"We do cleanings, x-rays, fluoride applications, sealants, and a lot of education," said Dr. Cerilli, whose chief role is raising money to keep the charity running.
"The overwhelming majority of the kids we see have never seen a dentist," he added. "Some of them have never even used a toothbrush. In this group, preventive dentistry is not high on the list of family priorities. They don't have $100 to have their kids' teeth cleaned. As a result, their oral health is terrible."
The charity employs four full-time workers: two dental hygienists, a nurse-practitioner/administrator, and a bus driver/data analyst. Annual operation costs run about $325,000. Raising that kind of money after the initial enthusiasm about our program has not been easy, Dr. Cerilli acknowledged. "The population in Hilton Head is only 37,000. Unlike other communities where this type of program has been initiated, we don't have a big hospital that we can become an appendage of or a large corporation that takes it on under its wing. It's a wonderful, generous community, but it probably has 250 philanthropic organizations all looking for money."
Still, he hopes the charity's efforts translate into not only better oral health for needy schoolchildren but also improved self-esteem and success for them in later life. "You don't hire many receptionists or people in professional schools who don't have teeth," he noted. "We think [our efforts] are going to increase employability."
For most of his 33-year career as an internist, Tom Connally, M.D., cared for high-ranking, well-to-do patients inside the Washington beltway, including Supreme Court justices, cabinet members, and billionaires. Soon after he retired in the fall of 2000, he started seeing patients one or two evenings per month at a free clinic in Arlington, Va., on a volunteer basis.
"I enjoyed it and found that I could contribute," he said. "To qualify for our clinic, you have to be below 150% of poverty. About 90% of the people we see were not born in this country, and they're struggling. They're grateful [for our help]. You have a feeling that you're doing something that needs to be done. Most of the people in the free clinic movement wish that free clinics weren't necessary, but we know they are."
Dr. Connally became the clinic's medical director in January 2005. He helps coordinate care provided by about 140 physicians who volunteer their skills in some way. "Half come over to the clinic at one time or another for an evening or afternoon clinic," he said. "The other half are specialists and subspecialists who see patients in their office."
He is also leading an effort to computerize the clinic's medical records. "I'm enjoying the quality control, partly because we do such a good job," he said.
For instance, he recently reviewed 40 randomly pulled charts of patients with diabetes. "Many had hemoglobin A1c levels that weren't so good, but that was due to the nature of the patient, not the nature of the practice," he said. "But not a single one had a blood pressure [reading] in an unacceptable range and not a single one had a bad LDL cholesterol level. We've almost taken large-vessel disease off the table."
Inspired by a Peace Corps worker, Dr. Mark D. Dressner has taken part in 11 mission trips to Honduras and Brazil. Dr. Matthew Davis