The dental professionals who work at Community Smiles, a non-profit clinic and training institution in Miami, were shocked by the work an unlicensed dentist in Little Havana performed on a young girl earlier this year.
“When we saw what he did to her, it brought me and some of my colleagues to tears,” said Dr. David DePorter, director of dental programs. “She suffered horrific trauma.”
Last week, City of Miami police officers arrested Humberto Francisco Pérez for providing dental care without a license and causing permanent damage to the girl, who is now 15, from his home clinic in February.
The young victim is now in the hands of dentists at Community Smiles who say the repair work will take years, and there’s no guarantee of success due to the damage. The brutality of the case also resonated with leaders of the organization, which houses one of three post-doctoral residency programs in South Florida that train foreign dentists.
“The reason this case bothered me so much is because our own residents are working so hard to do things the right way, the legal way,” DePorter said. “Some were professionals in their home countries for more than a decade, but when they got to the U.S. they decided to do everything that’s necessary in order to become licensed to practice here.”
Claribel Agramonte, the victim’s mother, has said she believed that Pérez was a licensed dentist. According to her, Pérez said he’d been a dentist in Cuba for decades and offered to repair her daughter’s broken tooth for $500.
Agramonte, an immigrant herself from the Dominican Republic, said it didn’t seem so strange that Perez’s clinic was in a back room in his house.
“That’s something that you see pretty often in the Dominican Republic,” she said.
Instead of simply repairing the fractured edge of her front tooth, Pérez decided to do more without her mother’s permission or knowledge. He saw that the girl needed orthodontics and came up with a quick and painful fix. He drilled down her four front teeth until there was very little left, damaging the nerves in her teeth. Finally, he created a sort of dental bridge out of a metal compound he had melted himself.
The result: Four metal crowns with some type of porcelain or porcelain substitute, a cartoonish bridge that Agramonte described as looking like rectangular pieces of gum. It had been a painful process for her daughter, both during the visit and in the weeks that followed. Finally, when her daughter’s gums began to blacken, Agramonte sought help at a licensed dental clinic. The dentist there is also a volunteer at Community Smiles, and he referred her to the program.
The experience traumatized the young girl, said Dr. Peggy Alvarez-Panabad, chief resident at the advanced education in general dentistry program at Community Smiles.
“You barely put your hand near her mouth, and she begins to cry,” said Alvarez-Panabad, who is handling the case under the supervision of faculty. “Treating her is difficult not only for her, but for the dentist who is treating her. We try to make the environment as safe and comfortable as we can for her.”
At first, Agramonte reported that the shoddy dental work had been done in the Dominican Republic. Later, the dentists at Community Smiles learned she was afraid to report Pérez to authorities.
Alvarez-Panabad said other patients have come into the clinic with dental work that doesn’t quite meet U.S. standards. In those cases, patients say they received dental care in their home countries, often in the Caribbean, or Central or South America.
“But even then, we’d never seen anything so severe from another country,” she said. “This was simply brutal, the way you might treat an animal. And you don’t even do this to animals.”
Pérez isn’t the only unlicensed dentist arrested recently by local authorities. Last week, for example, police arrested John Collazos, who they say operated a clandestine clinic in a Davie warehouse district.
In both cases, Florida Department of Health (DOH) investigators worked with local police. Ashley Carr, a DOH spokeswoman, asked that those who know of or suspect that somebody is offering dental or other health care services without a license report the cases to her agency.
In this current fiscal year, DOH investigators have looked into 37 cases of unlicensed dentistry. In the past five years, the agency has investigated between 42 and 142 cases each year.
It’s unclear what kind of dental training Pérez, 81, received in his home country, Cuba. He now faces nine felony charges ranging from child abuse to practicing without a license, and is out on bond while he awaits trial.
DePorter said this case highlights the need for the public to know there are affordable alternatives to unlicensed care. This year, Community Smiles will provide approximately 8,000 patient visits to low-income individuals who receive care at little to no cost, depending on their dental needs and financial means. The clinic is handling Agramonte’s daughter’s case pro bono.
“Our mission is to serve the underserved and everyone associated with Community Smiles is committed passionately to this cause,” he said. “We are here to help those who don’t have the financial means to seek dental care in private practice.”
Alvarez-Panabad recognized that it isn’t easy for foreign professionals to obtain the certification they need in order to practice in this country. But she said it’s unacceptable to do the work without a license.
In her own case, Alvarez-Panabad emigrated from Venezuela 15 years ago to marry. In the process, she left behind a burgeoning career as a dentist.
As the years passed in Miami, she took English courses and trained to be a dental assistant and hygienist. There were some personal interruptions – like having and raising her young daughter – that also delayed her dream. But finally last year, Alvarez-Panabad entered the post-doctoral residency program at Community Smiles.
“It’s taken me several years to get to this point but I think you end up putting more value into what’s been a challenge,” said Alvarez-Panabad, who next year will qualify to take the state board exams to practice dentistry in Florida. “My experience here has been incredible. I wake up each morning happy to come in.”