the honors college here, and like you said, majored in bio and minored in psych. So that's been really awesome. And I am in Delta Zeta as well. I'm in the pre-dental honor society, Delta Delta Sigma, Delta Delta Sigma. I'm in the Biological Sciences Honor Society. So I have my foot in a lot of doors on campus. It's been really cool to be able to meet a lot of different people from different walks of life. So yeah. Well, you know, it's a bit about me.

Dr. H

I like that you're on the dental path. You know, I started working with healthcare-focused kids many, many years ago. And I've I've never still to date had that many dental, which which I don't know why that is. I'm I'm maybe I because of that, I'm I'm meeting more and more dental students. But when you compare the nursing and the pre-med, it just seems like it's a small carving. Have you found that yourself?

Nikki

Yes, I definitely agree, especially when I first got to college. I didn't even know really, because I didn't come to college as a pre-dental student. I was pre-PA originally. But I mean, I didn't even realize that pre-dental was something that a lot of people did, or that there was even organizations dedicated to it. So it's kind of hard to find if you're not looking for it. But I think it's a growing field. I think more and more people are slowly discovering that it's a great path to be on.

Dominican Republic Trip Takeaways

Dr. H

So that's good. In the short time I've met the pre-dental students, one thing I've found that's a common denominator is quality of life with the uh profession, in in that the working time, days mostly, no weekends, you know, no call, and who wouldn't want that, right? Yeah, sounds great to me. Well, listen, we appreciate you being here today and and and part of our podcast. You're rather unique in that you've already been on a international service learning trip, and now you're going on a second, but this time leading. So if you could just tell us a little bit about your first experience and and then what you're anticipating this time as a leader.

Nikki

Yeah, my first experience was in the Dominican Republic. It was really awesome. I went with a team that included both medical and dental. So it was pretty unique because I got to see not only like the dental and school there and spend time with them, but also got the chance to spend a little bit to have time with the communities and the medical team, which I know that's not what you know I want to do as a profession, but it was really cool to just be able to see their perspective on things and be able to be a part of both teams. So last trip we mainly stayed in the dental school there and we got to observe how their students learned, how the teachers, how their whole like school system learned. And I thought that was really cool because I didn't even know we were gonna get to do that. So it's a very fun little surprise. We got to serve a philanthropy they have over there for sickle cell anemia children, which was really cool. So I had a really great experience and I just wanted to be able to give, you know, some insight to other people about how great the experience was and be able to lead a trip of my own. So that's why I'm doing it.

Dr. H

So with leading a trip of your own, what has has that been a huge challenge while going to school full-time, keeping great grades and and shepherding, herding a group of students all together?

Nikki

Um, I don't think it's been a huge challenge just because, you know, with that experience so far, it's kind of a little bit easier to have the knowledge going into it when people are like, what is this really gonna look like? You know, what is my money going towards? Where like all the small details that people who haven't been on a trip before might be asking. It was kind of helpful to have that background knowledge. So I was able to answer their questions quickly and just kind of, you know, encourage them and explain to them why that this is such a good opportunity. So wouldn't say it's been a huge challenge. Definitely it's been hard like timing-wise, because a lot of people want to be home for Christmas, but I think the Christmas season makes it even a better way to spend your the season of giving back to people.

Dr. H

For those who are listening, what are the dates for your trip?

Nikki

My trip is from December 16th to December 22nd.

Preparing To Lead In Mexico

Dr. H

That's great. It's so nice. It's it's gonna be a Christmas gift, so to speak, that you're giving to others. Yes. For those people that haven't gone on the trip before, what are those number one and two fears that you had a year ago going on your first trip?

Nikki

I think my first fear was probably that I wouldn't know anyone going or I wouldn't, you know, feel close to my team. I feel like you see all these pictures on like social media or stuff, and everybody looks like their best friends. And I was like, I don't know anyone who's going. Like, I hope we can like become closer, which is definitely true. I mean, experience like this one, like you're bound to, you know, you're sharing such a rare experience with people. Uh, even if you don't know them before, you definitely will get to know them by the end. So that definitely was not a problem. I think probably another concern that I had was just being somewhere new. I think that can be uncomfortable for anyone, but I feel like ISL does a really good job of, you know, making sure everyone feels safe and comfortable and that, you know, ISL has a lot of people who know exactly what they're doing. So there's not really any like questionable decisions or like I mean that the students themselves don't really have to know the area per se. So that was really helpful.

Dr. H

Students in the past have shared that the unfamiliarity with the language and the country that they're in was was a big challenge. In your case, that would have been Spanish. Was that it was that a challenge for you or anyone on your team?

First Trip Fears And Spanish

Nikki

Um, I think that specifically for me, I can understand a good amount of Spanish, but I'm not very good at speaking it. So I think my like main challenge was trying to communicate what I wanted to say when a translator wasn't available. I could know like pretty much the gist of what they were saying, but I just wanted to be able to respond. And sometimes it took a few minutes to get the right words across. So I think that was a challenge. But you know, the more time you spend using the same terminology and saying the same things, it becomes easier.

Dr. H

How about food or accommodations? I'm sure that's a considerable thing beforehand.

Nikki

I think some people, you know, might have concerns because you know, a lot of people haven't experienced what it's like to live in accommodations that are different from ours. But honestly, that was the least of my worries when I was there. We stayed in a really nice, not like you know, a five-star resort, but I had everything I needed. There was never a question of, you know, do I not have the right food? Or me personally, that was my least concern going on a trip like this.

Dr. H

Does um are there from the last trip that we'll move to the future one? Was there anything, a patient or situation or scenario that kind of stood out for you?

Earning Trust With Scared Kids

Nikki

I think that one of the patients that stood out to me most, like I said, we hosted like a clinic with the dental school the last day of our trip for kids with sickle cell anemia. And you know, kids and the dentist don't really get along. I learned that is not just something in the United States, that is a pretty much universal fear, which you know is totally fair. You know, we have loud, sharp instruments that are coming near your mouth. So I totally understand, but you know, it's kind of hard when you're obviously as you know an adult, you know that you're what you're doing is just going to help the children, but obviously it's kind of hard to convey that to a small child. So I think just a few of the patients that I was with that day were just very apprehensive and very scared, especially with people they don't know, you know, taking them back and just trying to clean their teeth, which isn't a super like invasive procedure, but they just, you know, it's fear of the unknown. They don't know what's gonna happen, and just trying to console them, especially from like another language was a big challenge. But there was this one little boy in particular who was so so scared he wouldn't even want to lay back in the chair. He just wanted to stay sitting up and not even go near. But with one of the little polishing hand pieces we had, like started playing with him and like touching it to his finger and just like showing him that it was not scary. And I think us being able to eventually clean his teeth was just like a big moment because he kind of like trusted us and just having to have like patient trust was really cool, even with the small child.

Dr. H

Establishing rapport, like what you described is huge. I mean, taking that extra time to make a difference, that positive influence that you had on that child probably would help in the future when he goes back for more visits because sometimes when you're scarred, you're afraid to go back or you have a really painful experience. So taking that extra time to do that, that's that's great you did that. So thank you for sharing that from your experience from that trip and looking forward to the trip right now. Do you hope to continue to have the same experiences as last time or or or build on those experiences?

Nikki

I think there's always room to build on your experiences. Obviously, I loved last trip and I would love to experience the same things again, but just using my experience and letting everyone know on the team like it's okay to like you don't have to be scared to talk to people or like don't view like your language barrier as an excuse to not want to interact with people because like they really do want our help. And you know, just to be able to give my team advice, I think is a way that I could build off of last trip. But I had a great time last trip and I would love to experience some of the same things again, too.

Dr. H

Well, we thank you, uh Nikki, for sharing your time with us. I'm excited to hear back. And again, this is gonna be a unique podcast this episode because Nikki's been on a trip before, shared with us just now, you know, what those experiences were like, you know, what what she's looking forward on the future one. And we get to chat with her in a couple, two, three weeks and find out how that second trip was. So we we thank you for excuse me, for your time tonight and wish you happy holidays because you're gonna be spending uh some of your holidays in Mexico and getting to practice your Spanish and uh putting a smile on young kids' faces.

Nikki

Yes, I'm so excited. Thank you so much for having me. Appreciate it.

Dr. H

Best of luck. Take care. Bye-bye.

Nikki

Thank you.

Dr. H

All right. Well, I'm excited again today to have uh Nikki with us. When you last heard from Nikki, she was getting ready to go to Mexico on a dental mission trip, and she's back now and and hopefully just as excited as uh before she went on the trip. And and as I recall, this is a multi- she's had multiple service learning medical mission trips. But Nikki, if you could just give us a uh a little update on on the dates that you went and and where you went.

Nikki

Yes, so we went to Puerto Penasco in Mexico, and we went December 16th through the 22nd, so right before Christmas time.

Dr. H

How was that right before Christmas time? It's not a typical service learning trip. You see, most of them are spring break or or may mesters or even the summer. What's it like going right before the holiday season?

Nikki

I think it was just a great reminder. You know, the holidays to me are all about, you know, thinking of other people and what you can give. So I think that was a great way to spend the Christmas season just thinking about others.

Dr. H

It's kind of a nice gift that you're giving them, isn't it?

Nikki

Yes.

Dr. H

What was a typical day like on this trip for you guys?

Nikki

Every day was a little bit different, but for the clinic days, we would wake up, we would have breakfast, we would kind of just meet as a team and talk about our goals for the day, what we planned on doing, just make sure everybody's on the same page, and then we would take the van over to the clinic, we would kind of touch base there, split into groups. Some of us would do vitals, some of us would be assisting the dentist, some of us would be doing patient intake, we would just go ahead and split into our groups and start our jobs, and then we kind of just rotated as the day went on through the stations until about lunch, and then we ate lunch and we would kind of come back to clinic, do the same thing, keep rotating, and then we would wrap up for the day and go home, maybe do some shopping or go out to dinner, and then just bond and go over the day.

Dr. H

How many dentists did you have on this trip?

Nikki

We had two dentists that were working with us.

Dr. H

Okay. And and I know you already had experience going into this trip. What about the students that did not have any dental or very little dental experience? What was it like for them to try to learn about the different instruments and the techniques? How did they get up to speed?

Learning Instruments In Real Time

Nikki

Yeah, it's definitely overwhelming. Dentistry has a lot of different complicated names for, you know, terms of instruments and procedures and stuff like that. So I can see how it would be intimidating for them to just kind of be thrown all into that. But the dentists were really helpful. And, you know, people on our team that did have experience, like myself in a dental office, we kind of just all helped each other out, you know, learn as we go and learn what instruments they needed for certain procedures. And then we were kind of able to just learn, like I said, learn as we go. It was definitely something that was a challenge for some people, but I think in the end it helped us grow as a team a lot.

Dr. H

No, I I don't have a lot of dental experience, but I I do know there's a different system for numbering the teeth or something like that. It I don't even know what they're called, if it's an American system or another system. Were were were there two different systems or and and if so, how did you get up to speed with those?

Nikki

No, it was actually the same system, which I thought was interesting. So they numbered the teeth one to 32. So when we would take the we took surveys of patient, like if they had anything in their mouth that was concerning, we would note that and write on this little chart what tooth it was and what we thought it was. So it was the same thing, and it was, you know, I guess easier to translate what it would be from what we're used to in America.

Dr. H

But now with those surveys, what was the state of dental or oral hygiene? What was your experience?

Nikki

Um something interesting that I noticed is that dental floss is not really a common thing that people use. I would say that brushing twice a day is probably pretty standard in Mexico, but every time we asked people if they had used floss, some people didn't even know what it was. So I thought that was very interesting.

Dr. H

Now, did you have a range of patients from childhood to elderly? And what were those age groups?

Nikki

Yes, we had mostly adult patients, but we did have some child patients as well.

Oral Hygiene Patterns And Pediatric Anxiety

Dr. H

So when you're dealing with the with the pediatric patient population, and and not to get into too many of the procedures, were were there challenges, you especially if you had to remove a tooth or or do some drilling or something like that?

Nikki

Yeah, mostly for the kids, on at least in this experience, we didn't have to do anything too invasive, like extractions or something like that. But you know, with kids, it's always very hard because they're scared of the dentist and they see all these pig sharp metal things coming at them and they don't want to, you know, get hurt, obviously. They don't know that the doctor's just there to help them. So it's always a challenge trying to console them.

Dr. H

But I guess it's no different in Mexico than it is in either of the state.

Nikki

I would say that dental anxiety for children is probably a universal thing, in my opinion.

Dr. H

What was the uh most surprising thing that you encountered or saw if there was anything that stood out?

Nikki

Um, I would say, and probably one of my surprises that I had, we went to a men's rehabilitation center one of the days, and we just kind of got to talk to some of the men who were there. And there was this one man who he spoke English, so it was a little easier for easy for us to like really talk about different different things without the interpreters. So he was telling us about his life because he used to live in America and he got deported, and he was just telling us about his story. And I have just never met a more like hopeful and positive man in my life. So I think that was very surprising, especially in the men's rehabilitation center, just how hopeful and how much of a positive outlook they had on life. So that was really awesome to see.

Dr. H

Well, it's it was probably great that you had that opportunity to speak with with him also, because I'm sure you made just as big an impression on him by having that interaction. So that's it.

Nikki

Like shook every person's hand on the team. It was just it was really cool to see how how thankful he was that we were there.

Deep Decay And Care Limits

Dr. H

Now, on the dental side, were there any any dental carries or any dental situations that really stood out?

Nikki

Um uh yes. So we saw a lot of you know deep decay in some patients. So that was kind of hard because there's only so much we can do in our clinic. We can only do really basic fillings, basic extractions. So if there's like a big infection at a root of a tooth or something, we don't have the surgical capacity to uh treat that as it should be. That was probably hard knowing that we couldn't accommodate for everyone, but we did what we could.

Dr. H

So, what what do they do for cases that you can handle? Like when you say a deep infection, do they have a process where they can refer them to a hospital or something like that?

Nikki

Um honestly, I'm not really sure what the process looks like because I think it's different for everyone depending on, you know, her like financial status and what they can afford because healthcare is very expensive over there. But I would assume it's similar to what it is in the US. If you have a deep infection like that, you probably need antibiotics, you probably need some other treatment, and you might have to get it like surgic surgically extracted as well.

Dr. H

Now, you've got dental experience going into this experience. How did the dental system you've already indicated that floss isn't something that's that's normally used in in Mexico? What other differences did you see? I mean, did you see dental hygienists and because you're used to that system here in the United States and were some of the instruments a little bit different from what we use?

Nikki

There was a few main differences that I noticed. One difference is that the dentists there don't usually work with assistants. So I thought that was very interesting because, you know, in America, we always have a dentist and a dental assistant working on procedures together. But the dentists usually just, you know, they're kind of it's I don't know how they do it because you need so many hands to hold all the tools at one time, but they just have adapted to doing things themselves, which I guess was really nice that we were there to help them, so it made things go smoother. But overall in Mexico, dentists don't really have assistance like that. So I thought that was interesting. And then another thing that was interesting is that in Mexico it's required to have glucose readings for every patient that's going to be treated. And we just don't do that in America. So I thought that was interesting.

Dr. H

What was the rationale for that?

Nikki

Do you know why they um it's if your glucose is above a certain level, you're not allowed to receive an aesthetic because that could be problematic.

Dr. H

Oh, wow.

Nikki

We don't do that in the US. So I don't know. I thought that was interesting.

Dr. H

How did how did this trip change your perspective of our healthcare system here in the United States once once you've returned?

Rehab Center Conversation That Stayed

Nikki

Um, I definitely am very thankful for the healthcare system we have here, especially in dentistry. I feel like our system is very preventative. We focus a lot on educating patients to how to avoid cavities before they even happen, which I feel like that wasn't as much as a priority with the people that I spoke to in Mexico. It's more about, you know, treating the issues once they arise. But the US, I feel like we're really good at, you know, providing patients with the information to prevent these situations from arising in the first place.

Dr. H

Well, speaking of prevention, do they are they scheduled for annual cleanings or dental hygiene checkups, kind of sort of like what we are here in the United States?

Nikki

I think it is a little bit similar. I think they do once a year, but you know, some people they know that they should be coming once a year, but they either don't have the transportation of getting there or you know, don't want to pay for it, or don't think it's important.

Dr. H

So how's this experience affected your future goals in in healthcare? I mean, are you does it did it reinforce you still want to become a dentist, or did it did it help you to per perhaps perceive that maybe speaking a little Spanish would help you with with your future patient population?

Prevention Versus Treatment Mindsets

Nikki

Oh yeah, I definitely think that speaking Spanish is always a huge plus, especially in healthcare. You're gonna have people that speak a different language than you. And I think, you know, not even just with Spanish, but with any language, you know, knowing how to communicate, maybe not verbally, and you know, give that patient comfort without using your words is a huge skill because as a dentist, you need people to trust you, and that relationship between you and your patient is you know very important to their treatment. So I think that's a huge skill that I think is very applicable for everyone. But yeah, I definitely am even more passionate about. Becoming a dentist now. I feel like the more I see, the more I love this profession.

Dr. H

So that's great. What uh just uh what about language? Was that an issue? I mean, you were in Mexico, did did most people speak a little English, or did you have to use medical Spanish for some of your patients? And did you have interpreters to help you?

Nikki

Yes, we did have a few interpreters. Our team was actually really special. We had a few students from USC that spoke Spanish, so we kind of had a little like double interpreter go action going on because we had like some designated interpreters, but also had some people on our team who were kind of willing and able to do that as well. So I feel like that made our experience a lot smarter just communicating because most people understand a little bit of English, but you know, it's always easier when you can speak freely and fully with someone.

Dr. H

Now, dental issues aside, you did vital signs and glucose checks on patients. Did you were there any other medical problems that that you detected? I know you were in a dental clinic, but do you like hypertension or anything like that? Did you find any of the things?

Communication Skills Beyond Spanish

Nikki

Yeah, so actually in the men's rehabilitation center, there was a man that we took his glucose and it was super high, and we're kind of just talking about his symptoms and you know what his life was like. And obviously, we're not, you know, physicians, we can't diagnose or, you know, really suggest that a patient has anything, but he was showing a lot of symptoms that were similar to diabetes. So it was kind of just interesting to reflect on that and you know, think about, you know, maybe he has some condition related to that and he doesn't even know about it. And, you know, it just kind of makes you think, oh, many people are probably struggling with things they don't even know about. So just like being able to tell him like that his readings were that high and just letting him be aware of that, even though it wasn't dental related, was also really cool.

Dr. H

Well, that's great that you share that experience. And excuse me, excuse me, moving forward, you know, you may have a patient in your future clinic that you may detect has hypertension that had no idea that they had it. So it's great that you were able to pick that up and and hopefully refer him uh for some extra help. For students that are considering a similar trip to yourself and a lot of a lot of students may be on the fence, you know, is this going to be good for me or not? Or is it gonna help me to get into grad school? What would you what would you say to them about this experience and and should they go for it?

Glucose Checks Reveal Hidden Risk

Nikki

Um I will always say go for it. I think trying something new and different, something that maybe puts you outside your comfort zone is always an opportunity for growth. And I think, you know, you can't really go wrong with that. I think for dental specific, it is a really good experience to just open your eyes to a lot of other cultures because not every country treats dentistry the same way. I think in order to be a dentist, you have to understand those differences and understand how people think about the dentist and view their oral health, even when they're not you know from our culture. So I think it's very important.

Dr. H

Well, now you've seen dentistry in three countries, is that right?

Nikki

Yes, yeah.

Dr. H

So USA, Mexico, and Dominican Republic. Dominican Republic. Yes. What is your overall perspective of those those three countries as far as dental care?

Nikki

Um, I would say uh it's kind of hard for me to say in the Dominican Republic because most of our experience, we were actually in the dental school. So, you know, obviously everyone that's in the dental school is going to be very focused on oral health, and that's really the main topic of conversation. But we didn't really get to go out in the community a lot and treat dental care like we did in Mexico. So I think I probably have a little bit of a skewed perspective in that way, but yeah.

Advice For Students Considering Service

Dr. H

Well, Nikki, thank you so much for being such a champion for dental dental health care and dental hygiene and and for leading a cohort of students and and hopefully for exciting students, you know, that are pre-dental, that that are wondering about is this a valuable experience for me? And and and and knowing that you've already had these experiences, we really appreciate what you've done for your cohort of of students. Any any last words you want to share with with our listeners before we sign off?

Nikki

I don't think so. I'm just really thankful that I was you know able to go on both of these trips. I think that's a really unique experience, and I would just encourage anyone listening to you know go for it if you're thinking about it, because you never know what it's gonna lead to.

Dr. H

Well, I like what you said. Step out of side of your comfort zone, and and I appreciate that. And and that that's what experiential medical education is you know, stepping out of your comfort zone, getting out of the classroom setting, going to a foreign country, you know, being challenged with language, a different culture, different food, and and you've experienced that a couple of times now and have done exceedingly well with it. So appreciate your time today and and uh look forward to following your progress.

Nikki

All right, thank you so much.

Final Encouragement And Thanks

Dr. H

I want to sincerely thank our guest, Nikki, for her willingness to join us on the International Service Learning Experiential Medical Education podcast. But most importantly, I want to thank Nikki for the passion that she has shared with us. Nikki is a great ambassador for dental care as well as service learning, and I'm sure that her future patients and their family members will be very privileged to have her as their health care provider. I am hopeful that by sharing details from her two service learning dental themed trips, she will have inspired other dental students to step out of their comfort zones and to go for it as far as pursuing a similar opportunity.

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