dental care

Medical Teams International and the Mobile Dental Program

by Marilyn Fonseca
Published 3/12/08 (revised 11/14/20) © 2008 Marilyn Fonseca
Photos courtesy of Medical Teams International

Over 600 students fill the classrooms of Vose Elementary School, in Beaverton, Oregon, a diverse student body in a district where 61 different languages are represented. But there is one issue that unites many of the students -- lack of dental care.

And so, on a cold winter day, students venture outside to a large Winnebago in the school parking lot. The motor home is really a state-of-the-art mobile dental clinic run by Medical Teams International (MTI). More than 800 dental professionals volunteer with MTI on one of 10 vans the organization owns and operates in 39 counties in the Pacific Northwest.

The Dentist

Dr. Crocker and Ms. Gardner with patient
Dr. Crocker and Ms. Gardner with patient

Today, three volunteers are giving free care to the kids. The dentist, Dr. Michelle Crocker, began working with the dental clinic several years ago as a dental student at Oregon Health Sciences University; she came with a mentor dentist. According to Dr. Crocker, students were encouraged to work at the clinic: it was a great way to see a lot of patients in a short time and get a lot of experience. After entering private practice, she continued to volunteer. "Once you see the need that is present, there is just a strong feeling that this is something small I can do to benefit these kids, and it doesn't take a lot out of me to just volunteer my time," she said.

Dr. Crocker may see 15 to 20 children in one day, depending on how much time each child needs. The vast majority of the kids have large cavities, and at least half have teeth that are abscessed and have to be extracted, according to Dr. Crocker. If the abscess continues to grow, eating will be painful, and eventually the child will be in pain all the time. "For kids, that is a big deal, in terms of focusing at school and being able to learn, being able to eat and have proper nutrition," Dr. Crocker said.

MTI makes it easy for her to volunteer. A clinic coordinator sets out the schedule in advance and ensures she will have both a clinical assistant and a hygienist.

The Assistant

Dr. Crocker and Ms. Gardner with patient
Dr. Crocker and Ms. Gardner with patient

Dr. Crocker often teams with Anna Gardner as her dental assistant. Like Dr. Crocker, Ms. Gardner volunteers because of the need and is astounded by the suffering in her own community, "I live not too far from here," she said. "It was shocking to me to see how many kids right here don't have any dental care."

Not all of the children at the school will get to see the dentist. Some are chosen by the school nurse or are referred by a teacher. In this case, the local Rotary club screened half the children in the school, and almost 100 needed immediate help, according to Sabrina Gomez, a school counselor. Only a handful of them had dental insurance.

Sometimes the children need work done all over their mouths. The dentist can only treat one section of the mouth at a time; the rest of the aid will have to be delivered during the next visit, a month away. That is difficult for the volunteers to face at times. "You know you are letting them out of here with active disease," Ms. Gardner said.

The time commitment among clinicians varies: some volunteer once a month, some once a quarter, and some once a year. To Ms. Gardner, the investment of her time is worth it. "It is really just a few hours of time, and that is really it, it is what we normally do daily anyway. I always think, if I didn't come out, what would the kids do?"

The Hygienist

A happy patient
A happy patient

An interest in public health leads hygienist Karen Phillips to serve on the mobile clinic. A volunteer for more than eight years, she comes out once a month and goes wherever MTI sends her. When she graduated from dental hygiene school she thought it would be "cool" to go overseas to places like Bosnia or Guatemala. But she realized she could help out locally and, like Dr. Crocker and Ms. Gardner, was shocked "that this is at our front door."

When the children first enter the van they are seated with Ms. Phillips. She takes films of their teeth and provides anesthetic before they move to the dentist's chair. Rarely, she has enough time to do a cleaning and teach the child about brushing and flossing. Most of the children know little about dental care, and often they have no supplies for cleaning their teeth. Some children have said that they share their toothbrushes with their siblings. It is not uncommon for the children to have no toothbrush or toothpaste at home. "They are set up for failure from the beginning when they don't have that," Dr. Crocker said.

While the clinic often "puts out fires," some students have made progress. The van has been coming to Vose Elementary School for 10 years now, so there has been an impact.

The Future

MTI Mobile Dental Clinic
MTI Mobile Dental Clinic

Medical Teams International wants to repeat the success of Vose at other schools, but they need more volunteer dentists. Forty more volunteers would allow the clinics to serve 1800 more people.

A large grant from Providence Health Plans will allow MTI to expand the program; part of the money will be used to recruit more dental professionals. One-to-one peer education is most likely to recruit more volunteers, so the focus will be to get the word out about the clinics, dentist to dentist. MTI can accommodate any professional need a dentist may have, so a dentist needn't fear the unknown of volunteering in the mobile clinic.

As Dr. Crocker said of dentists, "In general we are very lucky to have a career that benefits us both financially and spiritually, and it is a small thing we can do to help others."

About the Author

Marilyn Fonseca is a freelance medical writer in Portland, Oregon.

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