For 42 years, the only food that Maria could eat was what her two teeth could grind down, and all she could say were the few sounds that she could form with a gap in the roof of her mouth.

Countless meals left on the plate. Countless thoughts left unsaid. For far too long.

Maria was willing to do whatever it took to access the care that she needed. Even a 10-hour journey from her village to the clinic in Managua, Nicaragua, couldn’t deter her.

When she arrived, Operation Smile Nicaragua and the Exchange for Smiles team were ready and eager to help.

During its first-ever combined dental and surgical medical mission in March 2019, Operation Smile Nicaragua teamed up with a cadre of second- and third-year students from the University of North Carolina at Chapel Hill Adams School of Dentistry.

The team not only provides the highest quality of care to their patients, but also mentors the next generation of dentists.

“Our program employs a direct exchange: one UNC student paired with one Nicaraguan dentist,” said Ryan Cody, a fourth-year UNC dental student and founder of Exchange for Smiles. “At the end of the day, it’s the exchange of knowledge and resources for the gift of a smile.”

Maria’s care exemplifies the special dedication and devotion of this partnership.

By rallying together, the teams treated Maria’s two teeth, which had become infected over the years, and created dentures that would allow her to chew easier, eat better and smile bigger.

“We worked endlessly, Monday through Friday, fabricating dentures. We were nervous that we wouldn’t finish, as the denture fabrication process in the U.S. can take months,” Ryan said. “However, with teamwork, close communication and incredible laboratory support, the moment we were waiting for arrived.”

For the first time in many years, Maria got to enjoy her meal – a meat dish with rice – thanks to the dentures that the team had crafted for her.

Ryan said that by the end of the March mission, they had educated and treated 250 more patients just like Maria.

This included a combined 732 dental consultations and procedures on top of the 230 dental patients that the partnership treated during its first Exchange for Smiles mission in March 2018.

Ryan’s Exchange for Smiles journey started when the longtime Operation Smile student volunteer pitched the idea to his mentor Dr. Bill Magee III, the son of Operation Smile Co-Founders Bill Magee and Kathy Magee.

Using the guidance and encouragement he received from the Magee family, Ryan boarded a plane to Nicaragua and presented his proposal to the executive director of Operation Smile Nicaragua. Ryan’s proposal earned him the support of both Operation Smile Nicaragua and UNC.

After fundraising to cover dental equipment, Ryan headed back to the country to purchase equipment as a contribution to the center and an investment in the program.

Empowering two teams of students and mentors to treat Maria and more than 500 patients like her was the dream.

The guidance and mentorship of Teresita Pannaci, Operation Smile volunteer dentist from Venezuela who took part in both Exchange for Smiles missions, also served essential roles in the program’s educational effort.

As a functional orthopedic maxillary trainer, Teresita teaches fellow volunteers in multiple countries around the world. Her creation of a doll named DAM simulates the experience of a newborn living with cleft palate and helps students practice taking intraoral impressions.

“Exchange Smiles is a wonderful program with a powerful title,” said Teresita, who’s been a volunteer with Operation Smile since 1993. “In the end, the results exceeded my expectations. The excellent students of UNC, their participation, talent and commitment have favored the community of Nicaragua.”

The cornerstone of the Exchange for Smiles program is education. The dental school students learn from their mentors, but most importantly, the dental school students are given the opportunity to use what they have learned to teach oral health and hygiene skills to patients and their families.

For second-year UNC dental student and vice president of Exchange for Smiles Celeste Kendrick, the importance of oral hygiene instruction was one of the biggest lessons she took home from the experience.

“Some patients told us they had never been taught that brushing their teeth would help prevent oral disease and pain,” said Celeste. “They thought it was a natural, unavoidable part of life.”

When looking ahead to the next steps of its own education, the Exchange for Smiles experience has helped to calibrate the compass for both Celeste and Ryan.

“After being on a mission with a dental lens, I left slightly overwhelmed, yet motivated, after seeing firsthand how much need there is for dentistry post-surgery,” Celeste said. “This trip helped renew my purpose as a dental student and allowed me to see how important my education truly is.

“There are patients who need help, and though it may not seem like we’re making a difference by studying, they rely on us to do our part and become the best providers we can be.”