By Megan McCloskey
Stars and Stripes Pacific edition

Airman Richard Sandoval follows an instruction book as he carves the anatomy of a tooth into a wax mold that will eventually be used to make a crown at the Area Dental Laboratory on Kadena Air Base, Okinawa. (Stars and Stripes photo)

KADENA AIR BASE, Okinawa -- It's a mixed-medium artistry — wax, porcelain, metal and even a little gold.

A craftsman painstakingly sculpts the piece of tiny proportions, with the final creation resting not in a gallery but in someone's mouth.

At the 18th Medical Wing dental laboratory on Kadena, crowns, tooth implants, bridges, veneers, dentures and other dental products are crafted for patients throughout the Pacific theater. The lab -- known as an Area Dental Laboratory -- serves a population of about 180,000 -- a workload that came out to about 2,500 devices at a value of $494,000 last year alone.

In addition to the ADL at Kadena, there are two others in the Air Force. One is at Peterson AFB, Colo., and one is at Sembach AB, Germany. The ADL in Germany is being phased out.

Under glaring lights, technicians in blue lab coats wield small tools as they fastidiously carve the unique anatomy of a person's tooth into a wax replica or apply porcelain on a metal base to mimic the look of a natural tooth.

Stacked around their work areas are yellow bins, in-boxes of sorts with teeth casts, bite specifications and other characteristics of the patient's mouth. Each workspace has an almost sinister-looking tool called an articulator that allows the technician to simulate the movement of a patient's jaw. This helps them figure out how the smile line looks and where the upper and lower jaws meet.

"There's a lot to factor in," said lab commander Lt. Col. Villa Guillory. "It takes good carving skills and an eye for color to create the size, shape and texture of someone's tooth."

Crowns, for example, first are carved in wax. Then a mold is made for the metal substructure, and that is topped with either gold or porcelain. The end product needs to feel like the patient's real teeth.

Technician Terrance Hopson, one of 22 techs in the lab, said fabricating pieces for the mouth takes a fine eye for detail. With such specific measurements -- on a scale of thousandths of millimeters -- there is little room for error.

"You have to be pretty exact," he said as he polished a gold crown with the skill and ease of someone who has been doing it for years.

Across the aisle, Airman Richard Sandoval sat hunched over with his face close to an instruction book on how to carve the anatomy of tooth. He hesitated before each stroke, lacking the rhythm of Hopson and other more experienced techs.

"Right now I have to go step-by-step like the book shows me. I don't have my own technique or style yet," Sandoval said, adding he has been at the job for less than two months.

Master Sgt. Bob Czupryna said it takes about five to six years for a technician to become truly proficient at fabrication.

"Some have talent for different things," Guillory said.

The ceramics aspect is reserved for the experienced because matching the color of the patient's teeth is one of the trickiest parts of the job, she said.

Tech. Sgt. Sarah Bullard said it took her three years in the wax and metal department before she got a shot at working with porcelain.

"Artistry really comes into play," Guillory said.

Hopson said his three sons get a kick out his work, often asking him: "How many teeth did you make today?"

Note: Used with permission from the Stars and Stripes. @ 2006 Stars and Stripes.