Robert Quarzenski was in pain. One of his bottom front teeth was loose and sore, and it wobbled back and forth when he ate. The 49-year-old Elgin resident has no dental insurance and says he couldn’t afford to see a private dentist.
Quarzenski found help at the free dental clinic at Elgin Community College, which celebrated its first anniversary last fall. One afternoon a week, patients pack the clinic, where volunteer dentists work on their teeth and students from the college’s dental assisting program earn clinical hours.
Quarzenski had been to the clinic a year earlier to have a tooth extracted. This one had to be pulled too.
“It’s hurting, and no way could I afford to go to a dentist,” Quarzenski says, adding that if the clinic didn’t exist, he would probably just put up with the pain. “The dentists here are pretty nice. I’m glad this is here.”
The clinic is the brainchild of the Community 2000 health initiative, a group that has been looking at health and quality-of-life issues in northern Kane County for the last several years. A survey by the group revealed what members already suspected: The dental needs of many people in the community were going unanswered, particularly after the State of Illinois cut its dental benefits for adults several years ago.
“People were really suffering and weren’t able to get (dental) care,” says Trinka Waters, assistant director of the Community Crisis Center of Elgin, which manages the free clinic.
Waters was on a Community 2000 committee that visited other free dental clinics in northern Illinois and then approached Elgin Community College about collaborating through its dental assisting program. There are a handful of other free clinics in the Chicago area, including one in Joliet and St. Basil’s free clinic in Chicago.
“The community college had the equipment and the students,” says clinic coordinator Waters, “and this could give the students some good experience. And we would get the dentists.”
The latter task was spearheaded by Dr. Gregory Karr, an Elgin dentist who has been the clinic adviser as well as one of the chief recruiters.
Karr says the original goal was to get about 25 dentists to volunteer two afternoons a year, but that number remains under 20, so some dentists are giving more time. In addition, several doctors provide support services for special-case patients in their own offices for procedures that can’t be performed in the clinic.
“We’ve been somewhat successful (in recruiting volunteer dentists) but not hugely successful,” says Karr, who began by calling colleagues in Elgin and then branched into the surrounding communities. “Some say they don’t have the time. Others feel uncomfortable working outside their own offices.”
Still, enough dentists came forward to make it possible to open the clinic. Dr. Bruce McLane, who has practiced in Elgin for 21 years, spent seven afternoons working in the clinic during its first year, more than any other dentist. McLane admits to being very pleasantly surprised that the clinic opened at all.
“I was skeptical (the college and the community crisis center) would reach an agreement,” McLane says. “But they managed to work everything out and get the job done. To use the clinic for a dual purpose is remarkable, and it’s amazing to me the level of cooperation in such a relatively short amount of time.”
It wasn’t difficult for McLane to make the decision to volunteer. “This is something I believe in,” he says. “We’re still a privileged profession, and it’s our obligation to give back to the community whenever we can.”
Clinic patients are screened for eligibility by the health center of the Community Crisis Center or by Catholic Charities Physician Referral Service. The clinic sees only patients age 18 and older who live in Elgin-area ZIP codes; the region includes Elgin, South Elgin, Carpentersville, East and West Dundee and Gilberts.
Patients must show a financial need, but these aren’t necessarily people who are unemployed.
“There’s some misconception that these are homeless people, but the majority are true working poor,” Karr says. “They just can’t get by and provide for their families, and let’s face it, health care is expensive.”
Since the clinic opened, Illinois has reinstated some of its dental benefits for adults, but Karr says it’s only for a minimal amount of care, and dentists are reluctant to participate because the compensation is so small and the amount of paperwork so large.
“You’d rather just do the work for free,” Karr says.
And that’s what they do at the clinic, with help from the students. Elgin Community College has had a dental-assisting program since 1968. Students take 11 courses and need 300 hours of clinical office experience before they can get their certificate.
Marilyn Westerhoff, ECC’s professor of dental assisting, supervises the students, who do about 60 hours of work in the free clinic and then 240 hours of clinical work in private dental offices. The free clinic moved into the Health Careers Center, although some of the equipment needed to be upgraded before it was ready for patients. Fundraising efforts by Sherman Hospital and St. Joseph Hospital, both in Elgin, and the Morning Rotary Club of Elgin helped make the equipment upgrades possible.
There are four chairs for patients, separated by chest-high dividers so that patients can hear but can’t see each other as the dentist is working. There are also three X-ray rooms and a large reception area.
The clinic is open one day a week, on various days; it closes for school breaks but will be open during the summer term.
Up to six dental-assisting students work as 10 to 15 patients file in and out of the chairs. The clinic is open from 1 to 5 p.m., and there’s barely a moment’s rest.
Jayme Barcus, a 20-year-old dental assisting student from Aurora, got to the clinic about 12:30 p.m. on a recent day to set up the four rooms with the correct tools and to spray down the rooms with a disinfectant, making sure everything was sterile. Once the clinic opened, the students took turns assisting, keeping the rooms cleaned and stocked with tools, doing X-rays and sitting with patients who were waiting for the dentist.
“In class, you learn about things like the placement of tools, and here you get to utilize the information and get the hands-on experience,” Barcus says. “It’s interesting to be working with different doctors because you get a feel for the different ways they do things.”
Rita Eisenmann, a 26-year-old student from Mundelein, added that classroom work is no substitute for clinical experience. “Just the daily things, like seeing the blood and stuff — that’s something you aren’t going to get in a class,” Eisenmann says. “Being in the clinic makes everything you learned in class come together.”
If a student has a question, or a doctor needs extra help, Westerhoff steps in. She moves from patient to patient as the afternoon progresses, reading their charts, talking to them about how they’ve been since the last visit and explaining to students what needs to be done for them.
The dentists say it’s not a problem having so many different students around. Karr, in fact, says it’s a benefit having so many hands available, preparing one patient while he’s working with another.
McLane adds: “Marilyn is always there, so any time I feel I need someone more trained, she jumps in.”
Most of the people who come are in pain, and Westerhoff estimates about 80 percent need extractions.
“The teeth are so long gone, nothing else can be done,” she says, “and we don’t have the funding to do implants. This is really like an emergency room for dentistry.”
Quarzenski asked a common question as he was sitting in the chair, waiting for his tooth to be pulled: “How much would it cost to replace my teeth?” McLane explained that the clinic didn’t make replacement teeth, and then gave him some ballpark figures of several hundred dollars.
“In private practice,” McLane explained later, “you might be looking at root canals and crowns. Here, the treatment of choice is frequently removal. People are appreciative of being out of pain and being seen professionally by anybody, but it’s hard on them and hard on us to be taking out teeth when you know some of them could be saved, but it’s just not feasible at this point.”
The clinic doesn’t have the funding to get the replacement teeth made, and it doesn’t have the time to do restorative work. The clinic is solidly booked. People sometimes have to wait weeks to get a tooth pulled.
“We don’t have the facilities or the time to perform higher end dentistry,” Karr says, “but we’re doing these patients a service. This is certainly one solution to their problems, and for us, it’s a way of giving back to the community.”
