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Dentist Changes His Cynicism About Homeless Into Idealism : Health: Brentwood doctor offers free care for the dispossessed. He'd like to see the program expand nationally.

July 08, 1993|JEFF KRAMER | SPECIAL TO THE TIMES

BRENTWOOD — Jay Grossman always wanted to help people. It's part of why he became a dentist.

It's also why he was unpleasantly surprised when he caught himself carping about some of society's neediest people: the homeless.

"I think a lot of it was I was just sick of giving them money every time I came to a stoplight," he said.

All signs pointed to compassion fatigue. But rather than succumb to the syndrome, Grossman, 30, reflected on the ideals that led him to dentistry--and looked for a way to keep those ideals intact.

What he came up with was "Homeless Not Toothless," a program of free dental care.

Although his program is only 7 months old, Grossman has already performed 100 pro bono procedures and enlisted the help of two dozen area dentists. Patients are referred by the Venice Family Clinic, where they undergo an initial screening and, if necessary, a hot shower. Then they are sent to Grossman's elegant office on San Vicente Boulevard in Brentwood, where they wait their turn right alongside Grossman's regular patients.

Grossman said the response rate among homeless patients is 97%, considerably higher than that of his paying patients.

"These people are often damn intense about getting taken care of," Grossman said.

That's understandable. Many homeless people go years or even decades without dental care, and chronic pain is often what finally drives them to get help.

"There are a lot of homeless, toothless people out there," said John Payne, a homeless man who needs a root canal, as he leaned back in Grossman's dental chair during a recent visit.

Grossman's service is one of the few sources of free dental care for the area's homeless. The Venice Family Clinic has a small contract to purchase dental care at the UCLA Venice Dental Clinic, but under federal funding guidelines, that money can only be used for basics such as fillings and cleanings. Even for those limited procedures, demand far outstrips resources.

"We don't have sufficient funding to pay for all the dental services that are needed," said Mandy Johnson, director of homeless services for the Venice Family Clinic.

Until recently, a crude cure-all awaited those with more costly complaints. The only option was to put patients on a bus to Harbor-UCLA Medical Center in Torrance, where extraction is standard procedure, often after delays of 10 hours or more.

Now the clinic sends such patients to Grossman, who generally focuses on cavities, cleanings, home care and other basics, relying on a volunteer network of specialists to perform root canals, surgeries, denture work and other sophisticated procedures.

"He (Grossman) really is a model for other dentists in the community," said Johnson, who urged other practitioners to join the effort.

Grossman's goal is to expand "Homeless Not Toothless" statewide, then nationally as an American Dental Assn.-sanctioned program. One hour a month per dentist is all he's asking.

"If everyone gave me one hour a month, the homeless would have no more dental needs," he said.

Chiropractors, manicurists, barbers and other professionals could establish similar networks, he said.

But for all his rediscovered idealism, Grossman said he realizes there's little he can do for homeless people who--perhaps as a result of chemical dependencies or mental illness--don't seek out his services.

So his aim is to help those who want help--and like the dedicated practitioner he is, he brims with the possibilities associated with sound oral health.

He notes that dental pain saps energy, concentration and drive, and that unsightly or missing teeth turn off potential employers--all factors that perpetuate the vicious circle of homelessness.

As an example, he tells the story of a homeless patient who expressed an interest in word processing. Grossman gave him some basic instruction on his laptop computer, and the man was subsequently hired by a local firm to use the same software.

"Even if he had word processing skills, if he had missing teeth would he be hired?" Grossman asked. "I think not. Aesthetics is crucial these days."

For Payne, Grossman's patient, it's more than a matter of aesthetics. After several visits to Grossman, Payne's teeth feel better, but his mouth is chronically dry, a condition probably linked to smoking that makes hot food or drinks searingly painful.

After an obligatory mini-lecture on the evils of smoking, Grossman gives Payne a bottle of "artificial saliva" for relief.

Payne also needs a root canal and a partial denture--about $1,500 worth of dentistry to save one tooth. As recently as last year, that tooth was as good as gone.

"This is a one-of-a-kind dental program here," Payne said. "I'm really surprised I came across this."

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