This story originally appeared in The Daily Yonder.
When Cesar Martinez started feeling the pain in his mouth, he knew his battle to get his wisdom teeth taken care of would be a tough one.
Martinez lives in Newburgh, New York, a city of 29,000 residents about 40 miles north of New York City. Getting to a surgeon who participated in Martinez’ insurance plan meant a 45-minute or longer trip into the city, plus an undetermined amount of time waiting for an appointment.
Dr. Cameron Lewis, DDS, had a different idea. The traveling oral surgeon saw helping Martinez as just part of the job. Reaching rural residents, like those in Sleepy Hollow, New York, and Bethel, Connecticut, who may not otherwise have access to oral surgeons, has been a calling since Lewis’ sophomore year in college.
Rural residents are less likely to have access to specialized dental health care treatments. To help fill that need, Lewis decided early on in his career to travel to provide oral surgery where those services may not be available.
“I wanted to make a difference,” he said in an interview with the Daily Yonder.
Lewis said he knew from the time that he was 12 years old that he wanted to be in some form of medicine. When he was an undergraduate, he was inspired by a trip to South Africa.
“I went there to see how primary care was handled in South Africa, and we went to all the rural areas in the country,” he said. “It was so touching because I saw things I’d never seen in my life. The waiting rooms were packed. The ER was packed. The doctor was there for like six hours and no other doctor would be there for weeks and weeks. I saw so many patients holding their mouths. … I saw there was a need in dentistry.”
Lewis said getting into oral surgery took time. After a number of rejections, he was able to get into dental school and finish his education in oral surgery.
“I never gave up. I kept going, and I finally got my chance,” he said. “When I got finished, I saw the need that was all around, and I thought ‘Why be limited to one office when I can just move around and open up a business where I can spread myself around?’”
For the past eight years, Lewis has traveled to parts of upstate New York and western Connecticut to work out of other dentist’s offices. Using their equipment, he is able to do oral surgery like wisdom teeth extractions and implants for residents, like Martinez, who might otherwise have had to travel to another city to see an oral surgeon or to wait until a local surgeon has time to see them.
“The nearest doctors only came in once or twice a month,” Martinez said. “I was in a lot of pain. Dr. Lewis took out all four of my wisdom teeth. He told me that I needed a bone graft so I wouldn’t get any sinus infections or have problems breathing. I told him I didn’t have the money, and that my insurance wouldn’t cover it. … He said, ‘Don’t worry about it.’ And he did it anyway.”
According to a policy brief from the National Rural Health Association, over 46 million Americans lived in a dental health professional shortage area as of 2018. Of those, two-thirds were in rural areas, the policy brief said. Demand for dental care is expected to continue to grow, with rural communities expected to experience greater shortages of general dentists and dental specialists.
Inadequate oral health care can lead to more health problems, researchers at the Harvard School of Dental Medicine have found. Patients who live in rural areas experience a disproportionate burden of oral health disease, owing to an under-resourced and remote health care infrastructure, often complicated by geographic challenges.
Statistically, rural communities have less access to dental care, which leads to higher rates of tooth decay in children and advanced periodontal disease in adults. Poor oral health can lead to missed days at school and work, impair speech, affect nutrition, and lower self-esteem, studies show. Lack of access to dental health care is also linked to diseases like cardiovascular disease, pancreatic cancer, and others. Other factors that affect rural oral health are lack of fluoridated water and higher than average levels of tobacco use.
For Lewis, meeting new people every day, and helping those who might not have otherwise gotten help is the reward. Dental surgery, he said, can be life changing.
“It changes the way people view themselves,” he said. “There’s a lot of times people are so embarrassed because they don’t look at dentistry as a priority. … A lot of times people hide [their dental issues]. They don’t want to smile or don’t want anyone to see they don’t have any teeth, or that their teeth don’t look good. When you change that … and give them a whole different smile … they feel so much happier than they were before. You see a big difference.”
Lewis estimates that about 1% of dentists operate the way he does. Most, he said, prefer to have their own office and their own clients. But Lewis said his priority is making as much of a difference as he can for those in need.
“It’s not about having [my] own office, it’s about what makes a difference in people’s lives,” he said. “That’s what I care about the most. If I can change lives in this community, and in this community and I can change it in multiple areas, why not?”
This story is part of the SoJo Exchange from the Solutions Journalism Network, a nonprofit organization dedicated to rigorous reporting about responses to social problems.