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St. Louis GKAS program surpasses $2 million in donated care

St. Louis—They were just like any group of kids, happy to be off of school for the day and on a field trip. Five and 6-year-olds bounced around with the enthusiasm only new adventure can evoke. Pre-teens maintained their pre-teen edge: "I know what I'm doing here," without a trace of negativity.

What attraction could such a wide-ranging age group appreciate?

Free dental care was the draw. It was the Oct. 24-25 Greater St. Louis Dental Society's 14th Give Kids A Smile event.

In two days, some $244,000 worth of dental care was provided to 659 kids. Since St. Louis' first GKAS, in February 2002, more than 7,000 St. Louis-area children have received $2,221,866 worth of care.

"We're never satisfied," conceded Dr. Jeff Dalin. He co-founded GKAS in St. Louis With Dr. B. Ray Storm in 2002, a year before it was adopted as a national program by the ADA in February 2003. "There's always room for improvement," he said.

Improvements just keep on coming. The St. Louis University Center for Advanced Dental Education now provides 60 chairs under one roof for free dental care each February and October. Drs. Dalin and Storm borrowed a dental office slated for demolition for the Greater St. Louis Dental Society's first GKAS in February 2002. In October of that year, the St. Louis Community College at Forest Park provided 30 chairs, hosting GKAS for three events, before the dental school offered its space in February 2004.

"GKAS makes this clinic come alive," said Dr. Rolf G. Behrents, dean of the dental school. Alive it was, with more than 200 kids ditching school with the blessing of their teachers and school nurses on an unseasonably cold Friday. Saturday brought charitable organizations and younger kids with parents. Dr. Behrents assumes different vantage points around the clinic, literally beaming at the activity. Some 45 graduate students, all general dentists pursuing advanced dental education, are volunteering as part of their curriculum.

In addition to the graduate students, 120 hygiene students from the community college at Forest Park volunteered. Many of the 80 participating dentists have been with the program since its inception. Some 80 dental assistants from area dental assisting programs and at least 200 lay volunteers, called ambassadors, keep the program on schedule. Many of the ambassadors are patients and relatives of volunteering dentists.

Beat the clock

Each kid has a three-hour time slot at the clinic. Ambassadors manage long, orderly lines of kids through registration, then shepherd them individually from registration to triage to the various care stations—from hygiene to restoration to endodontics to oral surgery. The whole process is a model of efficiency and Dr. Dalin's familiarity with it doesn't make it less impressive to him.

"You've really got to see it to believe it," he said, taking the words out of the mouths of awed visitors. "You can do a lot in three hours."

Dr. Dalin stations himself at a desk outside the X-ray area. He explains to each child what he sees in his or her X-ray before an ambassador whisks the child away to the appropriate care station.

"It's all about the patients," says Dr. Mark Ortinau, quickly moving out of the way of a group of students entering the clinic. "Today is their day."

Dr. Storm and his wife, a dental hygienist, used their experiences on overseas missions to develop the flow of the mobilized GKAS clinic. They never imagined it would grow to the size it is in St. Louis or to a national level.

"It's so gratifying for my wife and myself to see these events throughout the country," said Dr. Storm. "We hope that GKAS events everywhere will develop more comprehensive care. After all, we don't need the screening process to learn these children need dental care. We know that already."

Garion, age 12, holds an ice pack to his jaw in the recovery area after having a tooth removed. "I don't remember going to a dentist before," he says. "My mouth has been hurting sometimes."

Dr. Tom Flavin is coordinating the endodontic/oral surgery section today. "I know they get used to the pain they have," he said. "We do our best to be sure they have no pain here, try to turn them into good patients."

Brothers Chandler, Gabe and Chase are 10, 11 and 12 years old. They've come 70 miles to be here today. Dr. Dalin examines their X-rays. Each of them needs restorations, in addition to cleaning.

"You're upper molar is a goner," Dr. Dalin tells 11-year-old Sammi. He asks her if it bothers her. She seems unsure.

Members on the board of directors, Drs. Flavin, Mark Ortinau and Mark Zust decide to take a quick breather and grab a bite in the volunteer's lunchroom. Each is overseeing a production area—Dr. Flavin is monitoring endodontics/oral surgery, Dr. Ortinau is coordinating the ambassadors and Dr. Zust is overseeing the restorative section of the clinic. (Board members Drs. Anthony J. Marino, B. Ray Storm and dental hygienist Jan Storm, are in the clinic.)

The three estimate that each event takes "hundreds of hours of planning." They say they couldn't do it on their own.

In 2004, community members helped the dentists fill out paperwork to attain nonprofit status so the event could receive funding and develop a solid infrastructure.

"Every GKAS needs to seek help outside the dental community in order to grow and serve the community as a whole," said Joan L. Allen, executive director, Give Kids A Smile, St. Louis. "If you reach out, you'll find people in the community in law or accounting or other areas that want to help and are also a wealth of information," the former teacher explained. "These same people can serve on the board or volunteer. We often have 500 volunteers and we need each one of them—from those who help load the trucks for on-site materials to the hygienists and oral surgeons."

In addition to two GKAS events each year, St. Louis volunteers also treat Smiles Factories patients after the clinics—kids requiring extensive follow-up care; and Tiny Smiles patients during the clinics—babies, toddlers and preschool-aged children. Guardians and children receive dental hygiene education and instruction.

"Some dentists prefer to provide treatment in their own offices," says Ms. Allen. "Smiles Factories is perfect for them because all patients are taken under GKAS protocols (the patients don't become permanent), and dentists can treat in their own offices."

Targeting kids

It's 12:30 p.m. and only four of the 26 children that school nurse Becky Cartmill recommended for the event have finished their treatment. They're killing time while waiting for their schoolmates in the library/dance hall/lunch room. One of the four had a filling and another had a tooth pulled.

"Most of the kids haven't finished quickly so I'm betting they need treatment," said Ms. Cartmill. "It doesn't surprise me."

Ms. Cartmill says she often assumes that if kids don't have medical insurance they probably don't have dental insurance either. She watches them through the year and keeps track of those who have pain, so she can bring them to GKAS.

She thinks school nurses are in a good position to select children who should participate in a GKAS program.

"We see these kids everyday," says Ms. Cartmill. "We know if they're having problems."

Taylor, 13, hangs around with her friends admiring their face paintings. She said she had a cavity filled and sealants applied. "I don't think I've ever been to a dentist before," she said. 

To learn more about Give Kids A Smile visit ADA.org at www.ada.org/goto/gkas.