Into the Breach: Fixing Smiles for Homeless Veterans

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Dental staff is hard at work on a patient. Photo by Paola Longoria.

Dental staff is hard at work on a patient. Photo by Paola Longoria.

The Hispanic Dental Association is having its 25th annual conference in San Antonio through Sunday. But on Thursday morning, its president and a number of its members rolled up their sleeves to deliver free dental care to homeless veterans at Haven for Hope.

The first-of-its-kind community event, “Sirviendo a Nuestros Héroes/Serving Our Heroes,” was staffed by the San Antonio Christian Dental Association and the Hispanic Dental Association.

The San Antonio Christian Dental Clinic on the Haven for Hope campus, where the event was held, was abuzz with activity on Thursday. Dozens of homeless veterans, both male and female, waited in the colorful lobby, while scores of volunteer dentists, dental assistants and hygienists attended to veterans in the clinic’s treatment rooms just out of view. The clinic houses 12 fully-stocked treatment rooms, four surgery suites, and a dental lab, among other state-of-the-art amenities, even lounge chairs where nervous patients can relax while waiting for a consultation.

A portion of the volunteers and staff pause for a group picture. Photo by Paola Longoria.

A portion of the volunteers and staff pause for a group picture. Photo by Paola Longoria.

There can be a lot of anxiety associated with dentistry, particularly when teeth have been neglected, but the atmosphere at the clinic felt more festive than fearful, as volunteer practitioners seemed to outnumber patients temporarily. The event was only lightly publicized, in case demand for services at this first-time event was too high, but apparently the dentists themselves got the word out about the volunteering opportunity, and quite a few showed up.

“Our veterans who have returned from serving their country often lack a dental home to care for their oral health needs,” said Vidal Balderas, DDS,  MPH, clinical assistant professor at UT Health Science Center and president of the Hispanic Dental Association. “We are trying to provide an avenue for the kind of care they deserve.”

The veteran-centric mood was apparent in the festive red, white and blue decorations sprinkling the clinic, but also by the volunteer dentists and dental technicians wearing patriotic smocks, scrubs,  T-shirts and ball caps proclaiming where they served. Several of the dentist volunteers had extensive military experience locally, serving at Brooke Army Medical Center and Fort Sam Houston, among other sites. David Rickey, DDS, the clinic’s dental services director, is a Navy veteran. And the clinic had a fairly high-profile veteran visitor in  Lt. General Ricardo Sanchez (retired), who showed up to talk with some of the homeless veterans privately as the day progressed.

(Retired) General Ricardo Sanchez greets homeless veteran dental patients. Photo by Paola Longoria

(Ret.) Lt. General Ricardo Sanchez greets homeless veteran dental patients. Photo by Paola Longoria

By the time the four-hour event ended, about 80 homeless veterans had been seen for badly-needed urgent and preventive care, including extractions, cleanings and fillings. If more extensive treatments were needed than were possible in one visit, additional appointments were scheduled.

While this event is a first of its kind, members of the Greater Hispanic Dental Association and the San Antonio Christian Dental Clinic work together on an ongoing basis. According to Christina Meiners, former president of the Greater San Antonio Hispanic Dental Association and the San Antonio Christian Dental Clinic board member, the focus of the partnership efforts are to help raise awareness of the importance of oral health and the effects it can have on under-served populations.

Texas is known as a “dental desert,” with too few professionals available for the demand, and many residents going without dental care regularly, including the poor, the elderly, and veterans. The situation is worsened because dental care was removed from Medicaid years ago, and then Texas chose not to expand Medicaid coverage, according to John Burnham, the clinic’s marketing director. Untreated dental decay costs workers and the economy $164 million a year, says Burnham, including time spent off work for emergency appointments, and the resulting burden on emergency rooms, which are often the first place homeless patients are seen – at tremendous cost to taxpayers who ultimately foot the bill for these services.

Volunteer dental staff working on a patient. Photo by Paola Longoria.

Volunteer dental staff working on a patient. Photo by Paola Longoria.

The San Antonio Christian Dental Clinic is the only clinic locally that provides free service by volunteers. Most clinics offer sliding scale fees, not completely free services. Each year, the clinic provides $3.5 million of free dental care, with over 60,000 procedures performed in more than 7,000 patient visits.

Its affiliation with UT Health Science Center lends the very apparent “state of the art” feel to the clinic, along with many dental students who do a clinical rotation here. If you were expecting a scruffy facility, joked the clinic’s Executive Director, Gloria Canseco, you’d be pleasantly surprised. The same could be said for the professionalism of the volunteers. One of the dentists I met on the tour, a UT Health Science Center professor whose background is military dentistry at BAMC, provides his expert volunteer services three days a week.

The unabashed delight of smiles in the faces of homeless patients, transformed by pro bono dental work, fairly leapt off a clinic bulletin board, labeled simply “before and after.” Years of hard living and difficult circumstances had aged many of the patients prematurely, and restorative dentistry seemed to rejuvenate them.

Dr. David Rickey, dental services director, (Retired) General Ricardo Sanchez, Gloria Canseco, executive director. Photo by Paola Longoria.

Dr. David Rickey, dental services director, (Retired) Lt. General Ricardo Sanchez, Gloria Canseco, executive director. Photo by Paola Longoria.

Burnam explained how getting their smiles back is part of a bigger picture of restoring homeless patients to a fuller life. Missing teeth can have an impact on a person’s employability, and so getting dental care can help a homeless patient on the road to employment. He described how dental care is just one part of the myriad services Haven for Hope can provide residents, with the clinic located on its campus.

In fact, as a previous article in the Rivard Report pointed out, the San Antonio Christian Dental Clinic, in partnership with UT Health Science Center, and with funding from the Greehy Family Foundation has been helping formerly homeless turn into registered dental assistants through their program since 2012. Some of the volunteers and staff serving at Thursday’s event were graduates of that program, which provides free tuition, worth $15,000 to $16,000 through private educational institutions, and a highly marketable – and portable – job skill upon graduation. In fact, one of the graduates went on to become a dentist herself, says Gloria Canseco, about the program that graduates 12 to 14 students a year.

Thursday’s dental clinic for homeless veterans may just be the first step in a short series of visits.

“Based on our community assessment, we anticipate between 20%-30% of those in attendance will need more extensive treatment. For patients presenting with profound needs, enrollment in our program of charitable care to under-served Bexar County adults is the beginning of a longer-term relationship and a healthier future,” said Canseco in a prepared statement.

A bulletin board highlights the dramatic transformations of pro bono dental work. Photo by Lily Casura.

A bulletin board highlights the dramatic transformations of pro bono dental work. Photo by Lily Casura.

“In particular, this event will aim to help relieve pain, eliminate infection, and restore a healthy smile at no cost to veterans. A new smile can have a profound effect on self-sufficiency resulting in fewer missed workdays, more confidence for job interviews, and greater overall health and an improved outlook on life.”

 

*Featured/top image: Dental staff is hard at work on a patient. Photo by Paola Longoria.

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