Two people who attended a Missions of Mercy clinic told the students the clinic "is for people who don't smile any more."
Two people who attended a Missions of Mercy clinic told the students the clinic "is for people who don't smile any more." Photo courtesy: YES!

Young people give voice to the voiceless-and often, the toothless.

By Rose Hoban

People drive for miles, sleep in their cars, skip work, wait in line – all just to see a dentist.

These “Mission of Mercy” clinics take place every few months around North Carolina and can serve hundreds of people in a day or two.

“It’s very triage-esque,” said Jacquelyn Hedrick. “People are categorized into different places based on what they need.”

Two people who attended a Missions of Mercy clinic told the students the clinic “is for people who don’t smile any more.” Photo courtesy: YES!

Hedrick also described how there just aren’t not enough volunteer dentists and dental hygienists to serve all the people who come. Many folks are turned away.

“They’re not going to work 48 hours around the clock, so they’re only going to serve whoever can be served,” Hedrick said. “Then everyone packs up and goes home.”

The clinics both inspire and frustrate Hedrick and her co-worker Leighton Harrell.

Harrell explained that having the volunteer events sets in place a culture for the dental professionals that this is their way of giving back to the community.

“[Dentists] might think, ‘I don’t have to see Medicaid patients, I can just do this clinic once a year, that’s my giving back to society,’” Harrell said. “But it doesn’t solve the problem at the root.”

Empowered youth

Both Harrell and Hedrick have thought a lot about dental clinics and access to oral health care over the past two years. Their conversations often resemble those of policy analysts at a think tank or academics.

But they’re high school students who have been working with the Raleigh-based organization Youth Empowered Solutions, or YES!, on a project intended to push state law- and policy-makers to improve access to oral health for North Carolinians. YES! works with young people to increase their critical thinking skills, raise their awareness of and engagement in social issues and give them the opportunity to participate in creating positive change.

In this photo from the Asheville Missions of Mercy clinic in April, 2016, patients have received their oral x-rays, have been initially assessed by the volunteer dentists and are being triaged into the section waiting for “fillings”. (The other two sections were “extractions” and “hygiene.”)
These people were waiting for their number to be called in order to see the dentist or hygienist who will provide them with care. Photo courtesy: YES! Youth Staff

“We know that a quarter of the population in this country is below the age of 18, and so, our current opportunities to leverage the power and voice of those young people in many cases is lost,” said Parrish Ravelli, a project director with YES! who works closely with the teens.

He said it’s inspiring to see the creativity and energy the youth bring to issues, what they need to learn are the mechanisms of creating change. The work with YES! gives the youth a platform to make the changes they’d like to see and to advocate for change in their communities.

“Now we‘ve delved into it, it’s interesting and involves us and attaches ourselves to the social justice work we all love,” said one of the teens, Carolina Le, a high school senior who’s been working with YES! since January 2015. She said that she hadn’t thought much about access to oral health care until she met the folks at the clinics.

Photos and oral histories

For years, North Carolina has ranked 47th in the nation for the number of dentists per capita, even as the state’s dentists average more than $211,000 per year in salary.

And according to Julie Spero, from the Sheps Center for Health Services Research at UNC Chapel Hill, the projections are that the state’s shortage will remain for the coming decade.

Lack of access to oral health care is the reality for many North Carolinians – in particular, people who live in rural areas. Seventy of North Carolina’s 100 counties are designated as dental health professional shortage areas, in 29 of those counties, there are fewer than two dentists to serve the population and in three of those counties, there are no dentists at all.

And according to Spero, North Carolina has one of the highest rates in the nation of people coming to emergency departments with dental emergencies, and is at a rate higher than most of the state’s Southern neighbors.

Image courtesy: Sheps Center for Health Policy Research at UNC Chapel Hill.

Even when dentists are available, many people neither have insurance or money to pay for care; hence the volunteer clinics.

With Ravelli, a total of five young YES! employees traveled the state, attending the Mission of Mercy clinics in Winston-Salem, Fuquay-Varina, Greensboro and Asheville, interviewing people who waited hours-sometimes days-to see a dentist and taking photos that they felt illustrated the issue of people who lack access to care.

“We could actually speak to them instead of us just looking  at numbers and basically fabricating what we think they would say,” said Jabari Brooks.

The youth used a technique called Photovoice, which uses photographs to tell a story that goes beyond the numbers.

“It’s a way to advocate authentically,” said Harrell. “It’s speaking to people and having their voices act as the testimonies for the numbers.”

Meeting people really struck a nerve for the teens, and they formed strong opinions about the injustice of not being reliably able to access dental health care.

Photo courtesy YES! Youth Staff

“People shouldn’t have to rely on these giant massive clinics to get care,” said Harrell. “There should be systems in place that offer everyone access to care, in a way that’s humane and not patronizing and that makes sure that everyone’s needs are met.”

As Harrell said this, the others nodded.

“It’s fascinating to talk to your community, and not just other youth, but adults and they’re actually listening to you,” said Nyeka Gardner, one of the newer youth workers. “It gives me more leadership, it makes me a very responsible youth.”

Developing leadership

Two of the youth who work with Ravelli, Jabari Brooks and Caroline Le presented their research to the state Oral Health Collaborative meeting earlier this fall. They did a dynamic presentation on their dental care access project that wowed the crowd of adults.

“It’s impressive for folks so young to be giving a great voice to these people that aren’t heard,” said Spero, who presented after Brooks and Le.

The teens also have the opportunity to present their findings to adults at national meetings, such as the National Convention on School-Based Health Care in Washington, DC, this past summer, where students met with North Carolina’s Congressional delegation to advocate for increased access to health care.

The youth also traveled to Phoenix to present their oral health advocacy work to a national conference this fall.

One of the YES! teens presents the group’s findings from their oral health project at a national meeting in Phoenix in October. “It was amazing and well received by folks all over the country,” Parrish Ravelli said. Photo courtesy: YES! Youth Staff

Hedrick said that sometimes her peers don’t quite get what she’s doing at first, but as she explains it to them, they get excited.

“I’d make the argument that social justice is an increasingly popular area of focus among people our age, at least among people I associate with,” Hedrick said. “I’d accredit a lot of that to social media, that there are a lot more people who align themselves with work similar to this, and belief systems similar to this, so it’s just picking up speed.

“We just managed to snatch up the few available spots to be able to get paid to care about it.”

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Rose Hoban

Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...