Giving Back: "I Know This Works"
Spice Isle Smiles Brings Generational Change to Children in Grenada
Quick Bites:
- Spice Isle Smiles is a 501(c)3 nonprofit organization dedicated to improving and protecting children’s oral health throughout Grenada, West Indies. They provide school-based portable dental clinics providing comprehensive dental care to rural K-6 primary schools in coordination with the Grenadian Ministry of Health.
- The organization was established in 2017 and formally registered as a nonprofit in 2020 by Brian Holmes, DMD, MPH, FICD (Fellow, International College of Dentists) and his wife, Tammy Holmes, who serves as executive director.
- In early 2025, the Spice Isle Smiles team completed their eighth dental humanitarian project in Grenada, where visits were made to five K-6 schools. Three of those schools have been visited annually since the organization’s first trip to Grenada in 2017.
- Holmes’ treatment approach focuses on the generational change that comes from educating students about good oral health habits, properly and timely placed dental sealants, and restorations of carious lesions at an early age, with extractions being a last resort.
- “I know this works.” In their first year treating students at the Bonair Government School (274 students), the Spice Isles team had to remove 109 severely decayed, non-restorable permanent molars. In 2025, there was only one student with a molar that showed permanent decay, and it was successfully restored.
- To learn more, get involved or donate to Spice Isle Smiles at www.spiceislesmiles.org.
Brian Holmes did not set out to treat children in his dental practice.
In fact, he didn’t start out wanting to become a dentist, either.
Yet, today, he does both as the co-founder of Spice Isle Smiles, a 501(c)3 nonprofit organization dedicated to improving and protecting children’s oral health throughout Grenada in the West Indies.
It’s an irony that’s not lost on Holmes, a WSDA member. And it’s a career trajectory that has brought him and his family tremendous joy in helping others both at home and more than 2,000 miles away on an island in the Caribbean.
Coca-Cola Dreams
Growing up in a small Utah town, the child of a soda delivery driver (his father drove for Coca-Cola for 42 years), Holmes had frequent and easy access to sugary drinks in his own home. Like many children, he had hoped to follow in his father’s footsteps – until the day the public health dentist visited his school and passed out the now familiar red disclosing tablets.
The tablets revealed he had his own oral health challenges to address. But it was also a light bulb moment for him.
“I came home and told my mother I wanted to be a dentist,” said Holmes. “I also realized I could have as many disclosing tablets as I wanted if I was a dentist. It was a good turning point in my career decision.”
Inspired by his experience with the public health dentist, Holmes pursued (and achieved) his career goal. After fulfilling his service in the U.S. Marine Corps, he worked part-time jobs in sheet metal and as a night shift driver for Wilhelm’s Portland Funeral Home and Crematory while a student at Oregon Health Sciences University (OHSU) in Portland.
“OHSU was one of my top schools to go to. I looked in a catalog of dental schools and it showed the number of clinical requirements – I looked for the school with the highest required number. OHSU had the most at the time,” he said.
He and his wife, Tammy, visited the school on their honeymoon; they loved the Northwest and Holmes clicked with the school. While on the tour, he met with the dean, who strongly encouraged him to apply despite not having completed his bachelor’s degree. The rest, as they say, is history: For more than 33 years now, Holmes has handed out those same red tablets as a general practice dentist.
“I still have them in my office and hand them out to kids and adults,” he said.
Upon graduation from dental school at OHSU, he and his wife, Tammy, briefly returned to Utah. Despite its own natural beauty, the couple found “it wasn’t the Pacific Northwest.” They uprooted and moved to Hailey, Idaho, where his first practice was across the street from a Head Start school, the federally funded program that promotes school readiness for children from low-income families. The director asked if there was anything he could do for the children and their families.
“So, for one afternoon every month, I saw kids at Head Start. No charges, no billing,” he said.
More Than Toothbrushes Needed
Holmes continued to build his practice and help at Head Start, but once again, he and Tammy found the PNW calling them. They moved to Florence, Oregon in 2000 where he would practice for 24 years.
Again, it took just three months for the broader local community to seek his services as a dentist. This time, he engaged with the Mapleton School District, serving children from low-income families in a community hard hit by declines in the natural resource industry.
“We’d do exams and talk with the students about nutrition and good oral health practices. The first year, about 87 percent of the children we saw showed signs of decay. The next year, same thing – 87 percent rate of decay,” he said. “I realized just handing out toothbrushes wasn’t going to change that. We needed to do something more.”
"I realized just handing out toothbrushes wasn't going to change that. We needed to do something more."
He would go on to partner with Denny Saunders and Medical Teams International, who contacted him about working in the mobile dental van in Yachats, a small coastal town outside of Florence. A dentist from Lincoln City couldn’t participate, so Saunders was dialing for dentists. Holmes agreed and spent a Friday in Yachats – but got to wondering if a mobile dental van could be brought to the school in Mapleton to help resolve the issue of the students’ high decay rate. Saunders brought the van over and they went on to provide 45 days of free care over a 15-year period in the form of fillings, extractions, sealants and fluoride applications. Gradually, they saw less and less decay until in 2008, it was down to around 12 percent.
Holmes reached out to local service clubs for donations and was able to widen outreach to students in towns along the central coast of Oregon.
Left: A student looks on as her classmate receives treatment. Right: A Spice Isle Smiles volunteer comforts a patient.
By 2008, his practice was flourishing, and he was able to build a new dental office building in Florence and bring on a new partner for the practice. Again, another phone call came, but this time, the request was for help farther away. A group in Ohio, The Tandana Foundation, heard about his work and asked him to join one of their care visits to Ecuador.
“My daughter went with me the first time – we thought we would work with local dentists that work with Tandana,” he said. “After three hours, I took over because there was no infection control. They wanted us to clean teeth for adults and there were all these kids hanging around. That’s when I began to realize: If you really want to make a difference, you need to focus on generational change by providing dental care for kids.”
Holmes worked with The Tandana Foundation for five years, bringing the decay levels of five schools the organization visited annually down to 12 percent with the application of sealants, fluoride, nutritional guidance and teachers who promote good oral health.
“That really made a difference.”
Another Phone Call, Another Opportunity
It was yet another call from a friend, Otis Wade, who tapped Holmes for help, this time in the eastern Caribbean Sea on the island of Grenada. Nicknamed the “Spice Isle,” Grenada is a major producer of nutmeg, mace, cinnamon, and cloves. Wade grew up in Grenada and was moving back to the island with his wife, Amy, to serve his native community through humanitarian work.
Would Holmes like to help?
“We knew it worked other places – at that point we knew the supplies, portable equipment, and instruments we needed,” said Holmes.
"We have set up a protocol Henry Ford would be proud of."
He also knew things needed to be done a little differently. The Tandana Foundation did not establish relationships with the government in Ecuador, and that proved challenging to their care efforts, said Holmes. This eventually disallowed the foundation from providing healthcare services in the country (although they are permitted to provide other community support projects). This time, Holmes thought, it would be different.
On his first visit to Grenada, he and Tammy spent two weeks at three rural schools with decay rates of about 95 percent. Children do not go to public health clinics on the island; only adults.
“We talked with the Ministry of Education and established a good working relationship,” he said. “The very first year we went to Grenada and did a report to the Minister of Health, explained what we were doing – that we want to work for you, under your direction. We shared our results in other places. He asked us to write up a protocol and share what we do,” he said. Tammy Holmes provided a detailed description of their efforts for the government’s review.
The next year they went, the Grenadian government required all NGOs to follow specific protocols, which were word-for-word copies of the documentation provided by Tammy.
Slowly but surely, the Holmes team began drawing on the help of local physicians and dentists in Grenada, along with volunteers from the Pacific Northwest and across the U.S. (an average of 15 U.S. volunteers per week), to assist for the care visits each winter.
They established school-based portable dental clinics at six elementary schools (K-6); three of the schools have been visited annually since the initial trip in 2017. In 2020, Holmes used his time during the pandemic to obtain his master’s in global public health, while also taking steps to formally establish Spice Isle Smiles as a 501(c)3 nonprofit, which helps defer costs and secure donations. Tammy Holmes serves as the unpaid executive director; their son, Royce, serves as board secretary and daughter McKenna, a marketing professional, is also a volunteer.
Since then, Holmes, his family, staff, colleagues – even friends who aren’t in the dental profession — have all joined him for various visits to Grenada. And the program’s impact has been nothing short of remarkable.
During the first visit in 2017, students at all three schools exhibited a decay rate of approximately 90 percent. This year, the decay rate is down to 5-11 percent at each of the same three schools. The amount of time needed to treat students has also decreased, meaning the team can see more students and visit additional schools.
"You have a skill; people need that skill. Go find them and offer it to them."
But perhaps their most promising statistic yet: In their first year treating students at the Bonair Government School, the Spice Isles team had to remove 109 severely decayed, non-restorable permanent molars. In 2025, there was only one student with one molar that showed permanent decay, and it was successfully restored.
“We have set up a protocol Henry Ford would be proud of,” said Holmes. “And the teachers see we are not there to pull teeth – but to provide generational change so students have better overall health as they get older.”
‘You Don’t Have to Go Far’
For Holmes and his family, Spice Isle Smiles has become a fulfilling part of their personal and professional lives. But change is on the horizon.
The Holmes now reside in Ridgefield, outside of Vancouver, Wash., to be near their grown children and grandchildren. In October, Holmes began a new role as the inaugural director of the Nehalem Bay Community Health Center on the northern Oregon coast.
“I am excited for the challenge – I’m not ready to be done!” said Holmes. The plan is to spend three days a week in Nehalem – and this January, Holmes will again be gone for three weeks in January for Spice Isle Smiles. There are plans to add more schools in rural northern parishes of Granada in 2026 and 2027.
"Our goal as dentists should be to eliminate early childhood carries. It's the most prominent disease in the world. As dentists, we should never celebrate extracting permanent teeth."
They’re always looking for volunteers at Spice Isle Smiles. But Holmes says you don’t have to travel to exotic locations to share your talents as a dentist.
“If anyone wants to know how to do it – it’s easy. And you don’t have to go far,” he said. “Find a community here in Washington that is underserved and go help. You have a skill; people need that skill. Go find them and offer it to them. The reward is enough. It’s like the Mastercard commercial. It really is priceless,” said Holmes.
“I am a proponent of sealants; it takes 10 seconds and has a lifetime impact. Our goal as dentists should be to eliminate early childhood carries. It’s the most prominent disease in the world. As dentists, we should never celebrate extracting permanent teeth,” he added.
“Our profession demands more of us.”
A fully staffed sealant station.
This article originally appeared in Issue 4, 2025 of the WSDA News.
