The poverty was shocking. Nothing in Connecticut prepared Trumbull resident Dr. Gregory Mokotoff for the reality of life in a remote area of Guatemala, where the Trumbull dentist recently spent a week volunteering in a dental clinic. He and nine other dentists along with a handful of assistants were up at dawn to catch a 7 a.m. bus to a clinic, where they spent the next 12 hours treating as many as 150 patients each day. "It's overwhelming," Mokotoff said Monday, a few weeks after his return from the Esquipulas, a town of about 60,000 about a six-hour drive from Guatemala City. "There are people living in fields. Families living under tarps in garbage dumps, scavenging whatever they can sell. Survival for many of these people is a day-to-day struggle. They are as poor as poor gets." Mokotoff, who has lived in town for 11 years, specializes in pediatric dentistry, although he and the others treated anyone who came through the clinic's doors. The trip was organized by the group Dentists Donating Service (DDS) International, a community service group. Mokotoff was one of nine staff members, including dental assistants and hygienists, from Kids First Dentistry, along with three other dentists from Waterbury and six more native Guatemalan dentists to spend a week at the DDS mission. "For 12 hours a day, we were doing everything," he said. "Filling cavities, extractions, normal cleanings, the demand is massive." Part of the reason for the high demand is the poverty in the area. The inhabitants' poor diet and lack of access to basic care means that many problems go untreated, he said. "You just have to do the best you can," Mokotoff said. "And when you're done, you feel good because you're helping people in need. But at the same time, you're sad because there is so much need."