NHSC Dentist Helps Cincinnati's Homeless Learn to Smile

"Over-the-Rhine" is not the type of place that most dentists aspire to plant their practices. The neighborhood—adjacent to downtown Cincinnati, Ohio—was once a comfortable, middle-class part of town, but has steadily deteriorated since the 1960s.

Nonetheless, Judith Allen, DMD and NHSC Loan Repayor, traded her private practice in an affluent northern New Jersey suburb to come here and care for Cincinnati's homeless men, women, and children at the McMicken Dental Center for the Homeless. Why she chose to make this radical transition speaks to those who measure success not by how much money they make, but by how much of a difference they make in people's lives.

Allen's personal metamorphosis began years ago. Early on, she demonstrated an iron resolve when she decided to go back to school and pursue a career while balancing her role as a wife and mother of two young children.

"I wanted to move on—to do more than what I was doing," she explains of her earlier career as a dental hygienist. "The only way to do that was to further my education."

She enrolled in undergraduate courses to brush up before applying to dental school at Fairleigh Dickinson University. It was an expensive private college, but it was also the closest institution she could find without relocating her family from New Jersey.

In addition to the struggle of balancing the responsibilities of dental school with motherhood, by the time she graduated, Allen's loans had ballooned to a staggering amount. "A lot of people that went to school with me are in exactly the same situation I was in," Allen notes ruefully. "Our school loans were like mortgages."

Allen was unable to secure loan assistance after graduating from dental school, and there weren't any NHSC positions available in northern New Jersey at the time. Instead, she financed the opening of a private practice in cosmetic dentistry and spent the next 10 years paying off her business loans, as well as slowly chipping away at her student loans. But she felt something was missing in her private practice, and wished she could use her skills as a dentist to help those in need.

Fate intervened when Allen's husband—who, in addition to being an Episcopal priest, is a brigadier general in the Air National Guard—was transferred to a new post in Cincinnati. Allen saw the move as an opportunity, giving her the chance to perform meaningful work.

Shortly after the move, Allen joined the McMicken Dental Center in Cincinnati's Over-the-Rhine neighborhood and was accepted into NHSC's Loan Repayment Program. The enthusiasm that Allen has for her work as clinical director of the McMicken Center is palpable, and her passion for helping Cincinnati's underserved is having dramatic effects on everyone around her.

"Did she tell you about Robert McGonagle?" asks Dr. Larry Hill, Allen's boss and the dental director for the Cincinnati Health Department. He explains that McGonagle was one of the very first patients Allen treated when she came to Over-the-Rhine. Hill describes how—in the process of securing McMicken's funding through state, private, and Federal grants—the center's budget had inadvertently left out money for janitorial services. "The clinic staff can empty the trash," he explains, "but maintenance of floors and walls and windows is a very big deal."

However, Hill continues, after Allen's successful dental work on McGonagle, the patient was so grateful that he volunteered to be the clinic's janitor. "He went to a church in the neighborhood and asked them to donate the cleaning supplies, and then he found a buffer and some other materials," Hill adds. "Robert has maintained the floors in that 3,000 square feet of dental space since May 2001."

And how does Allen feel about the sense of community people like McGonagle provide? "I love working here," she says. "I don't think I'd ever go back to private practice because this is so much more rewarding."

Not only does she find the work more personally fulfilling, it's almost like being a genie in a bottle. "I feel like every day when I come to work, I get to grant wishes," she says. "Most of the time, the wishes I grant are for someone coming in who just wants to have a good night's sleep and no longer be in pain. But at the next level, it's also about improving the way they look."

To illustrate her point, Allen offers numerous "before and after" portraits of homeless patients who have come to her for help. One photo shows a downtrodden African- American woman wearing a baseball cap and a jagged grin. An after-treatment photo shows her with a straight, gleaming smile. The only difference between the two photos is a few teeth, yet the contrast in the woman's appearance is astonishing.

Allen shows more photos of a young man her staff has nicknamed "Brad Pitt." In the "before" photo, he sports a gums-only grin. In the "after" shot, his toothy smile looks ready for television.

"When you see the difference, it's truly phenomenal," Allen says. "And do you know how much it cost? For a partial plate, he paid $40. It cost $40 to change him from one image to the other."

Allen adds, "The self-esteem attached to a smile is almost immeasurable. A lot of the people we see here haven't been able to smile for years; or they want to go home again, but they're embarrassed with the way that they look. But that's what we do here. We put people back together again, and when we do that, then all of a sudden we have an employable person on our hands-a person who can be a part of society, who can be accepted again."

Allen is inspiring her colleagues in a similar way.

"They have tremendous respect for the care that she provides, and they know that she couldn't do it without them," Hill notes. "They just work great as a team, and because of that, we've been able to get an expansion grant from HRSA to add an 'expanded function' dental assistant and a traditional dental assistant to the staff."

Thanks to the NHSC, Allen has almost paid off her student loans and is closer to "owning what's inside my brain and in the tips of my fingers," she chuckles. Allen plans to stick with the clinic beyond her commitment to the NHSC because, she says, "The rewards of doing this work are incredible—far beyond the money that is going to pay off my loans."

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