WILLMAR - Valery Lagos, 5, opened wide so volunteer dentists could peer inside her mouth and examine her teeth.

Her mother, Elda Recinos, stood nearby, offering soothing words and smiles for the little girl in the dental chair.

Friday was the ninth annual Give Kids a Smile event at the Rice Regional Dental Clinic, and the waiting room and exam rooms were filled with families seeking basic dental care that might not otherwise have been available.

The community event, part of an outreach effort by the Minnesota Dental Association and American Dental Association, gives underserved kids a chance to put their best smile forward.

"These are kids that do not have access elsewhere," said Renee Johnson, coordinator.

State and national organizers of Give Kids a Smile expected reaching 350,000 to 400,000 youngsters at 1,500 sites this year with free dental exams and basic care.

Nearly 50 children were registered for the event Friday at the Rice Regional Dental Clinic at Rice Memorial Hospital in Willmar.

Pediatric dental coverage, especially for low-income families on public programs such as Medicaid, has become more widespread as a result of the Affordable Care Act. But gaps persist and access to dental care remains a struggle for many families, said Dr. Linda Jackson, director of the Rice Regional Dental Clinic.

"There are still a lot of practices that are not taking that insurance," she said.

Finding a specialist such as an orthodontist or oral surgeon is also still difficult for the Medicaid population, she said.

The closest pediatric dentist that takes patients on public assistance is in St. Cloud, and oral surgeons have a one-year waiting list, Jackson said. "It's really difficult when the patients need the care and we don't have a location for them."

There's also an overall shortage of dentists in rural Minnesota, and the shortage is projected to worsen as many dentists currently in practice reach retirement age.

Give Kids a Smile is one afternoon one day a year, but for many underserved families it's a start, Jackson said.

Among the patients she saw Friday was a child with cavities in every single tooth, she said. "This at least got her in the door."

Thirty volunteers were on hand to help with everything from registering families at the front desk to interpreting and providing hands-on dental care.

Dr. Michael Gardner has a dental practice in Willmar and volunteers at Give Kids a Smile almost every year. "It helps a lot of people, that's for sure," he said.

For Steve Gerberding, it was his first time participating. Normally Gerberding can be found in the administrative offices of Affiliated Community Medical Centers in Willmar but on Friday he was directing hallway traffic, answering questions and helping the staff.

It reinforced the connection between oral health and overall health, Gerberding said. "This is part of an overall public health strategy to meet basic needs."

More than this, the day provided many feel-good moments, he said. "It's wonderful to be able to serve children and families in this area. It's very gratifying."

Carris Health began spreading the word last month about Give Kids a Smile and encouraging families to make appointments. The free care was available for children from birth through age 18, no insurance or paperwork required.

Recinos heard about the service at her children's school. On Friday she had four of them - ages 3, 5, 6 and 8 - lined up for oral exams.

She said through an interpreter that she plans to bring them back for future dental care. "It has helped a lot," she said of the Give Kids a Smile event.

Along with basic care, the event was a chance for staff to educate parents about starting early with their children's oral health. Families were sent home with complimentary toothbrushes and educational materials in both English and Spanish about daily brushing, the hazards of sugary drinks and more.

A child's first visit to the dentist should occur before their first birthday, Jackson said. "That's what we recommend."

The Rice Regional Dental Clinic recently wrapped up a project funded by Delta Dental that promoted education about the importance of oral health for ages 0 to 3. The clinic, which also serves as a rural training site for dental and dental hygiene students at the University of Minnesota, is now working on improving customer service to reduce wait times and increase care. There's now an additional part-time dentist, a dental hygienist and dental therapist on the staff, plus additional support staff, Jackson said. "That's really helped us keep up with the demand."

Many of the families who brought their children to Give Kids a Smile will come back for future care and make it their dental home, Johnson said.

"This is what we're here for," she said. "They can feel comfortable when they come back next time."