Volunteer dentists, hygienists filling a need

If you are an adult in the Puget Sound area with severe tooth decay but no money, Kirkland oral surgeon Dr. Stephen Knoff may just be your only option for relief.

Knoff, a volunteer with Medical Teams International's mobile dental clinic, is the Christian humanitarian agency's lone active oral surgeon on the Eastside. And Medical Teams is one of the few groups in the region where uninsured adults can get oral surgery — complicated treatments that taxpayer-supported community dental clinics don't offer.

Knoff is one of 300 dentists and 600 dental hygienists and other professionals behind what may be the nation's largest mobile dental clinic run by volunteers. They roam aboard one of 10 converted Winnebagos — three in the Puget Sound area and seven in Oregon — and, for no charge, they clean, drill, fill and pull teeth inside the mouths of grateful patients.

For a decade, Knoff has set aside Wednesdays for nonpaying patients referred from the dental vans to his Totem Lake clinic. They come from as far as Stanwood and Tacoma, a testament to the dearth of affordable care. Knoff figures he treated almost 100 patients last year for abscessed teeth and other serious problems, giving away $100,000 worth of services to disbelieving patients.

"The need out there is so huge, and the supply is so minimal," Knoff said. Even giving "one day a month will make a huge difference."

The work by volunteers such as Knoff has helped offset criticism that dentists do little pro-bono work even as they battle legislative efforts intended to expand affordable care.

Earlier this year, the Washington State Dental Association succeeded in watering down a legislative proposal to loosen licensing rules for foreign-trained dentists, something supporters had hoped would plug a dire shortage of dentists.

The dentists also have been waging a lengthy turf battle with dental hygienists over whether hygienists should be allowed to perform routine cleanings without dentist supervision, in order to reach patients who might otherwise forgo dental checkups. And, state records show, most dentists won't accept poor and disabled patients covered by Medicaid.

Providing charity care "I don't think is the culture of the dental schools," contends Kate Mills, a veteran dental hygienist and a patient advocate in Kitsap County. "I don't think there is much emphasis on giving back."

Mills said she often struggles to secure emergency dental care for low-income residents in Kitsap County.

Though the county has 120 active dentists, "trying to find a dentist to take one of our patients is almost impossible," said Mills, who testified for the dental hygienists' bill.

Mills praised Medical Teams and other groups that donate dental treatments. But she called them a poor substitute for regular preventive care.

Dick Frederick, who oversees Medical Teams' dental operations in Washington, believes many dentists would welcome a chance to provide charity care if they could dispense with insurance and billing headaches. Frederick said the dental vans offer a hassle-free way for the dentists to volunteer, be it one day a month or one day a year.

"What they went to dental school for, they can practice it" in the van, Frederick said.

Medical Teams, based in Tigard, Ore., said it provides $5 million worth of free dental care to 15,000 children and adults in Washington and Oregon each year.

A fourth van will enter service in Washington later this year, dedicated primarily to King County. Frederick said he hopes to staff it by taking advantage of the fact that most dentists typically do not work on Fridays.

Many Medical Teams dentists are retirees. One such person is Dr. Allen Brown, a Seattle dentist who closed his practice after 45 years and donated his equipment to the group.

On Wednesday, Brown worked on a first-time patient, Marty Askelson, in a well-equipped, if cramped, white Winnebago in the parking lot of Northshore Senior Center in Bothell. The Winnebago features two dental chairs and an X-ray machine; dentists can handle root canals and extractions and anything that doesn't require general anesthesia. Medical Teams charges a fee only for dentures, which are sold at steep discounts.

Askelson, 74, of Kenmore, marveled through a numbed mouth that he got a cavity fixed for $15 (charged by Northshore, not Medical Teams). He described Brown as "very thorough, very professional" and grinned that the price was unbeatable.

Askelson planned to return for treatment of two remaining cavities.

Kyung Song: 206-464-2423 or ksong@seattletimes.com