ST. LOUIS — Mariah Moore, 19, pulled her own tooth to relieve a toothache. She pushed and pulled it for a week before it broke loose.
That was more than a year ago. Recently, Moore was in a chair as two dentists sliced into her gums to remove ragged fragments she had left behind. Moore was among 30 young people living at Covenant House in St. Louis who visited Cigno Dental Care in north St. Louis County for free treatment.
The event was part of a national movement called Dentistry from the Heart, operating in every state except Alaska and Hawaii.
Brian Carlsen, the group's director of operations, said dentists across the nation are seeing worse problems since the recession began.
"People let their dental care go because it's not as important as rent or groceries," Carlsen said. "And when they finally visit a dentist, it's an extraction."
A 2008 report by the Kaiser Family Foundation found tooth decay to be the most common chronic childhood disease.
But the young people at Covenant House can't afford dental care, said Tammie Belk, director of operations for Covenant House. They are homeless, often because they have fled a family crisis.
Even the federal health centers "have sliding scales, and you have to pay something," Belk said.
The recent free services provided by Cigno Dental Care could be preventing much more than tooth decay.
The U.S. surgeon general has linked oral diseases to ear and sinus infections, weakened immune systems, diabetes, heart and lung disease "and other serious health conditions."
Gena Lange, an orthodontic resident with St. Louis University for Advanced Dental Education, has been involved in the Give Kids a Smile program that has helped hundreds of children in the St. Louis area with free dental care.
"It's very serious. These infections in the tooth can lead to abscesses, which can get into the bloodstream," she said.
Fluoridated drinking water helps only a little. "Not all water in Missouri is fluoridated," Lange said.
She said young people tend to consume sugary drinks and carbohydrates, then go to sleep without brushing their teeth. The acid from bacteria causes decay.
Treatments at the event ranged from exams and cleaning to minor surgeries.
Sam Cigno volunteered his office and staff for the event. His son, Antonio "Tony" Cigno, flew from Milwaukee to help. He did the same in May when his father first invited Covenant House for dental care.
Tay Brown, an associate with Cigno Dental Care, joined the effort.
"I've had a fantastic life," said Sam Cigno, who has operated the office for more than 40 years. These events are his way of sharing, he said.
Cigno estimated his office had donated about $25,000 in dental care at the previous event in May. His equipment supplier, Goetze Dental of Maryland Heights, donated the day's supplies.
The national Dentistry from the Heart program began in 2001 when Vincent Monticciolo of Port Richey, Fla., planned a free dental care day to announce the opening of his practice.
"When he arrived at work that morning," Carlsen said, "people had set up a tent city that stretched from his front door."
The program has grown exponentially, he said, to 48 events two years ago, 100 last year and 200 so far this year.
About 52 people, adolescents up to age 21, reside at Covenant House. Not all attended the event.
China Dyson, 19, left the dental chair smiling. "Cleaned, checked, everything's fine," she said. She couldn't remember having seen a dentist before.
Jeremy Edwards, 20, said he signed up for the dentist visit because "it may be a little pain for a day, but that's better than pain for the rest of your life.
"I want my teeth bright," he said. "Turn off the lights; my smile will brighten up the room."
Lindsi Hughes, 19, was distressed. "I need fillings," she said. "That means a needle. I hate needles." A short time later, she braved the procedure after Tony Cigno spent several minutes giving her a pep talk, and Gina Cigno Haas, Sam Cigno's daughter and business manager, held her hand.
Tony Cigno said he plans to start a similar program in Milwaukee. Meanwhile, helping in St. Louis is "the most rewarding day of my career. ... We get more out of giving than they get out of receiving."