SAN DIEGO -- Two dentists and two Navy dental corpsmen are working on the mouth of John Gardinier, an Army veteran who served in Vietnam and now lives in Tijuana near the clinic where he can get methadone for his drug addiction.
"It's no good to have teeth that are rotten," Gardinier, 64, had said as he waited to be treated at the dental services area at the 25th annual Stand Down in San Diego for homeless and hard-luck military veterans. The relief effort brings together dozens of government agencies, nonprofits and volunteers to provide veterans with a variety of health and social services.
Dr. Ben Kim, a volunteer and former Army soldier, and Dr. Shay Razmi, head of the dental department at Naval Medical Center San Diego, hovered over Gardinier -- aided by dental corpsmen Brock Frost and Joshua Fallick.
Gardinier's remaining teeth show the ravages of age, drug addiction, smoking and lack of care. The pain from those teeth that are rotten and those that are worn to the roots had been intense and made it difficult for Gardinier to eat.
"You doing OK?" Kim asked as the extractions continued. "One more to go."
Within minutes, Kim and Razmi pulled seven of Gardinier's teeth. He was given pain medicine for when the Novocain wore off and also directions to a community clinic where he could get a set of low-cost dentures.
So it went all day Friday, the opening day of the three-day Stand Down.
At last year's Stand Down, Navy dentists, technicians and volunteers saw 270 patients and pulled 190 teeth, a 25% increase over the previous year; this year's numbers are expected to increase by another 25%, when final tallies are made.
The focus of Stand Down has long been on providing medical care, counseling for substance abuse, assistance in finding shelter and clothing, and referrals for follow-up help from the Department of Veterans Affairs.
But in recent years, dental care has taken on prominence.
When a veteran's teeth go bad, it can exacerbate a variety of health conditions and even lead to life-threatening heart problems, Razmi said. Bad teeth can also trigger depression and a sense of hopelessness, she said.
"Many of them have not had dental exams for 15 years or more and their mouths are full of abscesses and pus," she said. "Their conditions are often very complicated, and they have been in pain for a long time."
Later this summer, Razmi and the others will be at the Stand Down for veterans in Orange County. In September, dentists from the Ostrow School of Dentistry at USC will be at the Stand Down in Compton for the second year.
Dental and eyecare problems are the "hidden" conditions of homeless and downtrodden veterans, said Dr. Santosh Sundaresan, director of the USC Mobile Dental Clinic. "There just isn't much public perception that these are problems."
USC dentists have also provided care for veterans at an event in Northern California and an event on campus for women veterans.
"On our first trip, we were just blown away by the degree of dental need among the veterans," said Dr. Thomas Levy, director of undergraduate endodontics at the USC school.
San Diego hosted the nation's first Stand Down, which this year attracted 1,050 veterans. The event ended Sunday night.
For three nights, the veterans slept on cots in open-air tents; dozens of groups and individuals -- including service organizations, church groups, charitable foundations, and big-ticket corporations -- sponsor booths where assistance is offered.
The VA, Veterans Village of San Diego, and the Navy medical center were major sponsors and participants. Active-duty Marines and sailors helped with the tents and logistics chores and mingled with the veterans, reinforcing the concept that the veterans' service is still honored by those currently in uniform.
By early afternoon on Friday, the dentists and technicians had seen 80 patients. Dentists were busy helping patients on four reclining chairs, providing X-rays, exams and, most frequently, extractions.
Jason Brabant, 32, an Army veteran hurt in a rollover vehicle accident, had waited months to have troublesome teeth pulled. The pain has added to his anxiety and sleeplessness.
Bobby Grant, 55, a Navy veteran, who has been living in a public park in Escondido, was proud that his front teeth are still good. "But the back ones are going, going, gone," he said.
Jack Pletzer, 54, an Army veteran, told the dentists that he's been losing weight rapidly because his teeth hurt too badly to eat. He uses a wheelchair and has other conditions, possibly tied to his diabetes and his refusal to take the medicine prescribed by a VA doctor.
"I don't like that doctor," he said.
The dentists pulled four of Pletzer's teeth, sutured his gums to stop some bleeding and gave him a stern lecture to take his diabetes medicine regardless of his view of the doctor. "OK," he said meekly.
Bad teeth can sometimes lead to desperation. "I been thinking of just pulling mine out with my fingers," said Gardinier, a prospect that horrified the dentists.
Like nearly all the others, Gardinier was a good patient, no complaining and effusive in his thanks. "He was gung-ho," Kim said. "They teach that in the Army."
Because it needs space for two large air-conditioned vehicles that comprise the mobile clinic, the dental services area was tucked away at the corner of the Stand Down sprawl over a playing field at San Diego High School on the eastern edge of downtown.
Even without much visibility or any advertising, the veterans with dental issues found the dental services area with no trouble.
"Word of mouth has been good," Razmi said.
By Tony Perry
Los Angeles Times
July 16, 2012