Health, Public Health

‘A Godsend’: Mobile Dentistry for Indigent Adults in South County

GILROY — It’s not even noon, and dentist Brendon Nguyen has already seen four indigent adults in the leased mobile dentistry clinic parked in front of the County-run Valley Health Center in Gilroy.

He’ll see six or eight more before his day’s work is done, providing a full range of dental services for free or very low cost to low-income patients. His patients definitely appreciate the care they get, but what many taxpayers may not realize is that these services potentially save significant public dollars by keeping the patients out of more expensive emergency care and even helping them get fit enough to work.

Although the well-marked, fully stocked dental vehicle sits in plain sight, like the nose on Pinocchio’s face, its monthly visit to the rural South County city of Gilroy is not publicized in advance. If it were, there would be a long line wending along the sidewalk, and most people would be left standing there, unhelped and still in pain, when the van pulled out in the late afternoon.

Such is the extent of unmet need. Rather, patients must get a referral from any of a number of agencies that serve the poor, and set up an appointment.

Yet, until November 2017, many poor adults in the area had even less access to dental care. That’s when founder Cheryl Walter’s 15-year-old nonprofit, On-Site Dental Care Foundation, started coming to Gilroy. That means fewer people need to take a daylong, difficult-to-manage ride up to San Jose to get care. That’s a huge relief.

But, as it turns out, the South County mobile dental care unit, as infrequent a visitor as it is, could easily have folded almost as soon as it got started.

Healthy mouth, healthy body

Many people don’t realize how critical oral health is to overall well-being. First, experts say bad oral care can lead to heart disease and a host of other life-shortening health problems. And as anyone who’s ever had to nurse a bad toothache for a weekend can attest, you can’t do much when you’re in severe pain.

And, adds Walter, director of the foundation that contracts with Santa Clara County to run the rolling dental clinic, bad teeth can even lead to chronic homelessness. “If you have missing front teeth, it’s very hard to get employment,” she says. “So we do full restoration services to make [patients] employable.

“And we’ve had a number of success stories of where they were able to go out, get employed and actually turn their lives around and get stable housing.”

Controlling costs

Walter left her job with the County and started her foundation on a shoestring in 2003 — and it still runs as much on thrift and ingenuity as on actual dollars. She takes no salary, works out of her home office, and pays her staff modestly.

Says Nguyen, one of a handful of dentists who work with the program and the one who was working in Gilroy recently, he’s not in it for the money, either, though he does get paid.

Compared with working in a private practice, he says, “There is definitely a financial sacrifice.

“But one of the things that I do enjoy most is what I can do for the County, what I do for the patients that are underserved. You see a lot of people that you wouldn’t normally see, and it’s definitely fulfilling work.”

Nguyen estimates that the first time a new patient comes to the mobile clinic, he or she hasn’t seen a dentist in seven years on average. That’s enough time to develop some serious oral health problems, especially if they use meth or certain other drugs known to degrade the mouth.

“You see those who have never been to a dentist before in all of their life,” he says. “And those are the people that we want to get back on their feet and really give them some dental education, so that they can continue to maintain their oral health, systemic health.”

A leap of faith

The foundation attends to the underserved under contract with Santa Clara County (as well as Alameda) and tries to leverage the modest allocations of public funds with private sector fundraising.

When Walter realized the extent of the unment need in the Gilroy area, she was already running a mobile dental program in San Jose. So she scrambled to find the staffing, equipment and another mobile unit to make servicing South County a reality. As an experienced hand in the public health sector, she figured she could go ahead and launch the Gilroy service last November, confident that when the County did its annual reallocation of federal Ryan White funds (aimed at serving people with HIV/AIDS), she’d get enough money to cover the expenses.

Oops! She was wrong.

For the first time in her memory, the County didn’t rejigger the Ryan White funds last year. SO the whole thing could have fallen apart as a result. But by that time, Walter was committed, and she refused to pull out of it. So she scrimped and shifted money around to keep it going, then contacted South County Supervisor Mike Wasserman.

Wasserman immediately recognized the problem and set out to solve it. An aide said he recently was able to assure Walter that the money will be forthcoming, so she’s going to keep the Gilroy visits going through the fiscal year ending in June. Now that the funding need is on Wasserman’s radar, Walter says she hopes the Board of Supervisors will continue funding the program through the next fiscal year, and beyond.

‘A godsend’

Gabriel Clark, a retiree who lives with HIV/AIDS, moved to from Houston to Gilroy six months ago, and he’s impressed with the dental services he receives from the on-site mobile clinic. He’s grateful he found out about it, which he says he might not have if he weren’t being tracked by public health programs because of his HIV status.

Not only is the rolling clinic conveniently located for him, but Clark has also found the staff to be professional, thorough, friendly, and compassionate — something he hasn’t always experienced elsewhere. Best of all, the staff detected and corrected some incipient oral health problems before they could cause real trouble for him.

“So many of us long-term survivors are on support or disability or whatever, and can’t afford dental care,” he says. “So it’s been a godsend.”

 

Author: Chuck Carroll

 

May 4, 2018

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