Dr. Brian Hollander, longtime HVO volunteer, was traveling through Nepal in 1978 and saw a need for basic dental care and education. At the time of his initial trip, there were only thirty practicing dentists in the country of twenty-five million people. At the time there was no good way for the expatiate community to access dental care, and they had to travel to Bangkok or Singapore. Because of this serious need, the American Embassy asked if Dr. Hollander would stay to practice dentistry. He said, “If you build a clinic, I’ll stay.” They built a clinic, Dr. Hollander stayed to provide care, met his wife, and remained for thirty years. His son, Dr. Jesse Hollander, was born and raised in Nepal until he was sixteen years old. In 2013, Dr. Hollander was excited by the opportunity with HVO to develop a sustainable oral health project in partnership with his former Nepali colleagues. Now, both Hollanders return frequently to Dhulikhel Hospital in Kathmandu as volunteers at the dental school. Dr. Jesse Hollander has also brought his wife, a pediatric dentist, and his young daughter.
On their most recent trip, the Hollanders, along with three of Jesse’s colleagues, Dr. Andrew Phillips, Dr. Clark Brinton, and Mr. Michael Gordon, arrived at Dhulikhel with a 3D printer and scanner they generously donated along with enough resin for several months of use.
They dedicated the ten days of their stay to training local dentists on the use of the printer, including organizing a symposium for fifty dentists on site. Jesse noted that the number of attendees of this one conference exceeded the total number of Nepali dentists practicing in the whole country when his father first visited—a notable improvement in access to care.
3D printing is still relatively new technology for dental practices, even in the United States. In July 2022, Dr. Jesse Hollander, Dr. Clark Brinton, and Michael Gordon launched their own company, 3D BiteLab, to help dentists all over the world more easily incorporate 3D printing into their practice by providing custom designs, recommendations, and trainings. 3D technology can be used to make dentures, surgical guides, and prosthetics, among other things, for a fraction of the cost in a fraction of the time.
The dramatic decrease in cost and time is a major step towards broader and easier access to quality dental care. For patients waiting on conventional denture fabrication, it could take a month before their dentures were available. Now, that process takes a single day, making things infinitely easier for those who have to travel far distances from rural areas. These travelers can now simply stay overnight and return home the next morning, dentures in hand, with no need to make another long, return trip weeks later. The printer is also portable and can be packed into a truck and taken to remote areas to serve patients on site.
In addition to making prosthetics and procedures simpler and more cost effective, the fact that a digital design exists for patients’ dentures means that if anything happens to one—it is lost, gets cracked—there is a digital record of that design, making it easy to print a patient a new one quickly and easily.
Printing dentures, surgical guides and hybrids were the main focus for this trip, as they can take a long time to make and are a common need, but the printer has many other uses. For example zygomatic implants, which are needed when there is not enough bone for a regular implant, must be stabilized on the same day they are implanted or very soon thereafter for maximum chance of success. Before 3D printing, it was difficult to get all the necessary pieces of the procedure in place to meet that timeline. Now, it is easy to perform a digital scan, use the 3D printer to create the prosthetic quickly, and get it screwed into place, all in one day. The team was able to complete two zygomatic implant surgeries and immediate prosthetic deliveries while they were on site.
Dr. Dashrath Kafle, HVO’s on-site coordinator, had some previous experience using a 3D printer, which helped the training process. The Hollanders and their team found that the local dentists were eager to learn more about the technology and its use and were happy to stay late to maximize learning opportunities.
They were able to learn the necessary skills in just a week. “This trip was a lot different from previous trips,” Jesse says. “Those were more structured. This was a fun chance to give them more choices on training. It encouraged them to stay longer and absorb more.”
Along with the symposium, the team worked with local dentists using chair-side training and hands on activities, getting dental records, taking impressions, and converting them to digital designs. They performed the full workflow, start to finish, on two dentures, two zygomatic implant cases, and two implant crowns. Teaching went both ways—Jesse learned some new techniques for taking impressions even as he was teaching others.
“The whole goal of a volunteer trip is to establish a mutually beneficial relationship,” he says. Ideally, everyone learns something from one another.
3D BiteLab puts that philosophy into practice by hiring Nepali dentists as digital designers and provides virtual training six nights a week, walking trainees through different cases and answering questions. Jesse is a proponent of virtual education: “Digital technology helps us stay connected and keep teaching even though we are halfway around the world.” At Dhulikhel, he and HVO volunteers started a WhatsApp group with twenty of the local dentists so that they could continue to have open communication available for consultations even while on different continents.
3D printing is still in its infancy in the oral health sphere, and Jesse expects it will continue to grow as resins improve and access increases. Oral health as a whole, both in the U.S. and abroad, will benefit greatly as providers are able to offer more services in-house for faster, cheaper, high-quality results. “Digital workflow is becoming the standard of care,” says Jesse.
As for the future, the Hollanders intend to continue traveling to Nepal with HVO as frequently as they are able, bringing more volunteers and focusing on partner needs. Jesse would like to return annually. “For me,” he says, “coming from public health into private practice, it’s been really rewarding to be able to give back and get back into what excites me and why I got into dentistry.” He and his colleagues from 3D BiteLab funded the donation of the first 3D printer themselves, and they hope to get others excited enough about their work to donate, helping them continue to supply the Dhulikhel dentists with resin and eventually purchase a second printer.
Jesse encourages others to volunteer or donate: “I want people to realize there’s more than making money. There’s so much more we can do and give with the skill set we’ve got.”
If you would like to support their goal of providing 3D printer resin and two more printers to the dentists in Nepal, visit his fundraiser here:
3D Dental Equipment Fundraiser for Nepal
If you are an oral health professional interested in volunteering with one of HVO’s projects, contact HVO recruitment specialist Lauren Franklin for details.
To learn more and hear from the volunteers themselves, watch this video they created during their recent trip to Nepal: