A whale of a smile

Smile Quest fights tooth decay in area's youth

Killer whales dangle from the ceiling in one of the rooms in Warden's dental clinic, Smile Quest.

Not exactly the place one might expect to see killer whales — in a dentist's chair — yet there they are.

Smile Quest administrator Dorothy Yamamoto can explain:

Visiting dentists who help out at the clinic don't exactly know which of the three rooms are Room One, Room Two or Room Three.

But tell someone their next patient is waiting in the "whale room," and suddenly the mystery disappears.

Same goes for the Winnie the Pooh room, and for the monkey room.

Smile Quest has been around for 13 years.

The group is a non-profit organization to help those who need the care, to provide education, information on health care or to assist those interested in entering the field, Yamamoto said. Patients pay on a sliding fee scale.

Smile Quest is the lone health facility in Warden. There are no doctors or other facilities because the town is under Samaritan Hospital's jurisdiction, said Warden city administrator Mike Thompson.

"It's part of Grant County Public Hospital District One, but that doesn't prevent anybody from developing a medical facility in that area," said Scott Campbell, marketing director at Samaritan Healthcare.

Campbell said he thought that the lack of a facility on Warden ground was a combination of the small population base and the fact that there are facilities in both Othello and Moses Lake.

Thompson and Campbell said there used to be a clinic with a physician's assistant in Warden, but it closed in 1996, Campbell estimated, due to lack of utilization.

Smile Quest doesn't appear to have that problem.

Yamamoto said that Smile Quest got started because she and a retired dentist who lives in Moses Lake were concerned about the oral health of area children because of decay and oral diseases, which Yamamoto said school nurses report is the number one unmet health problem in Grant County.

They decided to go into the schools and take preventative measures, educating the children and alerting parents about oral health, examining and cleaning the students' teeth with fluoride.

"There's a window of opportunity where you can reverse the disease," Yamamoto said. "You can re-calcify the teeth with things like fluoride and varnish, but if you do not do something with that window of opportunity, it's gone. Then the child gets cavities, and it's too late, and the child grows into pain and distress."

Yamamoto said that the teachers and principals knew exactly which students were suffering.

"(The children) would suck on pus all day," she said, pointing to her mouth. "This thing does not detach from the rest of the body. It all works together, so when you tell little Johnny to sit down and do really wonderful in your class, it's kind of hard when (the student is) in a lot of pain and suffering."

Yamamoto said that the team tries to get in to access the children as early as possible, alert parents as to what they see and take preventive measures and apply sealants, or coating on the teeth, so bacteria can't set in.

Starting out, a problem arose in that the team hadn't been aware of just how much decay there was, she said.

"It's not a solution when you can only do part of the solution, so we decided we wanted to do something else in order to be able to do the rest of, and be, the solution," she said. "(Smile Quest) is what we did, with many dentists that come in here. They fly in, they drive in all the way from the coast. We have some locally, and we have dentists that are skilled and specialize in their own field, like root canals and oral surgery. Some of them are pedodontists; they specialize in children's dentistry. And they come in and they bring all their expertise to this place, and they take turns to work on the kids."

Smile Quest was then opened up to the community.

"We started out as a little proto-pilot project down the street, and we didn't know if people would come to us for help," Yamamoto said. "We opened it up and it was standing room only. It was just people packed from wall to wall; we didn't know what to do."

Dentist Wallace Robertson has been working at Smile Quest as needed for the past three years, once a month. He practiced in Dayton for 37 years, but retired upon getting bought out and came over to help Yamamoto on an occasional basis.

"There's a real need for what's going on in this clinic," he said. "Taking care of the people who are on DSHS, who cannot get into dentists in other areas. The amount of decay we see here in the younger generation, especially the Hispanic generation, is deplorable. The education that the younger people get here is, I think, something that needs to be done."

The clinic is also a University of Washington learning site, Yamamoto said, which means dental students are invited to come and get experience.

"We need them; this is a critical shortage area," she said. "I just got a letter that 20 clinics are hurting for dental people to help them out. Not just dentists, but hygienists and dental assistants and on and on and on. It is a critical dental shortage, because all of these students are over on the west side; they don't come over here. If we show them somehow in their curriculum or (during) the time that they spend in school that there is such a need here, possibly that might stir up some interest in them."

Smile Quest also works with Skill Source, farm workers out in the field and recently participated in the Big Bend Community College Job and Career Fair to help people learn more about the field.

"We get something, a wonderful chance to give them a skill and have somebody around where they can help us, help the kids, help the community, help senior citizens and help everybody around," she said. "And they in turn can help themselves."

Smile Quest goes into nursing homes and treats patients with Alzheimer's disease as well, she said.

Yamamoto said that 20 percent of the population owns 80 percent of the oral diseases.

"We know that poverty, (a patient's) ethnic group, if they live in a rural area and if they're low education, the chances of having diseases are even greater," she said. "So we know that this is a place that really needs the care. We decided we want to do this, and we walked into school districts such as Royal City and we cleaned them up. If you go in that school right now and see any of the kids in there, if they've been in our program and you open their mouth, they will show you they've cleaned their mouth; they keep it clean and they are now decay-free."

Eighty-five percent are now decay-free, Yamamoto said. Of the 75 percent of the population that had decay when Smilequest first began, 75 percent of their mouths had decayed, she said.

"The thing is, you clean them up, you teach them - it's not just the kids, it's the parents too - through activities; fun things, assemblies, classroom visits and then you go back and monitor them every six months, they're clean," she said.

Smile Quest visits 20 school districts and also recently helped out at Pasco-Sherman, the only Native American boarding school in the state, Yamamoto said.

"It was the most incredible time of our lives because we set up a dental clinic in their long house, where they have their powwows," she said. "Normal people aren't invited, and we were honored to be invited, to be their guests, to walk into the long house and treat their kids."

Yamamoto said that the dentists can put up four operating units in an hour. They only go where they are invited, by school nurses or administration, she said.

Part of the process involves educating parents about good dental hygiene as well. For example, Yamamoto said that many mothers are mistakenly under the impression that they have hereditary soft teeth; part of Smilequest's mission is to dispel those kinds of myths.

Yamamoto estimated that Smile Quest has seen 13,000 children in the last 13 years, one way or another. Nor do they abandon their patients after a cleaning. In fact, she said they know many of their patients by name.

"We just revisited Royal High School," she said. "We've been doing this 13 years. They have walked into the high school, the first kids that we've seen, and you should see their mouths. It is really, really, really rewarding to see these kids. And they can smile."