WILLMAR, Minn. — Estrella Paxtor Lopez sat motionless in the dental chair, a perfect patient.
Dental student Nick Schulte and dental assistant Sara Enderle worked on her teeth with nary a problem.
It was a Friday pediatric day at the Rice Regional Dental Clinic in Willmar, a rare service that brings dental work to rural Minnesota.
Most counties outside the Twin Cities have too few dentists available, according to medical leaders. And with the average age of Minnesota dentists reaching 56, increasing retirements are expected in the near future.
LIke with other health-care professionals, it is becoming harder to attract dental workers to rural areas. The lure of big cities, and perhaps less work, is attractive.
The Willmar clinic is giving dental students and other professionals a chance to see what rural dentistry can be like. And, to many at least, it looks promising.
Schulte came from Dassel and returning to rural Minnesota from the Twin Cities University of Minnesota dental school is appealing.
"I didn't get into this field because I want to be rich and have Fridays off," he said.
The Willmar clinic, which caters to low-income families, helped him decide on his rural calling. "That is where the biggest need is. You can do a lot more good."
With many dentists retiring, he added, "it is a huge opportunity."
Dr. Linda Jackson, who supervises the university dental students at the clinic, said the patients benefit while students receive a deeper foundation than clases alone can provide.
A Chicago native who worked 22 years for the Indian Health Service, including at the White Earth Nation, Jackson herself embraces the rural lifestyle.
"You can have a good life in a rural area," she said, but dental schools are in big cities. "They get used to big city life."
When she lived in Detroit Lakes, she found plenty to do. "It was very family oriented."
Waving her hand, pointing to Willmar outside the clinic, she said: "This is just great. I don't know why people shy away from this."
Before the clinic, emergency room visits were higher as many people, often immigrants, had no dental care and waited until they had a serious problem to seek help. Often, they had nowhere to go other than the ER.
The clinic is a joint effort of Rice hospital and the university. Dental students rotate through the clinic every four weeks, seven at a time. Dental hygienist and therapy students spend two weeks at the clinic.
Dental therapy student Katie Ask, a native of suburban New Hope, said the clinic rotation was her first rural experience, but now is open to working in rural Minnesota.
Dental hygienist Renee Johnson, an instructor, said the clinic also provides outreach to families in an attempt to get them to become regulars in dentist offices. For instance, people connected with the clinic visited more than 500 new parents last year.
In many cases, existing dentists cannot fit in new patients, often leaving out immigrants and other poor rural residents.
Part of the issue is that the federal government pays dentists only a fraction of their costs when patients are on government programs. Dentists say they cannot afford to take on too many patients who cannot pay.
The University of Minnesota requires each of its dental students to be exposed to underserved areas, with most of rural Minnesota fitting that definition.
The university's Dr. Sheila Riggs, chairwoman of the Department of Primary Dental Care, said that dental health issues often are linked to other medical problems.
"Breaking news: The mouth is connected to the body," Riggs said.
For children, she said, dental issues are the top reason they miss school.
In the Willmar clinic, Riggs said, "our chairs are full all the time and it is students delivering the care with wonderful faculty overseeing them."
Clinic features kids
Willmar's Rice Regional Dental Clinic is for everyone, but it is obvious the emphasis is on children.
"Give kids a smile," is how Chief Medical Officer Dr. Ken Flowe of Rice Medical Center described the Rice-University of Minnesota collaboration.
Ruth Diaz, a Texas native and Willmar mother of three, said what may be surprising to some: Her children "love coming to the dentist."
Diaz, who has worked as an interpreter and volunteered at the clinic, said the facility is not like other dentist offices. "It is like family."
In a brief life in Minneapolis, the dentist office was "not that friendly an atmosphere."
Her daughter, 6-year-old Angelica, played with dental-themed toys nearby while her mother talked about the Willmar clinic.
"I like to see the stuff," the girl said. "I love the doctors."