Giving Time, Giving Smiles

All year, all across America, dental professionals and dental suppliers donate time and equipment at mobile clinics for uninsured kids and adults. Here’s how the industry’s benevolence is saving smiles, stopping pain and changing lives.

Patients begin lining up for free oral health care in the dark of night, often days before the opening of a temporary clinic staged with life-changing rows of dental chairs. Volunteer dentists use donated equipment and supplies to perform extractions, root-canal treat­ments or denture fittings. Grateful patients flash rehabilitated smiles or even shed tears of joy.

What may sound like a scene from an overseas medical mission to an impoverished country unfolds in every state across America, where school gyms, sports arenas and convention centers are transformed into large-scale dental offices.

The undertakings allow altruistic dental professionals and suppliers to fill not only festering cavities, but the gaps in access to oral health treatment for scores of uninsured children and adults. Such efforts also provide referrals for a permanent dental home, even as some organizers advocate in Congress for a more comprehensive strategy for addressing neglected oral health needs.

“It’s not just those that are destitute, it’s actually the working poor who don’t have dental insurance,” said Bill Blasing, executive director of America’s Dentists Care Foundation, a Wichita, Kansas, nonprofit that organizes Mission of Mercy events. “Folks either aren’t given insurance by their employer or they can’t afford the premiums or they can’t afford the dental care.”

HELP FOR CHILDREN

Caries is the most common disease of childhood and also the most preventable. When children have untreated dental decay, they experience greater absenteeism from school and poorer academic performance. Yet half of all American children have never been to the dentist.

The Give Kids a Smile program began as a grass-roots effort that now recruits about 10,000 dentists a year to treat 300,000 children, typically in weekend events held each February. In all, 130,000 dentists and many more dental hygienists, dental technicians and dental students have treated 5.5 million children. Like at similar events, dentists are covered by their malpractice insurance while volunteering.

Jeff Dalin, DDS, who practices in St. Louis, organized the first event there in 2002 with only 15 dental chairs.

“We have skills that only we can use. Nobody else knows how to do this,” Dalin said. “These kids should be able to eat. They should have good self-esteem from nice looking teeth. They shouldn’t be in pain.”

Dalin said he got the idea after his local dental magazine published a list of overseas volunteer opportunities.

“I said, ‘Why are we going over there? Shouldn’t we clean up our own backyard first?’”

A year later, the program became a national movement thanks to backing from the American Dental Association Foundation. The foundation provides supply kits and a primer on how to hold the events, covering everything from patient liability waiver forms to publicity materials.

Major industry backers include Henry Schein, which along with its supplier partners has made donations worth more than $13 million. Colgate has given $800,000 in addition to about 300,000 toothbrush and toothpaste sets each year.

“You may have a family and they only have one toothbrush and there are five children,” said Reneida Reyes, DDS, MPH, a pediatric dentist in Brooklyn, New York, and president of the foundation’s board. “The corporate support that we get is critical. We wouldn’t be able to do it without it.”

TEARS OF JOY FROM GRATEFUL PATIENTS


At this mobile clinic in October, 1,300 volunteers — including more than 700 medical and dental professionals — treated more than 2,000 people in two days.PHOTO COURTESY OF CDA FOUNDATION

The dental volunteers who give up their weekends to help patients in need say their reward comes in the hugs, handshakes and kind words they receive from grateful patients. Here’s what some who have received free oral health care say about the experience:

“When you were done with one station, you waited a small moment for another chair to open up at another station. Not one person was judged. I didn’t have insurance and knew the work I needed would have cost at least $2,000 if I had insurance. They saved my life and I bet they didn’t even realize it. I am so grateful for the help and the kindness along the way. And I did cry while I was there, but tears of joy. And I would like to also add that I got the best dental service of my life.” — Melissa, who attended a Colorado Mission of Mercy event (Source: adcfmom.org)

“My kids think it’s fun to go to the dentist — they’ve learned how to brush their teeth properly, they get new toothbrushes and floss. Everyone there is so professional — they’re always willing to help. If they can’t provide a service, they figure out who can. I don’t know what I’d do without them.” — Chris, whose two sons receive care at St. Vincent de Paul in Phoenix, a 2016 recipient of a $375,000 grant from Healthy Smiles, Healthy Children, a program of the Foundation of the American Academy of Pediatric Dentistry (Source: healthysmileshealthychildren.org)

 Dalin said the scope of care varies by event but in St. Louis, children are offered full services. Appointments must be made in advance so children aren’t forced to wait in line. Over three hours, the young patients receive care and education, beginning with digital X-rays. Dental hygienists perform teeth cleanings and teach proper brushing and flossing skills. Most children require restorative work, which can mean root-canal treatments or multiple fillings.

Some patients are unforgettable. Dalin recalled a girl in middle school who required extensive work at the clinic.

“Then we get a letter from the guidance counselor thanking us. She was a child that would always show up at school disheveled, always in trouble, always in the principal’s office,” Dalin said. But after her dental treatment, her attitude changed and she began to finish her work and do well in class.

“She was in pain and nobody listened,” Dalin said. “She had no access to care. As soon as we got her out of pain, she became a model student.”

Demand for free dental care has not subsided despite the passage of the Affordable Care Act, which requires dental insurance for children but contains a loophole: parents are not penalized if they choose not to participate.

Organizers said that might be due to high deductibles for private insurance plans and the lack of a waiver for preventative services. Even for children who qualify for Medicaid, the government insurance for low-income families, it often has been a challenge to ensure that they enroll. For instance, even when parents left a Give Kids A Smile event with a list of Medicaid providers for follow-up treatment, their children often returned — untreated — to the next event. So now, for children who require too much work for one day, pediatric dentists will finish their care at no charge in their offices.

“We put in the letter that goes home with the child that we want you to find a dental home; here are possible places for you to consider going,” Dalin said. “Give Kids A Smile is not to be a permanent solution. We don’t want to become the regular dental office.”

But Reyes said without larger, systemic changes, some children will remain without access to care apart from charity events. She has been part of an advocacy group asking Congress to ensure that coverage is mandatory for children, noting that they are more vulnerable and don’t have the resources adults do.

“Happiness is a healthy smile,” she said. “Seeing children that have a healthy and pleasant smile makes me happy.”

HELP FOR ADULTS

For adults, Mission of Mercy events provide a wide range of services throughout the year that typically treat 1,500 people over two days. The nonprofit America’s Dentists Care Foundation started the first mobile clinic in Virginia in 2000. The movement has spread to every state, with the foundation providing equipment for rent and planning support. The group owns three semi-trailers equipped with the tools and instruments needed for a dental clinic. Two trailers can supply a 100-chair clinic and the third has 45 chairs for smaller events.

The charity has provided $130 million worth of dental care to more than 200,000 patients, although a number of other affiliated Mission of Mercy events are not included in that tally.

Blasing, the executive director, said he’s met patients who drive in from other states or camp out for days. Some have told him that unsightly or missing teeth have led them to suppress their smiles or forgo job interviews. Some parents also bring their kids for treatment.

“The impact is almost immeasurable,” Blasing said. “If you see someone get a set of dentures at a clinic, their whole countenance changes. There are so many tears of joy all the way around, from the patients to the doctors.”

Blasing said equipment and supplies are donated or purchased at a discount. For adults in need of more care, it can be a challenge to provide a lasting solution.

“What often happens if someone needs follow up care, a lot of these doctors will just hand them a business card and say, ‘Call my office next week and we’ll finish up what you need at no charge,’” he said.

Blasing said he’s heard that some dental industry professionals may be hesitant to participate because of concern about the quality of care provided. He said state-of-the-art sterilization equipment is used and sanitation protocols are in place to prevent the spread of bloodborne pathogens.

“I think it’s important that the rest of the dental profession understands that the need is there and recognizes that the dental profession is a profession with a big heart,” he said. “For folks who haven’t taken a look or gotten involved to see how well done it really is, we try to make it as close to an office environment as possible in a mobile setting.”

THINK DIFFERENTLY, THINK BIG

Dental volunteers say you can’t put a price on a healthy smile, but some • organizers do break down the worth of services provided during a mobile clinic weekend. At a 2014 Mission of Mercy event held at a community college in Troy, New York, more than 200 dentists performed 7,000 procedures worth an estimated $809,000. Here’s a look at some of what they did:

  • 1,044 comprehensive oral exams: $91,808
  • 473 extractions: $91,900
  • 34 crowns: $42,126
  • 32 interim partial dentures: $20,672
  • 192 applications of topical fluoride: $7,296
  • 143 amoxicillin prescriptions: $1,558

Source: nysdentalfoundation.org/mom.html

SUPPORTING LOCAL EFFORTS

Other charitable work within the dental industry focuses on providing funding to community-based organizations that provide dental care and preventative services day in and day out to those in need.

Since 2010, the Foundation of the American Academy of Pediatric Dentistry has given more than $3 million through its Healthy Smiles, Healthy Children program. That has amounted to helping 70 organizations in 26 states treat nearly 300,000 children. Last year, the program distributed $1.1 million.

One such recipient, Kid Smiles Pediatric Dental Clinic in Columbus, Ohio, received a $20,000 Healthy Smiles, Healthy Children grant in 2015. The clinic opened in 2012 and relies on nearly 400 volunteers to provide dental and administrative services, allowing children to have the continuity of a dental home.

The nonprofit organization charges $10 per visit and provides the comprehensive services found in any pediatric dental office. In addition to providing care, volunteer dentists and hygienists provide educational outreach at elementary schools and preschools. More than 20,000 children have attended presentations and received a toothbrush, toothpaste and dental floss.

In a variety of settings and through multiple efforts, the dental industry is providing major contributions of time, money and products. As a result, countless children and adults have the opportunity to avoid pain, and improve their oral health and their prospects for success in school or at work.

And organizers say volunteers are always needed.

Featured photo courtesy of CDA FOUNDATION

MENTOR June 2016;7(06):12–15.

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