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Raynard Yoakum was in pain. His mouth was swelling up. He needed a tooth pulled.

He was one of the first patients at the new dental clinic in the Boys and Girls Club of Dane County, which opened Monday. The clinic, at 4619 Jenewein Road in Fitchburg, is run by More Smiles Wisconsin, a nonprofit organization offering low-cost dental services in south central Wisconsin.

Yoakum said he’s homeless and lives with friends and family on the north side of Madison and wouldn't know what to do if More Smiles wasn't available.

Yoakum is not alone. Almost a third of Wisconsinites don’t regularly visit a dentist, and one in five children in the U.S. don't get dental care. More Smiles wants to help Dane County patients get a handle on their dental health, which they say affects everything from disease and employability to confidence and school attendance.

The Fitchburg location is More Smiles Wisconsin’s second clinic; the first is located in the Salvation Army at 630 East Washington Ave. Discussions about opening a clinic in the Boys and Girls Club started about five years ago, but it took a grant from Delta Dental to turn the idea into a reality, said Jeff Okazaki, executive director at More Smiles Wisconsin.

“Dentistry is a very costly business. The overhead is really high and reimbursement from the government is very low,” said Neema Jahdi, the full time dentist at the new clinic. “We all have bleeding hearts, we want to help, but it’s impossible to run any business if you can’t fund it.”

More Smiles accepts Medicaid and Badgercare and offers a sliding scale payment for the uninsured. The new Fitchburg clinic has a reception desk, three patient rooms rooms and an x-ray machine.

“It’s not the biggest facility in the world, but it’s big enough,” Jahdi said. “We’re willing to help anyone that needs it.”

More Smiles Wisconsin is hoping to open a third clinic on the north side and eventually would like to expand to surrounding counties and rural areas. They’ll need more grant funding before that can happen, Okazaki said. The Fitchburg location is still looking for volunteers and monthly donations, said Michael Johnson, president and CEO of the BGCDC.

Jahdi said while it’s easy to assume tooth decay comes from neglect, his years in the dental field have showed him that’s not necessarily the case.

“You don’t realize that people have the choice between a toothbrush and toothpaste and eating,” Jahdi said.

MORE THAN TEETH

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DENTAL CLINIC

Jeff Okazaki, executive director of More Smiles America, at the Boys and Girls Club in Fitchburg, on Monday, January 22, 2018. PHOTO BY MICHELLE STOCKER

The impact of dental care goes far beyond teeth, Okazaki said. Reseasch shows that oral health can affect heath issues like cancer, heart disease, diabetes and stroke, he said. Dental care can even touch areas like the ongoing opioid crisis, he said.

“(If) somebody is homeless on the streets and has a 10-out-of-10 toothache, self-medication becomes an option for them,” he said. “That’s an area we can address.”

In 2015, Dane County emergency rooms received over 2,000 visits for non-traumatic dental pain, adding up to $2.5 million in charges. Okazaki noted that visits to the E.R. don't often solve the original dental problem.

“If they provide an antibiotic and a painkiller, eight weeks later when the antibiotic wears off, the infection comes back,” he said.

Dental issues may be painful and medically costly, but also play into self-esteem and can present “significant barriers” to getting even an entry-level job, Okazaki said.

“If you have an interview, and you have a completely bombed-out mouth, you have missing teeth, bad breath and damage, either you feel uncomfortable enough that you don’t want to smile, or you do and they look at that and go, ‘We don’t want this person customer-facing,’” he said.

Jahdi has seen patients who really wanted to make a positive impression at a job interview, but were missing their two front teeth. Giving them something to fill the gap often isn’t perfect, Jahdi said, but “makes a tremendous impact on their confidence.”

“People feel better about themselves, because they can smile,” Okazaki said.

“You see it all. There’s plenty of sad stories; there’s lots of good ones too,” Jahdi said. “People are very appreciative because they know what it’s like to have nothing.”

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BOYS AND GIRLS CLUB CLINIC

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DENTAL CLINIC

A tray of supplies in the hygiene room at the dental clinic at the Boys and Girls Club in Fitchburg, on Monday, January 22, 2018. PHOTO BY MICHELLE STOCKER

Tooth pain can lead to kids missing school, Johnson said, and he’s seen it at BGCDC. Johnson said he decided to really push for a clinic at the club after a survey of parents showed him that kids were on months-long waiting lists to get dental work done.

“If your teeth are hurting and you’ve got tooth decay, it’s hard to wait six to seven months to see someone,” Johnson said.

Johnson conservatively predicts 1,500 visits a year at the Fitchburg office. Parents were ecstatic when they learned about it and Johnson said he was inundated with emails, texts and messages that said, "Oh my god, can I sign my kids up?" and "This is amazing!"

Johnson’s also hoping to inspire kids to choose oral health care as a profession, as only about 5 percent of dentists in America are people of color.

It seems like Jahdi is setting a good example of a considerate dentist. Wanda Smith visited the clinic Monday and was delighted that Jahdi actually spent time explaining her situation to her.

“He spent like 15 minutes talking to me. I’ve never had a dentist do that,” she said. “I think he really cared about making sure I understood exactly what we were going to do and how we were going to do it.”

Smith used to work at a hospital, but when she gave up her job to run her own small business, Peace Network, Inc., a mental health counseling service, she gave up her insurance as well. When she found out about the BGCDC clinic, she booked an appointment right away.

“I had a $30 co-pay for a first visit, which was really cheap, right?” she said. “I’m so happy that we have something in the neighborhood.”

Her only complaint? She heard the staff say they need some coat hangers. “It’s the first day, so they’re working out all kinds of stuff.”