Project gives refugees something to smile about

Project gives refugees something to smile about
7 Feb 2005
By RACHAEL SERAVALLI
Lincoln Journal Star
Mat Wur strides into the room. He is confident, sharply dressed in a brown suit and tie. But one is instantly drawn to what the 35-year-old refugee is wearing on his face: a broad, toothy smile. He has plenty to be happy about.
Twelve years ago, he escaped the psychological and physical suffering wrought by civil war in his native Sudan. And he has triumphed over the physical scars of having eight of his front teeth pried from his mouth in a painful Nuer tribal ritual when he was 8 years old.
In 2002, Wur received dental implants that replaced nearly all of his missing teeth and gave him the chance to fit into his new cultural surroundings.
"It was like getting something back that I'd been missing for a long time," Wur said. "Before, it affected the way I would talk with people. They would just look at my mouth wondering what caused it, what happened to me. (The implants) brought back my self-esteem."
Now, a new $230,000 grant will help 20 to 25 more Sudanese refugees get similar help.
In the process, this group of refugees may end up teaching Americans something about themselves.
While there is a general understanding that Western society considers missing front teeth a sign of lower social standing, economic means and intelligence, almost no data exist to confirm this belief.
UNL anthropologist Mary Willis and University of Nebraska Medical Center's College of Dentistry Randy Toothaker hope to study the effects of the procedure, such as changes in diet, dental care, self-esteem and comfort in social settings.
"So this provides an excellent opportunity to understand the implications of living without front teeth," Willis said.
For Wur, one of five original participants, the before stands in stark contrast to the after.
A poorly fitting denture helped with appearances but was relatively useless for chewing, he said. And when eating in restaurants, he would avoid hard-to-eat menu items or take most of his meal home to cut everything up in small bites. Now, with the implant, he can eat comfortably in front of others.
Willis said the small amount of data they already have collected is compelling. It includes evidence of an improved self-perception and the refugees' increased willingness to laugh or smile without covering their mouths.
"Ultimately," she said, "I think no matter what people say, teeth have a huge impact on someone's ability to succeed."
And the grant from the Jacob and Valeria Langeloth Foundation itself is special, said Willis. The foundation is known for encouraging multidisciplinary studies and supporting unique projects that combine medical health with emotional healing.
Besides the anthropologist and dentists, the project will enlist the added expertise of several others: two linguists to study changes in the refugees' ability to make sounds, a nutritionist to monitor their eating habits and show them new ones, and a psychologist to analyze the emotional and social impact of the procedure.
Jerold Edmondson and David Silva, linguists at the University of Texas at Arlington who are on the research team, said virtually nothing is known about how people who are missing front teeth acquire language before and after receiving the implant.
"We're really breaking new ground here," Silva said.
Despite the patience required to participate in the studies, the refugees are eager to help. Missing teeth are considered by many in the tribes to be a sign of beauty, but almost all Sudanese interviewed by researchers wanted replacement teeth.
In fact, Willis still receives several calls a week from refugees who would like to have the implants.
It's not clear how the practice began. Researchers believe it started long ago as a way to continue receiving nourishment when lockjaw from tetanus was rampant in the tribes.
Wur said he viewed the ritual as "a mistake," which may have been performed to preempt problems with dental decay. And Santino Deng, a Sudanese refugee from the Dinka tribe who also has the implant, said the ritual may have been used to tell members of different tribes apart.
Whatever the origin, the implants' benefits are clear.
Since getting the implant, Wur is moving on with his new life and look. He recently graduated with a degree in behavioral science from Concordia University and has considered helping future refugees cope with the cultural issues they encounter when they come to the United States.
And Deng, 25, who arrived from Sudan four years ago, said he can speak better English now. He said he hopes his Sudanese friends will eventually have the implants, too.
"The way that I have my teeth, I am very happy to have them," Deng said. "I feel great. I feel proud."
But at about $6,000 per person, the cost is prohibitive, so the team again is depending heavily on donated time and materials, including the titanium plates that comprise the scaffolding for the new teeth. The process takes about eight months from start to finish.
Nobel BioCare of Yorba Linda, Calif., donated all of the implant materials for the Sudanese refugee dental project, which allowed them to help about five more people than they originally planned.
Both Wur and Deng said the implant procedure caused them far less pain than the initial extraction.
"I knew it was a terrible pain, and I didn't want to go through that again," he said. "Now I am pain free."