Dental Defender Hygienist Brings Tooth Care To 20 Small-Town Schools

It takes about an hour for Dorothy Yamamoto to hoist and wheel an air compressor, electrical cords, dental trays and other equipment from her pickup truck to a gymnasium stage in the town’s only elementary school.

The chair unfolds. She connects her rubber hoses to water, her extension cords to power, her suction spray to the compressor. She then displays the most-sought commodity: six different sets of stickers and multicolored toothbrushes her patients can claim as their own after their examinations.

A music class practices behind her. When gym class is in session, she closes the stage curtains for privacy.

Yamamoto, 42, circuit-riding dental hygienist, is open for business.

Since she quit work in a Moses Lake dental office, Yamamoto has traveled to schools, day-care centers and nursing homes to treat people cut off from traditional dental services.

Yamamoto, an assistant and sometimes a dentist visit 20 schools in districts in Moses Lake, Soap Lake, Othello, Quincy, Ephrata, Royal City and Warden. She has cleaned teeth and examined 2,700 kids since 1992.

The gym stage is a relative luxury. Once she set up in a storage room, other times in classrooms or nurses offices.

“We’ve been in a bathroom. We have to go in and put up sterile drapes. It’s not an ideal situation, but these kids need care.” Her first patient in Warden was a 7-year-old girl who never had seen a hygienist before, let alone a dentist. She had lesions and infections, and her front teeth have a blackish tint, the middle stages of decay. Her mouth is in need of emergency care, Yamamoto says.

“You need to brush your teeth every morning and every night,” Yamamoto tells her.

“We don’t have toothpaste; it’s all gone,” says the girl.

“You don’t need toothpaste,” explains Yamamoto. “You still need to do it. I want you to give these to your mom. It’s really important.” She hands the girl a note with information explaining the problem and how to treat it.

The girl is typical of some of the children who receive treatment.

Warden Elementary has 520 students, 65 percent of them Hispanic. Most parents work as potato packers or in packinghouses. Dental care is not a priority, says Principal Richard Mack.

“The kids look forward to this so much,” says Diana Carter, 46, a dental assistant who works with Yamamoto. “This is the only toothbrush they get, sometimes.”

One girl, Yamamoto recalls, was in pain all day at school and not sleeping at night. Puss from her dental infection would accumulate in her mouth.

Other children don’t smile because they are self-conscious about their appearance.

“I’m convinced she serves a real need in this area,” says Bill Bonaudi, president of Big Bend Community College in Moses Lake, where Yamamoto has provided information to parents with day-care children.

“There’s no access to continuing dental care. You don’t even think about it until you’re school age. She’s working early on trying to prevent these problems.”

The problems are preventable. With advances in dentistry and a change in state law, Yamamoto can apply sealants and other decay-fighting formulas that isolate bacteria and can make lesions disappear.

It’s not children on welfare who have the worst dental problems, but rather, those not enrolled in any insurance program because of language barriers, ignorance, misinformation or income limits.

“These people go without and their children go without,” Yamamoto says.

Yamamoto accepts medical coupons for her services or enrolls the children in the state welfare program. Taxpayers reimburse her for each patient. Because she has no office overhead, she can earn a living and pay an employee. Volunteer or retired dentists help out and are reimbursed.

Yamamoto’s second patient is a 9-year-old third-grader who has seen her several times. Still, three of his teeth need a dentist’s attention.

“I think I’ll call your mom,” says Yamamoto.

“We don’t have a phone,” he says.

“Please tell your mom to take you to the dentist. You need to have this done.”

A University of Washington graduate, Yamamoto worked as hygienist in Moses Lake for 20 years and understands the demands of running a dental office.

Many dentists have agreed to see more welfare patients as long as they aren’t the only office in town doing so. That’s her next project - getting more dentists to schedule appointments for poor children. “I’ve taken every dentist in town for lunch,” she adds.

She also wants more programs for mothers of infants. Unlike middle-class families who often don’t bring their children to a dentist until age 3, poor families need to start earlier, Yamamoto says.

Typically, poor mothers with tooth decay and disease spread the germs to their children through shared utensils and food.

“I have mothers come in and tell me, ‘My mother had poor teeth and my grandmother had poor teeth. I just have soft teeth,”’ Yamamoto says. “They think there’s nothing they can do about it. They don’t know it’s not hereditary, that it’s an infectious process.”

One patient in Warden is a success story. Yamamoto first saw Victoria Bernal, 7, three years ago when she had six teeth in the beginning stages of decay. They were cleaned and sealed, and with daily brushing, the healthy surfaces have been rejuvenated.

“Now she has a chance, and why not? It’s painless,” says Yamamoto.

Still, neither Victoria nor her two younger siblings have been to a dentist. There’s a five-month wait for those on welfare, says Rosa Bernal, 30, Victoria’s mother who works as a part-time English-Spanish interpreter.

“At least with Mrs. Yamamoto, I know that at least once a year my kids will have their teeth checked,” she says.

And the message of brushing and flossing seems to be working, says Bernal. “She was just telling me today how she’s supposed to brush three times a day, and how she has to floss.”

, DataTimes ILLUSTRATION: Color photo