Some New Brunswick dentists are doing pro bono work for Syrian refugees, because they say a mouth full of disease and decay is no way to make a fresh start.
"It's to give them a fair chance," says Dr. Mike Ramey, a Fredericton dentist who has pledged to provide one year of comprehensive care to several Syrian families making up 33 individuals.
"So that they're able to focus when they're taking English language training," he says.
"So that if they find employment, they can show up for work, without having to take sick time."
Throbbing pain from chronic and flaring infections has driven Syrian patients to New Brunswick clinics, in tears.
Dentists in this province say these adults and children have some of the worst cases of dental neglect that they've ever seen.
"It's just about as bad as you can imagine dentistry getting while the patient is still alive," says Ramey.
Ottawa's interim federal health program, which covers refugees, only pays for urgent treatment, such as tooth extractions.
It doesn't cover cleanings, preventive or restorative dentistry. It also doesn't pay for orthodontic care.
Even when dentists are performing an insured service on Syrian patients, it's unlikely to happen in the budgeted time, says Saint John dentist, Dr. Bella Panjwani.
She says the language barrier is a serious challenge when it comes to getting informed consent.
Working with a translator is better, she says. But it also eats up time.
And it doesn't always work.
Recently, Masad Alsharari, a Saudi student studying business at UNBSJ was at Panjwani's clinic trying to gently persuade a female patient, in Arabic, that she should have an abscessed tooth removed.
"But she was too afraid to open her mouth," says Panjwani. "He kept talking to her for an hour or maybe two hours but we couldn't finish."
Some dentists try to schedule evening appointments to accommodate sponsors who can only volunteer their time after work.
Finding transportation to and from appointments is a constant problem, says Alsharari.
Tuesday evening, March 15, CBC News waited at Panjwani's clinic, along with Alsharari, for two Syrian patients who never appeared.
It was later explained that they had had five needles that afternoon and didn't feel well.
Panjwani shrugged it off, with good nature.
"You can definitely waste a lot of time," she laughs.
"And you have dedicated that hour or half hour, 45 minutes, and they don't show up, it definitely affects your whole office system.
"But that's what it is, right now," she concludes with a smile.
Panjwani says it takes patience and compassion to remember that coming to Canada is almost certainly overwhelming to people who didn't choose to uproot their lives to be here.
Even for those who do choose to immigrate, the change can be overwhelming says Panjwani, who immigrated to Canada in 2002, along with her oncologist husband.
In their native India, she volunteered to help feed children in the slums.
Now she sees her dental outreach as another form of public service.
And she says, as a foreigner herself, she can relate.
"I exactly understand their feeling," she says. "And I know how the stress is."
It's not clear how many dentists in New Brunswick have offered their services, with the understanding that the language barrier does make the work more complicated and that some of their time will likely go unpaid.
Panjwani and Ramey say they know others who are stepping up and they'd like to see more.
In spite of some pleas by officials this week to slow the pace of Syrian arrivals, the province has confirmed it's moving ahead to meet its target of 1500.
Ramey says more hands will make lighter work.
He says this is a rare opportunity for dentists to help accomplish bigger things.
"I believe in what we're doing," he says. "I believe that these 25,000 refugees that our country has agreed to sponsor, and the costs associated with that, is going to do more to end the war on terror, than dropping the same value in bombs over in the countries that they're from."
"The way to respond to the aggression and the war and the killings is to do the exact opposite, which in my mind is to be compassionate and generous."