Community Dental Care filling outsized demand for care

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Pe Vilai talks Thursday with Dr. Lucy Gores about a toothache and jaw pain at the Community Dental Clinic, located in the Heinz Center on the Rochester Community and Technical College campus. Helping with some translation is Pe’s daughter, Kanita Vilai.

It's only 2 p.m., and already Community Dental Care of Rochester is on its ninth emergency appointment of the day. Which isn't quite correct, because there was no appointment in this instance, just a family at the door with a patient in pain.

The day's 10th emergency patient sits in the waiting room.

Emergency patient No. 9 is Pe Vilai, 65, who is here with his daughter Kanita, who is 20. Were this not an emergency, Vilai would have had to take his place at the back of a line that is 2,500 patients long. The native of Laos is retired from his job as a janitor at John Marshall High School and heard about the clinic from his wife. He last saw the dentist four years ago. Now his tooth is infected and it has to go.

His dentist today is Dr. Lucy Gores, one of four dentists, six hygienists and 12 support staff who work at the 3-year-old center, just beginning the long search for funds to expand into a second, 16-chair facility in order to serve a pressing need in the region for access to dental care that accepts public insurance.

With 97 percent of its patients either on public care programs or uninsured, Community Dental Care is one of a handful of clinics in the region to take public insurance or provide dentistry on a sliding scale. Patients come in its doors after getting turned down at private dental clinics all over town.


"We had a patient call 10 offices and they all said, 'Sorry we aren't taking Medicaid,'" said Dr. Vacharee Peterson, CEO of Community Dental Care. "They finally called an insurance company who gave them our number."

In an effort to serve the waves of patients at its doors, each 14-hour workday at Community Dental Care is organized in hours longer than those offered at Apache Mall — two seven-hour shifts. The first patients arrive at 7 a.m. and two shifts of staff see them until 9 p.m.

They are seen in a six-chair Heintz Center office space that has far out-performed its constraints, given that it is barely the size of a large convenience store. The waiting room is a small entry hall. A bathroom has been converted into an X-ray area. A small lab space doubles as a storage room and two side rooms have been converted into offices. Everything else is used to treat patients.

"That was going to be a break room," says Clinic Manager Tiffany Young, pointing to a pair of chairs in an exam room at the end of the hall. "But because of the waiting list, we turned it into two more operatories." The staff room, Young said, offered an added bonus. "It's got a door," said Young, "so it's nice for kids. If they want to scream, they can scream."

The low reimbursement rates offered in Minnesota have put pressure on the centers that accept Medicaid. Last year, the center saw nearly 5,000 patients, or 51 per day, and provided nearly 18,000 services, or four times what it planned to offer when it opened its doors in 2012.

"It's really a plight for people of southeast Minnesota," said Peterson. She points to state data showing that just 42 percent of Minnesotans on assistance received dental care in Olmsted County in 2012, a rate below that of either Hennepin or Ramsey County and far below the estimated 60 percent of those receiving private insurance who access dental care each year.

Dental care is, of course, a path to reducing stress and increasing dignity, with the plight of untreated dental problems spilling over into homes and schools. "You see a lot of kids who are misbehaving in school," Young said, "because they are in pain and haven't been sleeping for four nights."

Gores graduated from dental school at Creighton University last May. She is a third-generation dentist in a family of dentists. When she isn't taking a shift here one day a week, she works in the roomier environment at Lakeside Dentistry.


"I always wanted to go into public health, " she said, waiting for Vilai's Novocaine to set in. "I grew up in Rochester, but I've never seen this side of Rochester," she said, referring to the high levels of cavities, broken teeth and periodontal disease in her practice. "It's nice to see the need in this town and be a part of helping where I can."

"I think they do need to expand the clinic," Gores said. "We are booked out until October already."

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Pe Vilai is examined by Dr. Lucy Gores DDS complaining of a toothache and jaw pain at the Community Dental Clinic Thursday June 25, 2015 located in the Heinz Center on the University Rochester campus in Rochester, Minn. At left is licensed dental assistant Mackenzie Gilseth and in the back is Pe's daughter Kanita Vilai.

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