http://www.contracostatimes.com/mld/cct ... 086642.htm

Posted on Mon, Mar. 13, 2006

Dental clinic struggles to keep smiling
BAY POINT: The staff serves children from low-income families, but growing demand means a need for more space
By Laurie Phillips
CONTRA COSTA TIMES

"Cómo estás, bonita?" Mireya Gutierrez asked the little girl as she angled the dentist's chair back. Beneath a pair of mirrored sunglasses, Crystal Ramirez-Ornelas widened her eyes at the syringe approaching her mouth, her pink boots starting to twitch.

The 4-year-old bawled as the anesthetic took effect, allowing Gutierrez and Dr. Joanna Cheung to replace a cavity with a filling. As they worked, the adults took turns wiping the girl's tears away and assuring Crystal that she was "muy valiente."

When they were done, Gutierrez led Crystal across the converted classroom inside the Bay Point Family Health Center to a cabinet, where the girl selected a sticker and a ring for her bravery. For the first time since she entered the exam room Thursday morning, Crystal managed a small smile.

Since the children's dental clinic opened with one part-time dentist almost five years ago, hundreds of children have received treatment there. And as word has spread, the clinic's staff has struggled to keep up with demand in a facility that, when it opened, was neither equipped nor envisioned to handle the demand it now sees.

The room "is not that big," said Concepcion James, the manager of the health center, "but you can do a lot with a small space."

Last year alone, the staff logged at least 1,600 patient visits, treating each child with portable equipment that overheats from frequent use in a room that lacks running water, a linoleum floor and permanent equipment. Between March and October last year, the clinic stopped taking new appointments because the dentist -- who by then was working full time -- was maxed out. A second chair and dentist have since been added.

To reconfigure the room and equip it with commercial dental equipment -- and double the number of children served -- the clinic's staff has been working to raise $210,000. It has received commitments from eight community groups for about 70 percent of that cost, but still needs $64,500.

"We see a lot of patients who come (who) have nothing," Cheung said between visits. "Without this help, they wouldn't get the regular service we (provide) here."

The clinic accepts families who qualify for Medi-Cal and the county's health care program, but those who don't are asked to offer a $10 donation for services. Children with medical emergencies whose families cannot afford care will not be turned away.

The clinic began with grant money after a county health worker found that a quarter of the children she surveyed in Bay Point had visible tooth decay. Many visitors to the clinic come from Spanish-speaking immigrant families who lack insurance, regular dental care and knowledge about how to properly care for their teeth.

"Everything in your mouth is important -- it's part of your body, and you have to care for it," said Angelica Matamoros, one of the health educators known as Promotoras.

So while children are in the exam room, their parents sit with one of the Promotoras in another room to review the basics of flossing, brushing and nutrition. Children should drink less soda and juice and more water, parents learn, and babies should never be allowed to fall asleep with a bottle in their mouth -- the milk that pools causes tooth decay.

Those were just a couple of points an educator explained to Maria Miranda of Bay Point last week as she demonstrated the right way to floss on a set of model teeth. Miranda's children -- 6-year-old Maria, 3-year-old David and 13-month-old Vanessa -- played with rubber-topped hourglasses they had been given. The sand in each runs through in two minutes, the proper amount of time to brush.

Dental disease is the No. 1 disease among children, staff members noted, but parents often don't think of it as such because they may not notice it until their child complains. If left untreated, cavities -- bacterial infections in the mouth -- can cause facial swelling or inhibited breathing.

James, the health center manager, said she's glad to know the clinic provides a valuable service for the community.

"It feels good to know that the children who come here, when they leave, they feel better," she said. "People can't even imagine how a beautiful smile enhances how they feel about themselves."

Laurie Phillips covers Pittsburg and Bay Point. Reach her at 925-779-7164 or lphillips@cctimes.com.

DENTAL CLINIC

The children's dental clinic at the Bay Point Family Health Center is at 215 Pacifica Ave., behind Riverview Middle School. For more information, call 925-427-8302.