Neena Patel tells the kinds of stories that make your mouth hurt. She’s a dentist with Miles of Smiles, a nonprofit organization offering free services to low-income kids in Clay and Platte counties who don’t have access to dental care. She regularly sees young patients who haven’t been to the dentist in years – or ever.
“We had one case where the child needed to have every single tooth extracted – all 20 baby teeth,” she says. “It was like nothing we could even try to salvage. What do you do at that point? She was only five years old. It hurts my stomach sometimes when I see those cases.”
A kindergartener with a mouth full of decay may sound extreme, but Patel sees similar situations in her chair every day – kids with gum disease, damaged teeth and countless cavities who have been living in pain. Some of their parents can’t afford dental care, and others simply don’t know the importance of oral hygiene – or if they do, it is often lower on their list of priorities than other essentials like groceries, gas and medical care.
“Many parents just think, ‘I grew up having cavities, so now my kid is going to grow up having cavities,’” Patel explains. “A lot of people don’t realize it’s what you feed kids that causes it. These parents are so grateful because they just didn’t know. It’s as much about educating the parents as treating the kids.”
Part of that education – which includes attending church fairs, community events and back-to-school nights – involves getting parents up to speed on the long-term consequences of undetected tooth decay and infection. According to a needs assessment conducted in 2000, the second-biggest need in the Northland was dental care for low-income children. Miles of Smiles was created two years later. Since then the organization has treated more than 19,000 children, both in their North Kansas City office and through mobile clinic visits to about 40 area schools. Access to free dental care has given thousands of children the chance for a healthier adulthood.
“[Untreated tooth decay] can lead to heart disease, stroke and diabetes,” says Christy May, executive director of Miles of Smiles’ since its inception. “Most importantly, when your teeth are hurting, you don’t feel confident. When you don’t get your smile fixed, maybe you don’t get a job, or you don’t smile for your yearbook picture. All of those things are important as kids grow up to feel good about themselves and what they’re doing.”
The most significant part of Miles of Smiles’ outreach is its mobile clinic, which sets up for two to three weeks at each school it visits and treats approximately 40 to 70 kids at a time. The clinic is equipped to provide dental cleanings, fillings and other basic restorative care. Patients requiring additional attention are referred to Miles of Smiles’ permanent location. The mobile clinic offers another chance to teach kids and parents the importance of dental care.
“Each kid whose parent gives consent to treat them in the school gets oral health education and an oral health kit,” May says. “They go home with a toothbrush, toothpaste and floss. When we’re at the school for two or three weeks we’ll see the kids three or four times. It’s nice because they don’t have to leave the school, so they don’t have to miss classroom time. They just walk down the hall, go to the dentist and go back to class.”
Miles of Smiles reaches additional patients through partnerships with community organizations like Synergy Services, a Parkville shelter for homeless and runaway youth. According to Synergy’s Amber Smedley, a lot of the children she works with have traumatic stories and have “been through a lot.” Trust can be difficult for them, so they’re hesitant to get the dental care they often desperately need – but Miles of Smiles’ dentists make it a little easier.
“Miles of Smiles is familiar with working with the population we serve,” Smedley says. “Our kids not being seen in some upscale dental practice that they don’t feel welcome at is really beneficial to us. Initially they hate [going to the dentist], but afterward they’ll say they’re really glad I helped them through that.”
It’s not easy to convince younger kids who are unfamiliar with the dentist to let a stranger poke around in their mouths. May recalls one first grader who had never been to a dentist and was so anxious about his first visit that he crawled under the table and would not come out. Instead of trying to coerce him, the dentist got down on the floor and gently spoke to him.
“Our dentist told him that he hoped he would come up in his chair and let him count his teeth,” May says. “He thought that was pretty terrific, so they had him come back the next day, and they took X-rays and polished his teeth. The next day he came back and had a couple cavities filled. He probably felt so good. He probably had been in pain and wasn’t even sure what to do about that pain, and every day from the time they saw him from the very last day they left the school, that little boy came by for a hug. They had established such a great relationship with him and made him feel better.”
The clinic continues to grow – last October, it relocated to a 2,500-square-foot office that has three operatories instead of two, and they’ve seen a 25 percent increase in patient volume. They’ve also started offering online registration that can be accessed via smartphone. But with more than 25,000 kids in their service area meeting income guidelines, May says they still struggle to reach everyone who needs their help.
“It’s a different mentality when you work with children in private practice versus children that just want to be helped,” Patel says. “Their teeth are hurting, and you fix one side and they’re like, ‘Can you do that to this side?’ We had one little girl that was like, ‘I’m so tired of coming here, but I just want my teeth to not hurt.’ The parents and the kids are so grateful most of the time.”
KCUR contributor Angela Lutz is a freelance writer. She can be reached on Twitter @amLutz.