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The narrow passages course with dental students in turquoise scrubs scrambling like shipmates to general quarters.

"You should come see 18's roots," one periapical connoisseur says to another, dodging patients as they head toward digital X-rays.

For the 60-plus patients beginning to fill chairs at the University of Nebraska Medical Center College of Dentistry, anxiety distorts the carnival atmosphere into something dreadful.

Skeletal grins in black and white -- panoramic X-rays -- glower from rows of computer monitors.

In dense-packed cubicles, students pull titanium pliers from beneath sterile cloths that also hide cigar-sized syringes.

For three hours, the dental college's Sharing clinic will unite patients and students in a yin and yang of pain and relief. Need meets an opportunity to learn.

Everyone wins: Grab a Motrin on the way out. For now, students try to focus patients on that future.

Michael Nichols, 41, shakes visibly in the recliner of fourth-year student Kari Simms, tugging on the first of five teeth she'll extract tonight.

The tooth clutched in Simms' pliers crumbled two months ago and erupted in agony a fortnight ago as Nichols ate popcorn shrimp. He hasn't been to a dentist since his braces came off when he was 15.

Six Tylenols didn't ease the pain of the shrimp's revenge, so he set off for serious pills at Saint Elizabeth Regional Medical Center.

"I was crying real bad."

Lacking money and insurance, Nichols couldn't entice a private dentist to fix him. He was directed to Clinic With A Heart, where volunteer dentists evaluated him, then referred him here. Most of tonight's patients followed that route.

Across a tan partition from Nichols, a young man in agony grips his forehead, oblivious to the encouragement of two students.

Reassuring words spring from every quarter: "We'll go slow ... a little pressure."

"You did that awesome," Simms tells Nichols.

Beyond the back partition, fourth-year student Addison Killeen pries on Hagir Awad's impacted wisdom tooth. It fights him -- it's like pulling teeth.

Tears roll into Awad's dark cornrows.

A white-coated, gray-haired professor takes the tool for a moment. That's what 30 years of experience can do, he says to nobody in particular as he steps away.

At the opposite end of the renovated Lincoln dental college, patient Michael Hicks ponders a choice.

The 48-year-old laborer came for a cleaning. He'd never been to a dentist and thought the Sharing clinic might be a good opportunity for him to take care of his health.

But he's leaving without having any work done.

Dental calculus -- fossilized bacteria cemented by calcium -- is all that holds the teeth in his head.

They'll have to go.

"Every last one," he says.

Hicks learns he can have the extractions done at a Sharing clinic Nov. 11. He'll miss work, he says. He'll be fitted later for dentures. He makes a face of what he'll look like without choppers.

"I want to keep my teeth," he says.

* * *

Gwen Hlava directs dental hygiene students here.

"Typically, they (patients) need more than we can get done in an evening," she says. For some, it would take four three-hour appointments to properly clean their teeth. Volunteers encourage those patients to return.

Students yearn for the experience, Hlava says.

"Students don't gain skills by seeing the easy patients. They gain expertise by treating difficult patients."

Not all lessons deal directly with dentistry.

"We might see meth mouth," Hlava says. "The crown is just eaten down to the gum line." When people get high, they're not concerned with oral health.

The dental college realizes, Hlava says, not all experiences can take place in school. The students think everybody is ambulatory, pays at the door and makes an appointment.

"Nothing could be further from the truth," she says. "That's the smallest segment of the population."

Hlava hopes students also take away a complementary lesson: "That by virtue of their education they have a responsibility to give back."

"That has to come from within. They realize that if they didn't offer this for free, this person would never have anything."

James Jenkins, a professor in adult restorative dentistry, knows people prioritize spending, and cigarettes sometimes win over broken teeth.

In time, the nerves die and the pain subsides, he says, but they can still get infected, and infected teeth can turn life threatening.

Jenkins has seen plenty of red, swollen faces.

At times, he says, an infected tooth drains into the mouth and it's not bothersome. At other times, it drains into bone.

It's gratifying, he says, to be able to relieve that pain.

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* * *

Every couple of months, folks from Sharing clinic sit with dental managers from People's Health Center, Clinic With A Heart, People's City Mission and the Lincoln-Lancaster County Health Department.

They make sure they're stretching resources and not duplicating services, says Gwendy Meginnis of the health department.

The programs can tap into a variety of funding, bring different expertise. Each dollar of a health department minority grant, she says, buys $8 in care.

As a Sharing clinic approaches, poor patients get sent there. After, they get directed elsewhere.

On the mornings after a twice-weekly Clinic With A Heart at the Center for People in Need, faxed referral forms stream into the appropriate agencies.

The health department's dental program provided 8,151 patient treatments last year, Meginnis says.

"Eighty-eight percent of our clients were at 100 percent of poverty or below," she says.

The other 12 percent fell between 100 and 200 percent of poverty.

* * *

Every Sharing clinic patient checks out at the table of Associate Dean David Brown, known here as Doctor Brown. He looks a little like Coach Tom Osborne in his white hair and red sport coat.

Do you have any pop? Asks one woman wanting to rinse again.

"Pop?" Brown echoes. "We have water."

One departing man will leave 13 teeth behind tonight. Another silent fellow will leave 11. The extractions would have cost $100 apiece at a private dentist. They appear grateful, but they're not smiling.

Each patient gets an average of $350 in care, making tonight's charity worth $20,000, Brown says.

This was clinic No. 12, says Brown, who got the clinic going after a plea from Clinic With A Heart.

Lincoln's lucky, he says. Similar grassroots dental safety nets haven't formed everywhere -- Omaha, for example, he says.

Patient Cheryl Downey stops to give thanks.

Unemployed and uninsured, she needed some fillings restored. She quit smoking nine months ago and has chewed sugarless gum like crazy, pulling them out.

"This place a godsend," she says. "I can eat now."

Reach Mark Andersen at 402-473-7238 or


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