Have Drills, Will Travel : USC dental students bring mobile clinic to Fullerton to treat children of low-income families.

By the time they reach the fourth year of training, the students at USC’s School of Dentistry are fairly adept at handling a drill.

But when it comes to handling children, that’s something that just can’t be taught in a classroom, or even a traditional school clinic for adult patients. So USC’s aspiring dentists travel literally by the truckload out into the community to get some real-life experience while giving needy children a chance to get care they might otherwise not receive.

The school brought its four Mobile Dental Clinic trucks to Maple Community Center here last week, where students provided free treatment for 140 children--work that would have cost an estimated $65,000 in a typical private dental office, according to Dr. Randall Niederkohr, assistant professor of clinical dentistry at USC and director of the mobile clinic. The clinic also travels to other sites as far north as Bakersfield and as far south as Baja California.

“We ask for donations so that the families can feel like they’re participating in the process,” explained Joan Furman, executive director of the Care for the Poor Program at St. Jude Medical Center in Fullerton. “But we don’t require any payment.”

St. Jude has hosted the clinic for three years now, and Niederkohr says this year he has noticed some lasting results from the mobile unit’s previous visits.

“We’ve seen some kids who were treated here last year, and all they needed this time was a cleaning,” he said. In addition to their dental treatments, the children also are given dental hygiene training and even toothbrushes if necessary.

“Some of these kids not only have never seen a dentist, but they’ve never even owned a toothbrush,” Niederkohr said.

All the children were identified as needing dental care by the hospital’s healthmobile, which travels to sites in Fullerton, Brea, Placentia and La Habra every week.

However frightened they were, most of the children put on a brave face and tried their best to cooperate despite the discomfort and unfamiliarity of the experience. Others, particularly the youngest patients, weren’t quite so stoic. Some whimpered, others squirmed and a few even screamed.

“They really seem to appreciate what we’re doing,” said dental student James Fang.

“Sometimes it helps to raise your voice to get their attention,” said Stephen Hiroshige. “Or sometimes if you lower your voice and whisper in their ear, they’ll get quiet so they can hear you.”

And if all else fails, he says, “you can always threaten to tell their parents.”

All the work, including fillings, extractions, sealants, crowns and other services, are performed under the guidance of Niederkohr, with all the work done in keeping with American Dental Assn. and California Dental Assn. standards. But even with the close supervision, student Peter S. Bae said that for him, “the clinic is the first time we’re allowed to be a complete dentist because we get to diagnose, prepare a treatment, and then do the treatment.

“This gives us a chance to finally feel like we’re doing something instead of just going to school. We do get to do some work in school on adults, but those are ideal situations. This is the real world.”

Dental hygiene students volunteer to assist the student dentists. “It’s always nice to know, when things don’t go by the book, what to do then,” says hygiene student Nadine Lopez of the Hacienda/La Puente Adult Education Center.

Dentists already in private practice are also concerned about children who are unable to obtain care, says Joseph Renzi of Santa Ana, a pediatric dentist who heads the Orange County Dental Assn.’s children’s clinic.

More than 200 county dentists volunteer one day a year to work in the program, which is set up through the Orange County Health Care Agency’s public clinic in Santa Ana. About 1,400 children have received treatment at the clinic in the past year, Renzi said.

“These are all children who are identified by school nurses. They have no private insurance, and their family incomes aren’t low enough to make them eligible for Medi-Cal,” Renzi said. “We provide whatever they need in terms of basic restorative care, simple extractions and cleanings. But we don’t have the resources to do orthodontia or cosmetic work.”

The association also provides emergency dental care for adults, also through the public clinic. That program, Renzi said, is funded by the county.

But Renzi says children from low-income families aren’t the only ones who may not be getting the dental care they need.

“I see the full spectrum, from very low-income people who want to make sure their children get treated, and they promise to pay $10 or $20 a month, whatever they can, even if it takes them 10 years. And then I see other parents who have a much higher income level and even insurance who don’t bring their children in. Their child may be in pain, but to them it just isn’t a priority. It’s more difficult to provide care to those children than it is for those who can’t afford it,” Renzi said.

Ideally, children should have their first visit to a dentist by their first birthday, Renzi said, so that potential problems can be dealt with.

“We try to do a lot of community education so that parents can be aware of the importance of dental care. But some of them just choose to spend their discretionary income on other things. We’re trying to find some way to get the parents to put things in perspective.”