FOR MORE INFORMATION
Community Smiles/Dade County Dental Health Clinic operates from Lindsey Hopkins Technical Education Center, 750 NW 20 St., Miami.Pediatric services are offered from 8 a.m. to 3 p.m. two days a month; another day per month is set aside for orthodontic work.An appointment is necessary. The clinic serves people whose income falls below various measures. Jackson Memorial Hospital determines financial eligibility. Call 305-585-2222 for more information.Yamila Nuñez flashes her two new teeth to her mother Trissia Espinosa.
''See? They're shiny!''
Yamila's dentist, Lester Gil, had just done a pulpotomy -- a baby tooth root canal treatment. She had two teeth pulled because of decay; the root canal was necessary before implanting the crowns into her gums.
That was on her right side; the left side will be taken care of next month.
It's a lot of dental work for a 7-year-old, but this was only the second time the North Miami Beach girl had been to a dentist. The first time was a month ago after she complained to her mother about a toothache.
Yamila found help at Community Smiles, an outgrowth of the Dade County Dental Health Clinic, which has been providing dental care to the underserved since 1946. Three days a month, the clinic's volunteer dentists and orthdontists take care of children's teeth, a growing area of concern since the number of children with tooth decay has increased significantly over the past two decades.
''Dental disease is the most prevalent children's disease,'' said Beverly Largent, incoming president of The American Academy of Pediatric Dentistry.
Tooth decay affects more than one-fourth of U.S. children aged 2-5 and half of those aged 12-15, numbers that have steadily increased in recent years, according to a February 2008 report from the Centers for Disease Control and Prevention.
Low-income children are the hardest hit -- two-thirds of those between the ages of 12-19 who live below the poverty line have had tooth decay, according to the CDC.
The problem is acute in Florida, where nearly one child in five does not have health or dental insurance, making it one of the states with the highest uninsured children rates.
''Many of the children we see here are coming from other countries where they might not have this sort of information on how to take care of their teeth,'' said Gil, the volunteer dentist who worked on Yamila's teeth. She is originally from Uruguay.
Gil, a resident at the University of Florida's dental school branch in Hialeah, is training to be a pediatric dentist. A shortage of such dentists contributes to the problem. There were 250 pediatric dentists in Florida in 2007, compared with 7,015 general dentists in the state, according to the American Dental Association.
The consequences of untreated dental disease can be dire: When cavities are not filled, teeth can atrophy. That can lead to disease and leave a person unable to chew, causing malnourishment.
In rare instances, bacteria from the gums can spread to the brain. In a well-publicized case, Deamonte Driver, a 12-year-old Maryland boy, died after bacteria from a tooth abscess spread to his brain. The boy's Medicaid coverage had lapsed. A routine tooth extraction -- the kind the dentists do at Community Smiles -- could have saved him.
Dental disease also has cosmetic implications -- children may not want to smile if they have rotted or missing teeth.
''That is a problem,'' Largent said, ``because we want our children to be good social beings. We want them to be able to smile. We want them to be happy little children.''
Gil has been volunteering monthly at Community Smiles for the past year.
''Many of the kids just have so many problems,'' he said. ``They have cavities, they have teeth that need to be pulled out, some of it is caused by bad nutrition -- like feeding babies soda. And because their teeth hurt, they suffer more bad nutrition.''
Children with weak or missing teeth can't easily chew on the foods they need most during their formative years -- fruits and vegetables and foods rich in protein. The result can be physical and mental weakness.
After working in Yamila's mouth, Gil spoke to Yamila's mother about feeding her sugary foods less and brushing her teeth more.
The children who walk through the clinic's door have tiny teeth that are brown and splintered -- sunken into gums, marred by neglect, infected with bacteria. They get to the clinic after being referred from mobile health vans, outpatient clinics, screenings at foster homes and Jackson Memorial.
The clinic's director, Dr. Robert Wolf, calls the mouth the window to one's health. When a cavity goes untreated, decay eats into the center of the tooth, eventually entering the nerves and blood vessels.
Wolf said Community Smiles can serve as a model. Up to 45 pediatric dentists volunteer on a monthly basis. They, in turn, attend lectures and get credits from the Board of Dentistry. The clinic, which worked with 500 children last year, is funded through grants and donations.
On a recent weekday, Katiana Thelemegue, 4, accompanied by her mother Suzette Gume, had a dental sealant placed on her teeth. It was her first trip to the dentist.
The American Academy of Pediatric Dentistry suggests all children see a dentist by their first birthday.
''She is lucky,'' said volunteer dentist Alain Selenou, who had seen other children of the same age whose teeth looked ``like sticks.''
The little girl grinned widely, clutching a new toothbrush and a box of candy.
''She has very good oral hygiene,'' he said. ``It could have been much worse.''
