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As reported by The Hartford Courant, March 13, 2010.

Dentists of Mercy: Free Middletown Clinic Helps People with Pain But No Insurance

By Arielle Levin Becker

MIDDLETOWN Joshua Kerwin dreads the dentist so much that he went more than a decade without seeing one, even as his teeth decayed and ached.

But on Friday, he waited overnight to get a wisdom tooth taken out. He does not have dental insurance, and he can't afford all the dental work he needs.

So Kerwin, 31, took a day off from work, packed a cooler, got a ride from a friend and, at 2:30 a.m., arrived at the Aetna campus in Middletown. There, a few hours later, the Connecticut Mission of Mercy free dental clinic was set to begin.

Inside, rows of dental chairs lined floors that once held cubicles, 40,000 square feet of corporate office space now devoted, for two days, to the underserved. More than 1,600 volunteers were expected, offering oral surgery, fillings, root canals, child care, even some company in navigating the walk from one station to the next.

Organizers hoped to treat 1,000 patients Friday and 1,000 more today, about as many as the clinic could handle.

The clinic was scheduled to open at 8 a.m., but nearly an hour before that, the line was shut down. More than 1,000 people had already shown up.

Some arrived close to midnight. Security guards blocked the entrances to the Aetna campus, so prospective patients lined up their cars along the road outside and waited through the night. Tammy Castonguay arrived from Manchester at 1:15 a.m. and found 32 cars ahead of her.

It was sad, but not surprising, said Dr. Bruce Tandy, president of the Connecticut State Dental Association. Statewide, an estimated 1 million people do not have access to adequate dental care. Medicare doesn't cover dental work, and few dentists will treat adult patients on Medicaid because it pays so little.

The bad economy has stripped people of jobs and benefits, although Tandy said the unmet need is sizable even without a recession.

And he worries it will get worse. Gov. M. Jodi Rell has proposed cutting all non-emergency dental coverage for adults in Medicaid and state administered general assistance as a way to reduce the budget deficit.

That could mean even more people at free clinics like this one not the trend organizers were aiming for.

"As proud as we are to do this project, the underlying message is we hope someday we don't need this," said Dr. Laurence Levy, a Middletown dentist who helped plan the clinic.

At last year's Mission of Mercy in New Haven, volunteers treated nearly 1,900 people. The year before, 1,500 patients were treated in Tolland.

"This clinic is just a Band-Aid," Levy said. "There's no way we can meet the demand."

But Friday, they did what they could. Those who made it inside were grateful.

"This is amazing. Thank you so much. My husband's out of work," Castonguay told Dr. Sarita Arteaga and dental hygienist Jeena Kuttiyara as she eased into her chair their first patient of the morning.

One of her back teeth had split. But money had been tight since Castonguay's husband tore his rotator cuff at work.

"There's just no money for teeth," she explained. Her husband was in another section, getting a filling."

Castonguay, 42, had taken the day off from her job as an office assistant. She packed lawn chairs and blankets in case they had to wait outside, and a glow-in-the-dark crochet hook in case there was no light.

Despite a night without sleep, Castonguay remained cheery through the procedure, even with dental instruments crowded into her mouth. When they were out, she smiled as much as she could with numb mouth and gauze peeking out from her lips.

The attitude didn't surprise Arteaga, a professor at the UConn School of Dental Medicine. She had seen it before from patients at the previous Missions of Mercy.

"They're so appreciative," she said. "They're so relieved."

In the next chair, Elizabeth Dolan and Tim Holzhauer, third-year dental students at UConn, tended to Kerwin.

A couple months earlier, the pain in his teeth got so bad Kerwin finally went to a dentist. Since then, he'd been back several times for repairs. He estimated that the tooth Dolan and Holzhauer were tackling was his 10th to be removed.

"It's very expensive when you don't have insurance," said Kerwin, who manages a taxi company and lives in Manchester. His dentist, who was volunteering Friday, recommended the clinic.

When the first two Novocain shots didn't fully numb his mouth, Kerwin wondered if he was building a tolerance.

"Sorry," he said.

You've been here since 2:30, the dental students assured him. We can wait.

The next shot did the trick, and soon after, his tooth was out.

Dolan and Holzhauer's next patient, Robb Kudra, 55, of Ashford, also got a tooth out. He had gone 20 to 30 years with only sporadic dental care, despite pain on and off in his teeth. He gets his health coverage from the Department of Veterans Affairs and it doesn't give him dental coverage, he said.

Since he left the military, Kudra worked construction, drove trucks and did design engineering, but he isn't working at the moment. "The market stinks right now," he said.

As he prepared for the extraction, he saw his neighbor walk by, led by a volunteer to a nearby chair.

When the extraction was done, Holzhauer advised Kudra on what to take for pain and Dolan reviewed his X-ray. One tooth could be saved, with some work, or it could be extracted that day, Dolan said. Kudra said he figured he should try to save it.

"Do you have someone to see it for you?" Dolan asked.

"Not really," Kudra said.

"No," he added a few seconds later. "Not really is code for hell, no."

Organizers already are planning next year's Mission of Mercy. For many people at this year's clinic, that might be their next chance for dental care, Levy said.

"People have toothaches. They're in pain," he said. "They have nowhere to go."