Nine–year–old Tenesha has a healthy set of teeth, thanks to the USC Dental Clinic that serves homeless people on Skid Row.

Caring for the oral health and health education of homeless mothers and their children is the latest effort of the USC School of Dentistry clinic, the first and only free clinic in Los Angeles to offer comprehensive dental care for homeless adults and children.

Tenesha and her sisters received cleanings, fillings and sealant treatments to prevent cavities at the dental clinic, located at the Union Rescue Mission in downtown Los Angeles. When a baby tooth needed pulling, USC dental students inserted a spacer so that Tenesha’s new permanent tooth would grow in straight and strong.

For homeless single mothers, finding shelter and food is paramount. Often, little attention is paid to their children’s oral health, and there is a prevalent misconception that baby teeth do not need the same care as permanent teeth. As a result, children under two years old often develop “baby bottle syndrome’ ‘–a milk film left on their teeth that can cause decay. Older kids often do not brush on a regular basis, leading to more decay and cavities.

“The need is tremendous, but getting their children’s teeth checked is just not a priority for these women,” says Virginia Santos, administrative services manager with the School of Dentistry and a longtime dentalassisting instructor. “They are thinking about getting a roof over their heads and about survival?’

Since it opened two years ago, the clinic has served about 2,000 homeless and poor in the Skid Row/ Central Los Angeles area, where about 13,900 homeless people live. The U.S. Department of Health and Human Services has designated it as a Dental Health Professional Shortage Area for the Homeless Population. According to a needs–analysis conducted by the School of Dentistry, the population–to–dentist ratio in the area is 9,931 to 1.

Patients visit the clinic regularly. They receive cleanings, fillings, dentures, root canals, bridges, extractions, dental education and referrals to other agencies as needed.At the same time, the clinic is a training site for fourth–year dental students, hygiene students and students in advanced dentistry programs.All are supervised by School of Dentistry faculty memhers and volunteer dentists, many of whom are USC alumni.

Santos and other dental assistants also work with children and their mothers on brushing, flossing, proper diet and the impact of oral health on their overall health.

As evidence of the demand, the clinic’s six dental chairs are filled nearly 40 hours per week, accoinmodating 24 patients daily, with one day set aside for children:

The dental clinic has been invaluable in enabling homeless people to regain self–respect and confidence, which helps them to succeed in job interviews, find employment and rebuild their lives and their families, says Liz Mooradian, communications director for the Union Rescue Mission.

“There’s no question it’s been helpful in the recovery phase,” Mooradian says. “Many of the people here have horrific things wrong with their teeth. Besides having issues with pain and infection, their self–image is crushed?’

Charles Goldstein, D.D.S.,M.P.H., director of community outreach programs at the School of Dentistry, says the clinic’s business is helping people get back on their feet.

“If they have teeth missing, we try to restore their mouths so that they are not only healthy but presentable,” he says.

For many of the children, it may be their first visit to the dentist, says Todd Gilbert Wahlin, a fourth–year dental student who worked on Tenesha.

“We have a great time treating any problems they may have and teaching them how to avoid the same problems in the future,” says Wahlin.”The kids leave with a new toothbrush and toothpaste and a healthy smile?’