By federal estimates, roughly 49 million Americans live in communities that have been designated dental professional shortage areas—Lee County is one of them. But the health problems in this pocket of Appalachia—the cancers, the diabetes, the ruined joints—were nothing new. The rotten teeth were nothing new. The toothaches were nothing new.
In Lee County—remote, isolated, poor—the shortages of all kinds of health care had been a chronic problem. There were not enough primary and mental health care workers. And the shortage of dental providers was most acute.
And if dentists are in short supply in places such as Lee County, so is the money to pay them. “These are not forgotten people,” explained RAM dental director John Osborn, a Knoxville dentist. “The system has passed them up.”
Hundreds, sometimes thousands of aching teeth are extracted at these free weekend clinics.
The loss of a tooth to disease may prefigure other losses in life quality. In terms of oral health, complete tooth loss, or edentulism, has been called the “final marker of disease burden.” An extraction is emblematic of defeat. The extracted tooth will not grow back. But when routine care is long deferred, when more complex procedures are out of reach or not an option, the extractions serve the urgent need of relieving infection and relieving pain.
The news of the plans for the RAM clinic in Lee County claimed top headlines in the local paper. People talked about it for days in church and at the gas station and in the coffee shop out on the U.S. 58 bypass. On this Friday, at the airport, there was excitement in the air as volunteers worked to set up a sort of field hospital with tents and folding tables. Volunteer doctors and nurses, dentists and hygienists were coming from “out of town.” A man with a “Friends of Coal” bumper sticker on his truck arrived with pizzas. Members of the high school football team, the Lee County Generals, who were waiting in their red numbered jerseys to help unload the plane, ate the pizza quietly and hungrily, out by the runway. Then a great deep-throated roar could be heard and everyone looked up to the pale clearing sky.
“Here’s the plane!” someone shouted.
The World War II–vintage C-47 cargo plane landed smoothly, then stood there shimmering on the narrow landing strip at the foot of the mountains. RAM’s founder, Stan Brock, a lean, charismatic British-born adventurer, greeted the small crowd in his calm, serious way. He was, as always, tan and, as always, dressed in a khaki shirt and pants.