What happens to your mouth when you’ve never been to the dentist? Molly Wolfes can tell you. Puente’s Community Health Coordinator knows a woman who discovered it was so expensive to pay for an extraction, she decided to pull her own tooth. Another man had such advanced tooth decay, he came home from a day of free dental care with three teeth gone. They were too far gone to save.
Ever since she began work to establish Puente’s highly successful medical clinic, a satellite of San Mateo Medical Center’s Coastside Clinic in Half Moon Bay, Wolfes has also been campaigning for a mobile dental clinic to serve the communities of Pescadero, Loma Mar, La Honda and San Gregorio. No dental office exists anywhere on the South Coast, and many low-income residents lack both transportation to a dentist and the means to pay. Tooth decay, left unchecked, can lead to other medical problems, as both dentists and patients know. But without insurance, a deep cleaning alone can cost a thousand dollars, says Wolfes.
As a result, “A lot of times the treatment is based on cost, not need,” she says. “I think a lot of patients have had some pain, but they haven’t gone to dentist. They think, ‘I’ll treat that when its bad enough I can’t eat.’”
Not anymore. A new grant-funded partnership between Puente, Apple Tree Dental and Sonrisas Community Dental Center of Half Moon Bay is bringing world-class dental care directly to patients on the South Coast. Once a month, Puente’s childcare center in Pescadero is transformed into a professional dental office complete with reclining chair, x-ray machine, mobile lighting and suction boom. Everything is on wheels. Apple Tree Dental, which recently affiliated with Sonrisas, has a computer system to input patients’ dental records. And patients are charged just $25 per visit.
As word spreads in the community, up to 12 patients line up for a dental visit each month. By the end of the year, Puente will have logged 150 patient visits. The program exists thanks to a grant from San Mateo County’s Health Care for the Homeless/Farmworker Health Program, which in turn receives funding from the U.S. Health Resources and Services Administration. Apple Tree has made a number of in-kind donations too.
But the need exceeds the grant funds, says Dirk Alvarado, Executive Director of Sonrisas. It will take years to address problems that call for surgeries or reconstructive care, and to bring patients back into a state of overall health. Sonrisas, a nonprofit, will need to raise at least $20,000 to cover the gap. Sonrisas serves 1,400 adult patients a year, and also screens 1,400 schoolchildren from two Coastside school districts.
Alvarado remembers an earlier effort to bring dentistry into the field – literally. Back in 2014, Puente helped Sonrisas visit a few Pescadero farms during working hours. The dental “office” was an ad hoc folding chair in a tractor barn. “We knew we were onto something,” he recalls. “It cut down a lot of the barriers for the workers as far as losing productivity to travel to the dentist, and it helped the farmers because it was one less thing their workers had to worry about.”
He cringingly remembers how urgently those workers needed dental care. “The pain would be so bad, in their mouth and their teeth, they would be in tears.”
Dr. Dick Gregory, the San Mateo Center Director of Apple Tree Dental (and coordinator of the affiliated site in Half Moon Bay), has observed that dental decline can also lead to long-term self-esteem issues. “Sometimes, people that have not had access to dental care are ashamed of their smile. To smile unselfconsciously is not something they take for granted,” he says. “And when they finally can, that’s something that just lights you up.”
As dentists do triage, Puente has launched a simultaneous initiative to educate local residents about what it takes to maintain a happy mouth. Puente’s team of community health workers, also known as Promotoras de Salud, are going door to door, showing people the correct way to floss and brush, describing the warning signs of tooth decay, handing out free toothbrushes and dental floss – and of course, making appointments at the dental clinic.