Annual dental clinic gives free care, but need not going away

WATERBURY–Robin Stewart and her husband got to Wilby High School around 10:30 Friday night, early enough to secure a parking spot and a place in line. The Stonington couple had packed their car with pillows, blankets, a sleeping bag and food for the overnight wait to see a dentist for free.

They had plenty of company. The first patient arrived around 6 p.m. Friday night, 12 hours before the Connecticut Mission of Mercy free dental clinic opened. By 7:30 a.m. Saturday, close to 800 people had shown up, forming a line that stretched behind the school. Organizers expect 2,000 people to get treated at the two-day clinic in Waterbury.

“It’s lack of money and people don’t have insurance,” Stewart said. She runs a cleaning business and her husband, Milan Bozanic, was laid off. They don’t have the money for the thousands of dollars’ worth of dental care he needs. So every year, they go to the Mission of Mercy for care, waiting overnight to get seen and grateful for the services.

“We’re just following from city to city,” she said.

Now in its fourth year, the clinic has two goals: providing free teeth cleanings, extractions, fillings and other care to people who need it, and creating the awareness and will to eliminate the need for people to wait outside overnight to get help for a toothache.

“We’d like to put ourselves out of business,” said Michael Perl, a retired Essex periodontist who co-chairs the Connecticut Mission of Mercy.

On the first goal, they’ve been largely successful. There are patients who use the clinic as a regular source of dental care. This year’s clinic drew more than 1,600 volunteers, including regulars who say they look forward to it each year. A group of dentists from Georgia planning their own Mission of Mercy clinic came to observe.

The clinics have also raised awareness of the need for better access to dental care. But in the ultimate goal, eliminating the need for massive free clinics, organizers are less optimistic. The need has only gotten greater, they say, and any potential fixes seem far off at a time of high unemployment and limited state funds.

Although Connecticut has a relatively low rate of people without health insurance, an estimated 600,000 to 1 million people lack access to dental care. Many people who get health coverage through work don’t get dental insurance, and Medicare does not cover dental care.

Even having dental insurance doesn’t guarantee adequate care. Many plans limit coverage to $1,000 or $1,500, not enough to cover major dental work. Adults in Medicaid have dental benefits, but the rates paid to dentists are so low that few will treat many of them.

Gov. Dannel P. Malloy’s proposed budget calls for cutting back Medicaid dental services for adults, and it’s telling that many dentists, including the Connecticut State Dental Association, consider it a win since he didn’t propose eliminating the coverage entirely, as his predecessor did.

Children in Medicaid have better access to care, the result in part of a legal settlement that raised the rates paid to dentists treating children. But dentists worry that the rates will fall again when the settlement expires in 2013.

“It really isn’t getting better, not that I can see,” Perl said.

Bruce Bergstrom, executive director of the Kansas-based America’s Dentists Care Foundation, which trucks specially manufactured portable dental equipment to Mission of Mercy clinics across the country, said the need for free dental care has increased since his organization began in 2003.

Back then, the people who came to clinics were typically homeless or “down and out,” he said. But in the past two to three years, clinics have increasingly drawn families, people who are unemployed or who lost jobs and found work in lower-skilled fields that don’t provide benefits.

Bergstrom hopes the clinics will one day be unnecessary, but doesn’t expect it to happen in his lifetime. There are now Mission of Mercy clinics in 15 states, with 22 expected next year and 29 in 2013.

“Everywhere we go there’s a line,” he said. “Everywhere in America there’s need. Volunteerism doesn’t fix this, but it points out the problem.”

At the Connecticut Mission of Mercy clinics, the lines routinely start the night before. At last year’s clinic in Middletown, patients were not allowed on the property, the former Aetna building, in advance, so people parked on the side of the road outside and slept in their cars. This year, when Stewart got in line around 1 a.m., she was the 128th person.

Debbie Rost of Waterbury arrived shortly before 6 a.m. More than 90 minutes later, she was still waiting outside, with the hood of her jacket pulled on tight to keep warm.

Rost lost her job in manufacturing after 20 years. She has a new one, in a clothing store, but she’s one of two employees and doesn’t get insurance. She said she sees the dentist when she has the money. She’ll go if it’s an emergency, but that means putting of paying another bill.

When she left her old dentist, Rost had $2,000 worth of dental work to do. She didn’t get it done, and the amount of work she needed increased. Recently, her fillings had fallen out.

She wanted to go to the Mission of Mercy clinic last year, but didn’t have a car. This year, she does.

“I’m slowly working my way up,” she said.

Next to her in line, Mark Mahurin of Salem had his hands stuffed in the pockets of his jacket. Mahurin lost his job in retail almost a year ago. Even when he had dental insurance, he said, he had a $2,000 deductible before any coverage kicked in. He drove an hour and 20 minutes to get to the clinic Saturday.

“Is this the best this country can do for dental care?” he asked.

He wondered why dental care is considered separate from the rest of health care. “It’s health care,” he said.

There might not be long-term change on the horizon, but volunteers used the clinic as a way to chip away at the need, one mouth at a time.

They worked in a high school transformed into a massive dental center. Patients registered in the school auditorium, getting triaged on the stage. There were X-rays and numbing stations in the cafeteria, while the gym was outfitted with rows of stations for cleanings, fillings and other services. Signs above the bleachers hung like championship banners and marked where patients should wait for each service. By the exit, volunteers offered information on community health centers, which charge on a sliding scale for dental care, and state assistance programs.

Bergstrom said each volunteer becomes an advocate for improving access to dental care.

Jeffrey Rosow, dental director at Connecticut Valley Hospital and a Mission of Mercy volunteer, said the clinic reminds him to appreciate what he has.

“We probably get more out of it than the people who come,” he said.

Many of his patients at CVH only have access to dental care when they’re inpatients. Even those who are on Medicaid can have a hard time getting to a dentist if they don’t have a car or can’t take time off from work during the day, he said.

Patients recovering from addiction struggle in particular, he said, if they get out and aren’t able to get proper treatment for tooth pain, making it harder to stay off substances that could help with the pain.

Kathy Langlais, a dental hygienist at CVH and another returning volunteer, said she was struck by the Mission of Mercy patients, who were thankful and happy even though they were tired from waiting overnight.

It was a contrast to what she saw working in private practice, where she said patients could get unhappy if they had to wait 10 minutes for a cleaning.

“These patients have waited 12 hours,” she said. “They’re grateful.”