Single Mobile Dental Clinic Serves Thousands in Central Valley

FRESNO — The tiny farming town of Stratford in the Central Valley is a bare bones place. There’s no restaurant, no coffee shop, not even a gas station.

“This town doesn’t have much of anything,” said Patty Alamo, a district clerk at the Family Resource Center, which shares a campus with Stratford Elementary School. But then she pauses. “We do have a library.”

A library, but still not many of the other basic services people tend to take for granted. Like in many rural communities and smaller towns in the valley, there’s no dentist serving Stratford’s 1,200 residents and that means kids don’t have easy access to dental care. Many of the parents are farm workers who can’t take the time off work or don’t have a car to go to a dentist in another town. Lemoore, a town of about 24,000, is 10 miles away, Hanford, with a population of about 54,000, is a bit further.

“There are some kids here who have probably never seen a dentist,” Alamo said. “I think sometimes if there’s a cost involved, parents can’t afford it. They try to hold off as much as they can.”

So Alamo helps find the families most in need and refers them to the Healthy Smiles Mobile Dental Foundation. It’s the only dental clinic on wheels in the Central Valley, and it comes to schools like Stratford Elementary to provide no-cost dental care to uninsured and underinsured kids.

People like Alamo are vital to the operation, which treats about 5,000 kids and sometimes their family members each year. 

“It’s essential to have someone in the community to link the families with the service,” said Tai Hartman, executive director of the foundation. “Even with the transient population we serve, 40% of our patients this year are ones we saw last year. We don’t just hit and drill and run. We are a dental home.”

Founder of Healthy Smiles Pushed for Better Access

It’s what the founder of Healthy Smiles, Wayne Kodama, wanted. He started the organization in 1994 as part of his private practice to help impoverished kids. But the need was incredible and the organization soon branched off as a not-for-profit.

Last year, he died at age 52 from complications from the flu. His wife Susan remains highly involved in running the mobile dental clinic.  

“My husband, he basically wanted to provide a place where children would not be afraid, and could return for dental treatment without any fear,” she said. “When we go back to a school, the kids see us, they run to us. What child would come running to a dental office and say ‘when are you going to see me?'”

Healthy Smiles serves four counties in the Central Valley: Fresno, Kings, Madera and Merced. The mobile clinic goes to schools, community centers, and in at least one case, a city park in the farming town of Orange Cove. 

“The problems are worse now than 20 years ago,” said Hartman who has been with Healthy Smiles almost since its inception. “Parents are working their tails off in the fields, they don’t have cars and they just aren’t able to get to the dentist even if they could find care.”

She said many dentists don’t take Medi-Cal. Healthy Smiles does, but low reimbursements from Medi-Cal only pay for about 70% of the foundation’s operations, Hartman  said. The other 30% comes from donations and grants. Medi-Cal is California’s Medicaid program.

Cigna Grant Will Expand Foundation’s Reach

Healthy Smiles recently received a $103,000 grant from the Cigna Foundation

Some of those funds will be used to purchase portable equipment to expand services to areas where there’s a great need but not enough kids to warrant a clinic on wheels. Portables are essentially a delivery system in a suitcase, said Hartman, and as long as a dentist has a car, he or she can provide care just about anywhere. “This will give us a lot more flexibility to serve more children,” she said.

The organization Dentists Without Borders has been using portable equipment for years in underdeveloped countries where there is an urgent need for dental care and people put up with a lot of pain and suffering due to a lack of treatment. “It’s becoming more and more efficient, more effective,” said Hartman, adding that she’s had to convince funders that there are shockingly similar conditions right here in California.

She said the grant also will allow the foundation to focus on younger kids at child development centers, including putting sealants on primary teeth. Hartman said Healthy Smiles has put sealants on kids’ primary molars since she did a random study of 6-year-olds about 10 years ago. She pulled 360 charts from more than 11,000 patients seen by Healthy Smiles between 1996 and 2003. Among those patients, 94% of the children had cavities on primary molars and 75% had four or more cavities on primary molars.

A sealant is not only a preventive exercise but also a good introduction to treatment because it’s non-invasive, not painful and includes the child in the education process of dental care, said Hartman.

Mobile Clinics Play Vital Role in Safety Net

Mobile clinics like Healthy Smiles are important because the dental safety net is very small, said Shelly Gehshan, director of the Pew Children’s Dental Campaign. “If you can’t physically get to the private dental office and pay for it yourself, you’re going to be underserved,” she said.

According to a report by the Pew Charitable Trusts, 58.6% of the children enrolled in Medi-Cal in 2011 did not receive any dental care. The report, “In Search of Dental Care,” also found that roughly one in four federally funded health centers in low-income communities in 2011 did not offer dental services.

study by the Herman Ostrow School of Dentistry at the University of Southern California found that dental problems cause disadvantaged elementary students to miss an average of 2.1 days of school during the year.

That’s something Healthy Smiles is trying to help students avoid. The foundation was one of the first school-based dental operations in California. “We’re like the photographer. They go on school grounds all the time. They take pictures,” said Hartman. “We take pictures, too, but we take pictures of their teeth.” 

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