Something to Smile About
Ostrow dental clinics offer free services to Skid Row’s underserved population.
BY MICHELLE McCARTHY
A year ago, James Hartley, 51, was at what he refers to as his “road’s end.” Homeless, living on the streets of Skid Row and battling alcohol addiction, he was destitute and in despair. Additionally, his poor dental hygiene was affecting his self-esteem. “I couldn’t really smile,” he says. “I would cover my mouth or smile without exposing any teeth.”
After hitting rock bottom and seeking treatment at the Midnight Mission, Hartley noticed a flyer posted by the Herman Ostrow School of Dentistry for its two clinics downtown that offer free dental services for low-income and homeless populations at the Union Rescue Mission (URM) and John Wesley Community Health (JWCH) center. “I decided, ‘OK, let me go and check this out.’” Little did he know, it was a decision that would help put his life back on track.
Down and out on Skid Row
“When you’re homeless, your oral health gets pushed to the side unless you’re in great pain,” says Kathy Elizondo, assistant professor of clinical dentistry and clinic director for URM Dental Clinic. “They have so many other things going on.”
To help combat this problem, Ostrow established an eight-chair dental clinic at URM in 2000 that caters to the underserved in Downtown Los Angeles. The demand for services proved to be so high that in 2010, a second clinic with seven chairs was opened across the street at JWCH.
“I always considered the U.S. to be a rich country, and especially Los Angeles with all the glamour,” says Iranian-born Mehdi Mohammadi DDS ’12, assistant professor of clinical dentistry and clinic director for JWCH Dental Clinic. “Going to Skid Row was an eye-opener to see how many people do not have access to oral care.”
Approximately 2,000 people are homeless in the area, which encompasses roughly 50 city blocks. There are approximately 58,000 homeless individuals in Los Angeles County altogether. Encampments line Skid Row’s streets with inhabitants who often face substance abuse and mental health issues.
All procedures at URM and JWCH are performed by fourth-year Ostrow dental students as part of a seven-week rotation. “We do everything from cleanings to fillings to root canals, dentures, partials, onlays and direct restorations,” says Karen Sierra DDS ’18, a student at JWCH.
Faculty is on hand to oversee the students’ work and offer guidance when needed. “Before we start any treatment, we go through the patient’s medical history and make sure everything is up to date,” says Mary Lou Wood DDS ’18, a student at URM. “Then we present our case to the faculty. There is a start check, prep check and final check.”
Elizondo says the fast-paced nature of the downtown clinics appeals to the students and makes them feel productive. “Most of the time, they’ll see two patients in the morning and two in the afternoon,” she says. “At school, it’s normally one in the morning and one in the afternoon. We try to keep our clinic very efficient.”
In 2016, URM saw 7,000 patients and rendered $2 million worth of free dental work, while JWCH had more than 7,000 patient visits and rendered $1.2 million worth of free dental work.
Years since last dental visit
Reginald Drummer, 50, lived on Skid Row for a year and a half and hadn’t been to a dentist since he was a child; at JWCH, he had 40 restorations, two extractions, a root canal and received removable partial dentures.
Before going to URM, Eli Handy, 63, says it was approaching two decades since he had been to a dentist. He had decayed teeth restored, was given a cleaning and received removable partial dentures.
And JWCH patient Reginia Austell, 64, says she couldn’t afford to have her teeth looked at and simply stopped eating foods such as lettuce and nuts for years due to pain. She had all of her teeth extracted and received complete dentures.
“I’ve seen a couple of people where the calculus on their teeth is pretty much what’s holding them in the mouth,” says Hessam Toossi DDS ’18, a student at JWCH. “Sometimes you have to say, ‘I’m going to clean your teeth, but there’s a good chance they’re going to fall out.’ I’ve never experienced anybody saying they want to hold onto bad teeth, because a lot of the time they’re causing them pain.”
In addition to pain and discomfort, poor dental health can lead to medical issues such as cardiovascular disease, bacterial lung infections and malnutrition as well as diminished self-esteem. According to Elizondo, your mouth is a reflection of the condition of your body. So if someone is not taking good care of his or her teeth, there are usually other organ systems that are problematic.
“I used to smile all the time,” Drummer says. “I brought this picture of me to the clinic that showed what my smile used to be like. Now I have a full smile again. It’s impacted every area of my life. I’m confident. I got the résumé done. I’ve been applying for jobs. When I see people, it’s just different. I don’t have to keep my head down.”
Hartley says with the level of professionalism he witnessed from both students and faculty at the clinic, he isn’t surprised that Ostrow is renowned for churning out some of the world’s best dentists.
“I thought I was going to be in pain or bleeding, but there was nothing at all,” says Luz Valenzuela, 46, who had her mandibular anterior teeth extracted and received a removable partial denture at JWCH. “I told the student who did it, ‘If this counts as your graduation, you already passed.’”
Austell adds: “If the students had any questions, they always called a professor over before they did anything to make sure they did it correctly.”
Tears of joy
For many of the patients, even more impressive than the students’ professionalism and skill level was their compassion. “I was treated like a human being,” Hartley says. “They made me feel very comfortable despite my situation because there’s a bit of shame associated when you’re in those types of circumstances. I noticed there was always laughter in the background.”
It’s this deeper human connection and interaction with individuals the students might never come in contact with otherwise that Ostrow hopes will foster a sense of charitable giving.
“Ostrow likes to teach students the positive aspects of service learning, community practice and professional philanthropy,” Mohammadi says. “Before coming to this clinic, they thought, “After I graduate, I have to go to a private practice. Now they know there are other options out there, and one is a community clinic that provides for the underserved. Many of them now say they’ll consider joining a community clinic after graduation.”
The rewarding nature of the work and ability to change lives is what brings Elizondo, who has worked at URM since 2003, back to Skid Row day after day. “I especially love to do dentures and partials just to see the big smiles when we deliver them. They’re able to eat well. They’re able to speak better. For job interviews, they were embarrassed and not able to present themselves properly because they’re missing teeth. Now they can go to interviews and secure work, which is key. And it just lifts their spirits.”
URM student Vyvy Pham DDS ’18 recalls two patients in particular who cried after receiving their dentures. “They’d gone so long without teeth, they forgot what they looked like with them. That was memorable.”
Sierra says patients are always quick to show their gratitude for the free dental work. People have even spotted her walking down the street to the clinic in her scrubs and stopped her to say thank you. “They’re always thanking us from beginning to end.” It’s an experience that has influenced her future career path. “I initially didn’t know if I wanted to go into private practice, but after going to these clinics, it has helped me figure out what I want to do — community dentistry.”
No matter where they end up after graduation, the students say they will definitely be back to volunteer. “My plans are for sure to come back,” Toossi says. “I don’t think I can stray too far from it.”
“My whole life has changed”
A lot has happened for Hartley since he found that Ostrow dental flyer at the Midnight Mission and received nine dental procedures, including removable partial dentures.
For starters, he is about to celebrate one year of sobriety. He now has a job, an apartment and recently bought a car. “My whole life has changed, and the basis of that change was from the dental procedures I had done,” he says. “My self-esteem returned and I could smile. I could talk and was less of an introvert. It just helped me so tremendously.”
He even joined a running club and completed the 2017 L.A. Marathon. Next year, he will travel to Israel to run the international marathon.
“All this happened because my self-esteem returned and enabled me to self-actualize,” he explains. “So my whole life has changed completely. Before I got sober, I was in a place where I physically could no longer drink, but I didn’t want to be sober. I didn’t want to be where I was, and I didn’t have any place I wanted to go. It was hopelessness. Today, I have a life. I have a full life.”
This story originally appeared in the TroDent, the official publication for the Herman Ostrow School of Dentistry of USC. Read more stories like this in our Fall 2017 issue.