Volunteer dentists and a patient at the Mission of Mercy free dental clinic. Photo by Jennifer Mornhinweg, Anglin Public Relations.

by Danny Marroquin

It was 10 p.m. on a Thursday night. Ice from the latest winter storm was just beginning to thaw, and the damp Tulsa parking garage was lit dimly by florescent bulbs and portable heaters. With doors set to open at 5 a.m. the next morning, already a line of four hundred curled around the yellow tape and metal gates.

A family from McAlester watched the line grow from a lower-level staircase. They walked to the end, where people huddled under coats, caps, and fleece and rested on air mattresses. The bundled-up girl held mom’s hand while they talked. Dad didn’t want to stay, mom did. Others were having the same discussion. Wait or don’t wait? This trio walked to the front and then returned to the back of the line. They’d stay.

What brought the crowd on this cold night was free care at the Oklahoma Mission of Mercy dental clinic. The two-day clinic, held February 5-6 and co-sponsored by the Oklahoma Dental Association, the Delta Dental of Oklahoma Charitable Foundation, and the Oklahoma Dental Foundation, brought volunteer dentists from across the state to provide everything from fillings to root canals. Participating dentists were in noticeably good spirits.

“All egos are checked at the door,” said one Norman orthodontist.

Anyone who waited could gain entry to the Tulsa Convention Center for that much delayed trip to the dentist. And people needed it. By the end of the weekend, 1,805 patients got treated for a total of $850,000 worth of services, according to Jennifer Mornhinweg of Anglin Public Relations.

“We‘re all working people here,” said Michael Hardesty, 38, a self-employed carpenter and handy man out of Sand Springs.  Since leaving a bigger company to work for himself, Hardesty has had to forgo dental care. He sat at the front of the line with other friends and family who’d been organizing this trip for months. They had been there since noon Wednesday.

Hardesty said work is steady. He knows his clients well and advertises for new ones on Craigslist, but he still cannot afford dental care for his family.

“You have so much else to pay for – clothes, bills – that dental gets thrown aside,” Hardesty said. “It’s not immediately threatening so you just deal with it. The conundrum is when you go into the dentist and your options are $900 for a root canal or you get teeth extracted. Next thing you know they’ve pulled 9 teeth out.”

His daughter, Jennifer Roberts, was playing cards on the floor.

“It’s worth being here for the service they offer,” Jennifer said.  She had four cavities to fill.

Another couple waiting outside were Trisha and David Taylor. They said a man sleeping under an OU jacket next to them had driven 3 hours, and his wife, who had just undergone heart surgery, was sleeping in the car. Earlier they had seen a car with Missouri plates drive by.

David said he owns a construction company, and they can afford dental care for their kids but not themselves. They were going to show up at 4:30 a.m., but a friend told them they better get there sooner.

“I just said, ‘let’s dump the kids off and we’ll make a date night out of it,’” Trisha said.

“Yeah,” David laughed. “Cheap date.”

A dire need

Floor of the Tulsa Convention Center during the Mission of Mercy free dental clinic. Photo by Jennifer Mornhinweg, Anglin Public Relations.

The high attendance in Tulsa spoke to the dire need for affordable dental care. A 2008 survey by the National Center for Chronic Disease Prevention & Health Promotion showed that just 58 percent of Oklahomans had seen a dentist in the past year, compared to 79 percent in Massachusetts. Of those making between $15,000 and $25,000 per year, only 36 percent had seen a dentist in the past year.

Lack of dental coverage is in many ways the unsung issue of the current health care debate. As of 2009, more than 143 million Americans lacked dental coverage. A report by the National Association of Dental Plans showed that people without coverage were twice as likely to have not seen a dentist in the past twelve months.  They also had a higher rate of extractions, to avoid expensive fillings and root canals.

According to the Dental, Oral and Craniofacial Data Resource Center, those in lower economic classes tend to delay treatment until symptoms are severe. Going too long without care can make it even harder for people to improve their economic situation. When interviewing for a good job in a competitive market, the condition of one’s teeth can make all the difference.

Delays in treatment can also lead to expensive and life-threatening diseases such as oral cancer, which is an increased risk without yearly dental visits. The Tulsa World reported that four cases of oral cancer were detected by dentists at the Tulsa event.

“I think nationally it’s really an issue,” said Dr. Kevin Haney, a pediatrician from Norman. “If you look at Oklahoma’s number of diseases it’s not different … the simple fact is a lot of the people [can’t afford it]. It’s really kind of a shame.”

One man from Enid, who preferred not to be named, said that he’d paid for his last extraction with a bonus check. He heard about Mission of Mercy from his dentist.

So on Friday morning, he stood behind rows of filled chairs with three clipboards of information taken at the dental triage. He watched as his two children were briefed at the oral education booth before their root canals.

“Not all jobs offer dental care,” he said. “If it wasn’t for this we wouldn’t have gotten this done so quick. We don’t have any money to do this stuff.”

He looked at the bulky clipboards.

“I don’t know what [root canals] cost, but I know it’s a lot.”

“$1,000!” a seated man interjected.

Preparing for the task, opening the floor

Dr. C. Rieger Wood, event chair and president of the Oklahoma Dental Association, said he was impressed with the mood of the patients. He checked in with the line throughout the night, updating patients on how the event would proceed.

“When they walk through those doors, no one is complaining,” he said.

Wood said he had vowed to bring the mission to Oklahoma after attending similar events in Kansas and Arkansas. They tried to make improvements on those events, though Wood said it was “hard to beat Kansas.”

Dr. Haney said patients had to wait outside at the Arkansas Mission; in Tulsa they had the underground garage. The biggest improvement, Wood said, was a series of educational booths for patients to pass through on the way out.

“We recognized the common thread: where do these people go when they leave?” Wood said.

Alisabeth Deerinwater from the Tulsa Health Department worked the tobacco information booth. Dentists and patients alike stopped at her booth.

“They don’t come to us, so we have to kind of come to them,” Deerinwater said.

Dr. Haney said the biggest challenge was providing care the right way.

“It’s difficult to provide it safely… I’ve been amazed with the treatments so far,” he said.

Providing safe care to thousands in a matter of days was no easy feat. The equipment had to be trucked in from Kansas. The arena grounds were not designed to become impromptu dentist offices.

“You know, you need air, suction, water. It’s not set up for this. This is a basketball court,” said Dr. Richard Gilman, a Norman orthodontist.

Gilman said students from the Tulsa Technical Institute had installed the air and water systems earlier in the week.

Too many volunteers

Like many other volunteers who stepped into the break room and said, “I need something to do,” Gilman was working as a runner, taking patients to and from dentists at the signal of green and red cards. Red Cross workers and Army National Guard soldiers stood watch at checkpoints. In the outside lines, patients spread the word on which portable blue bathroom was the cleanest.

Haney said that there was still plenty of help, even though some volunteers couldn’t make it due to the weather.

“The Oklahoma Dental Association is a giving group,” he said. “They had more volunteers than they needed. We had to turn people away … I don’t think it’s any different than when the tornados went through Moore. In Oklahoma, we tend to be folks that step up.”

Haney, also a co-chair at the OU Department of Dentistry, said he had run a similar program with pediatricians in Norman, which brings in more kids every year.

A general feeling of giving was present throughout the event. One dentist, sipping a coke between patients, remarked on the good organization overall, “free and easy.”

“It’s very, very rewarding. We get to see they get the care they need,” said Renee Amason from Kiowa, a dental technical supervisor with the Oklahoma State Department of Health.

One patient did an impromptu card trick, which he ended by giving his dentist a paper cross.

“He was my best patient today,” the dentist said.

Additional Mission of Mercy dental clinics are planned for Oklahoma City in 2011 and McAlester in 2012. Variety Care Health Providers of Oklahoma City are currently working to bring Remote Area Medical to Oklahoma City, a similar project where three days of dental, vision and general medical care are provided on a first-come, first-serve basis.