Monday, July 21, 2014

USU Fellow Puts New Face on Dental Medicine

By Christine Creenan-Jones
Uniformed Services University of the Health Sciences

BETHESDA, Maryland, July 21, 2014 – Cancer, congenital disease, gunshot wounds and other trauma can transform faces into unrecognizable visages. Often, treatment -- or the injury itself -- leads to missing eyes, noses, ears and jawbones. Moreover, disfiguring facial wounds can also significantly impair daily functions, like talking, eating and breathing.

Treating these types of facial injuries can be challenging. It requires multidisciplinary collaboration between physicians, dentists, engineers and technicians who join forces to piece their patients back together.

Army Lt. Col. Cynthia Aita-Holmes -- a dentist who earned her master’s degree from the Postgraduate Dental College at the Uniformed Services University of the Health Sciences here as part of her maxillofacial prosthodontics fellowship at the Naval Postgraduate Dental School -- is part of this elaborate process at Walter Reed National Military Medical Center, also in Bethesda.

Aita-Holmes creates synthetic body parts from molds cast into silicone that are painted to match the unique characteristics of a person’s face. In best-case scenarios, the transition from skin to silicone is nearly indiscernible.

“I try to make my prostheses as close to perfect as possible because my patients have already endured so much by the time I see them. Hopefully, fitting them with a natural, comfortable prosthesis brings a little solace to their difficult recovery process,” she said.

Creating eyes that twinkle, ears that dip and fold in all of the right places and noses with the perfect bridge is equal parts science and artistry. That’s why Aita-Holmes uses both the left and right sides of her brain to make prostheses that are functionally sound but visually appealing.

“I had a patient who had the tendency to place her hand on the corner of her mouth to improve her speech with her prosthesis,” Aita-Holmes said. “One day, while out at her local grocery store, the cashier told her it was difficult to hear what she was saying with her hand over her mouth.

“My patient was happy when the cashier told her she couldn’t tell she was wearing a prosthesis,” she continued. “As her provider, I was thrilled, too. I want my patients to feel comfortable in their skin -- real or silicone.”

Across the country, a handful of military dentists like Aita-Holmes are maxillofacial students or practicing in military hospitals around the world. The field has become especially important over the past 12 years because thousands of service members have sustained facial wounds while serving in Iraq and Afghanistan. Although most combat veterans have been fitted with their first prosthesis already, a new one has to be made annually because daily wear-and-tear lessens functionality and authenticity.

Furthermore, cancer and congenital disease strike without restriction, making the need for maxillofacial prosthodontists imminent.

“I absolutely love what I do because I’m part of a team that delivers life-changing treatment,” Aita-Holmes said. “Personally, I can’t imagine a more rewarding and fulfilling career.”

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