Volunteers help thousands at Calif. free clinic

More than 6,000 patients, most of them seeking dental care, packed a free seven-day clinic held in Los Angeles last week, at times overwhelming the 250 dentists, oral surgeons, hygienists, and dental assistants who volunteered their services. Is this a sign of things to come for other states that have cut Medicaid benefits?

"It's pretty chaotic, but it's controlled chaos," San Gabriel, CA, dentist Daniel Cheng, D.D.S., told DrBicuspid.com during a break on April 30 -- a day he treated 600 patients.

Due to the sheer volume, patients were limited to one procedure. And the sponsoring organization -- Remote Area Medical -- fell short of its goal because of a shortage of volunteer medical professionals.

"I promised everybody they could get one treatment. Some have 20 cavities, so I have to ask, 'What's your priority? Whatever bothers you, I'll take care of it,' " Dr. Cheng explained. "If we can save a tooth, we'll save it."

More than 4,000 dental patients were treated at a free clinic held at the Los Angeles Memorial Sports Arena, April 27-May 3. Image courtesy of Remote Area Medical.

He was one of about 250 dentists, oral surgeons, hygienists, and dental assistants who volunteered to perform prophylaxes, extractions, fillings, and root canals on more than 4,400 dental patients who went to the Los Angeles Memorial Sports Arena April 27-May 3 and waited in line for hours -- some even overnight. Nondental procedures were also offered, including mammograms, Pap smears, and vision care.

"There are a lot of great people here," Dr. Cheng said. "The doctors really want to work; they're not here for an easy day. I really appreciate that."

Remote Area Medical, a global nonprofit organization, conducted the free clinic to provide medical, dental, and vision services to the underserved. This year, the volunteers provided medical services to 6,619 patients, up from 6,344 last year. In total, some 16,120 medical services were provided during the weeklong clinic.

Growing need

The clinic opened each day at 6 a.m. All 90 dental chairs, including five specialized areas for root canals, were immediately filled and stayed that way all day long, Dr. Cheng said. However, news reports noted that because fewer-than-expected volunteers turned out for the event, many dental patients endured long delays and some were asked to return another day.

Three oral surgeons performed root canals, Dr. Cheng said. About 30 were done on April 30 alone, many by an "amazing" surgeon who particularly impressed Dr. Cheng. "She was taking teeth out pretty fast -- faster than I could set up the chairs," he laughed.

Laurel Bleak, R.D.H., B.S.D.H., president of the Los Angeles Dental Hygienists' Society, said that all 30 hygiene chairs were full while the clinic was open. Most of the procedures were prophylaxes, extractions, and fillings, but many patients wanted prosthodontics and dentists did some partials, she said.

"The need is just overwhelming," Bleak told DrBicuspid.com. "One guy hadn't had his teeth cleaned in 20 years."

Volunteer hygienists cleaned thousands of teeth during the weeklong clinic. Image courtesy of California Dental Hygienists' Association.

Bleak was appalled at the condition of many patients' teeth.

"There was some really bad perio disease, and broken, split, and abscessed teeth. Just talking to patients, I saw mouths full of loose teeth; such recession, exposed roots, and brown deposits," she said. "It was hard to look into a mouth and see all this operative work and be able to do only one procedure."

Several people needed extractions but declined them because they couldn't afford dentures or implants, Bleak noted.

Most of those who showed up were working-class people who didn't have dental insurance, had insurance but couldn't afford the deductible, or whose insurance didn't cover the procedures they needed, she said.

One woman in her 30s who used to earn a good living told Bleak she's been out of work for two years. "She used to take good care of her teeth, but she hasn't been able to get dental care," Bleak said. "This is the story of so many Americans: She just couldn't get what she needed."

Denti-Cal, California's version of dental Medicaid, was eliminated last summer, leaving the poor with almost no access to dental care, Bleak said.

"With underserved populations, they can go to the emergency room [ER] for medical emergencies, but there's no ER for dentistry; there's nowhere to go," she said. "A lot more people are in dental distress because it's been a long time, and they've had fewer clinics to go to. It's tough out there."

15 teeth removed

Louis Tieu, D.D.S., M.D., traveled from San Francisco to Los Angeles on April 30 to volunteer for the day after receiving an e-mail from the California Oral and Maxillofacial Surgery Group seeking recruits.

"They didn't have anyone available that day, and I was able to take time off so I flew down for the day," Dr. Tieu told DrBicuspid.com.

He treated about 25 patients, mostly doing extractions.

"Most patients had teeth that couldn't be saved," Dr. Tieu explained. "A lot were in pain and needed extractions as soon as possible."

A young patient smiles after getting her teeth cleaned. Image courtesy of California Dental Hygienists' Association.

The most egregious case was a man in his 30s who needed to have 15 teeth removed so he could get dentures made. Dr. Tieu removed them in an hour.

"All his teeth were very loose. He was waiting for the extractions so he could get his dentures made, and he could move forward," said Dr. Tieu, who has volunteered in community clinics. "Now he'll really be able to smile again."

"It's not the ideal situation -- there's no privacy -- but they just need to have the work done. Many traveled far and had to wait a long time," he said.

All three volunteers agreed that it was very satisfying work.

"People are just so grateful that they got a toothache taken care of or their teeth cleaned," Bleak said.

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