Moving mountains

Tucked away in the mountains of southeastern Kentucky, down winding Highway 66, is the Red Bird Dental Clinic, a beacon of hope for many residents of Clay, Bell and Leslie counties. Geographic and economic conditions in this part of the commonwealth create limited access to oral health care—the next closest dentist is a 45-minute drive away.

“Without Red Bird, most people here simply would have no dental care. It’s extremely important to this community,” said Revelle Berry, who, with her family, is a longtime clinic patient.

When Bill Collins ’91 stepped in to help in 2016, the Red Bird Dental Clinic had been without a dentist since 2015.

“There were more than 300 people on the emergency waiting list,” Collins said.

His goal was to fill the gap until a permanent provider could be hired but the remote location made it difficult to find another dentist.

“I was working there two days a week in July. When I asked Red Bird’s executive director if they had any luck finding a dentist, she said ‘yes.’ I was relieved. When I asked ‘Who?’, she said ‘You,’ ” he explained.

In August 2016 Collins started working three days a week as dental director while also maintaining his own dental practice in Pikeville. The schedule may seem daunting but Collins felt compelled.

“These are my people,” he said. “I’m a mountain boy, just here to help.”

Forging a Partnership

It wasn’t long into Collins’ new leadership role that the Red Bird Dental Clinic began a collaboration with the School of Dentistry to bring students to the heart of the Daniel Boone National Forest and expand the clinic’s capacity to serve more people.

In 2017, the Red Bird Dental Clinic became a new site for third-year dental students to get hands-on experience, with all 120 receiving the opportunity to spend a weekend treating those who need it most.

“Generations of poverty have greatly exacerbated health conditions that need extensive, late-stage treatment, follow-up and support,” said Kari Collins, executive director of the Red Bird Clinic Inc. and Red Bird Mission Inc. “Our vision is of one of a healthier, sustainable community and UofL is an important partner in carrying out this vision.”

Red Bird Mission is a faith-based organization that started in 1921 with a private school and expanded to include job training, clothes closet, food pantry, adult education and senior citizen services. Medical and dental services also grew out of the charitable organization, eventually falling under the umbrella of Red Bird Clinic Inc.

Red Bird Mission board member Les Allen is a clinic patient and says having dental students come to southeastern Kentucky says a lot about the university. “It gives the impression that people are literally going the extra mile to give us a hand. It’s not convenient, but they do it. And, it adds to the clinic for patients to interact with students and to be part of the education process,” he said.

“This experience gives our students enriching cultural and clinical practice experiences that will make them compassionate, exceptional dental health care providers,” said Gerry Bradley, dean of the dental school.

Under Collins’ supervision, students complete numerous dental procedures—from extractions and fillings to crowns and bridges. In addition to Collins, the students work alongside and learn from UofL dental alumni Susan King ’85 and Bob McGuinn ’74 and former dean of the University of Kentucky College of Dentistry, Sharon Turner.

Since the partnership started, dental students have cared for almost 600 patients, many of whom were dealing with challenges specific to rural eastern Kentucky that impacted their dental health. These include a high poverty rate, opioid addiction and an overreliance on soda due to bad tasting water.

Filling a Significant Need

“We were as poor as a church house mouse — but we didn’t know we were poor,” said Burgie Collett on growing up in Leslie County in the 1950s and ’60s.

Collett attended a one-room school until eighth grade and graduated from Leslie County High School in 1972. Through the years, he participated in youth programs at Red Bird Mission Inc.

Although Collett left Kentucky to find work, he returned to Leslie County after retirement to care for his ailing parents. It was then that he became a Red Bird Dental Clinic patient.

“I’ve had two teeth pulled and numerous fillings,” he said. “The dental students are always friendly and make me feel comfortable.”

As a third-year dental student on her clinical site rotation to Red Bird last year, Sarah Jestel initially struggled to cope with the reality of a real clinical environment. “I would almost pass out when it came time to do an extraction,” she said.

Dentists at Red Bird pull many teeth due to extreme decay from too much soda.

“We are working to educate patients about how to have better dietary habits and about other prevention measures such as placing (dental) sealants and applying fluoride varnishes,” Collins said.

After working with Collins and interacting with the clinic’s patients, Jestel overcame her fear and even opted to return to the Red Bird Dental Clinic after her initial rotation.

“The patients were so appreciative of the work we completed, especially those patients requiring extractions,” she said. “Many had been in pain a long time.”

Fighting a Growing Addiction

Recent years have brought a harrowing new complication to the area’s oral health care challenges. Like many areas across the nation, the Appalachian region has experienced mounting problems related to substance abuse and addiction. The shrinking availability of jobs, widespread hunger and inadequate or unsafe housing constitute the norm throughout the area.

“When people don’t have hope, they get lost in something and, too often, it is drugs,” Allen said. “Our community is among the hardest hit,” Collins said.

“It seems to be more prevalent in depressed areas. We are seeing children of addicted parents homeless and wandering from house to house. If we don’t address this now, generations will be lost. It takes the active response of public and private entities."

Since moving back to Leslie County, Collett signed up to work as a volunteer firefighter. He is one of the first on the scene when handling calls related to an overdose. Collett said this fall he knows of about 60 local overdose calls in 2018.

“They are like zombies,” Collett said.

The Red Bird Dental Clinic recently began working with rehabilitation organizations to provide oral health care for those actively engaged in substance abuse treatment. The use of a mobile dental unit increases the clinic’s ability to serve those without access to care.

Terry Smith, a staff member with the faith-based Chad’s Hope addiction treatment center, said some of his clients have “rotten teeth or no teeth.” Even after completing a recovery program, his clients with bad teeth face the difficulty of finding a job and coming to terms with the effects of their addiction.

“These are men with no self-esteem. The only job they can get is maybe washing dishes,” he said. “Red Bird coming to help us is a godsend.”

Furthering the Clinic's Reach

The Red Bird Dental Clinic provides dental care for many patients who are low-income, underinsured or uninsured. The clinic offers a sliding-scale fee program, and individual donors, along with organizations like the Good Samaritan Foundation, Delta Dental and Avesis, give money to help cover the treatment for those with the greatest need. It’s the partnership of many that allows the Red Bird Dental Clinic to reach more people in this isolated region.

“Although I’m blessed to have a good job with dental insurance, we have a number of working poor in the area — lots of single parents just doing the best they can,” longtime patient Berry said. “People come here and know they’re getting high-quality dental care, and it is also a good feeling to know we are helping in educating future dentists.”

With Collins at the helm, the Red Bird Dental Clinic and UofL are providing better health care for the underserved.

“As long as my hands and my eyes hold out, I’ll be around,” he said. “We’ll do all we can to continue to serve those who live every day with the challenges of poverty.”