Richard Silva has a set of teeth in his hand, which he's grinding "ever so slightly" with a drill, as he puts it.
Thankfully, this set of teeth is fake.
Silva is the sole technician who works at the Watts Health Center's on-site dental lab. That's where he makes dentures – among other oral prosthetics – for the South Los Angeles patients who come through the health center's dental wing. The false teeth are given at low or even no cost.
The set he's working on has a bite pattern that needs adjusting.
"We missed the bite, ever so slightly," he said, maneuvering the drill over fake molars. "A bite that's a millimeter off sounds small, but that means you're not able to use [the dentures] at all. They're not functional."
For more than 40 years, Watts Health Center has provided this service, making it the only Federally Qualified Health Center in South L.A. to have this kind of lab.
And it's busy: Last year, the health center's dental team handled more than 12,600 appointments and treated nearly 4,500 dental patients, with 470 receiving dentures.
The intersection of oral health and life
"If you don't have a healthy mouth, you're not a healthy person," said Dr. Frazier Moore, the health center's dental director.
He explained that in South L.A., preventive dental care isn't at the forefront of most people's minds, and often gets prioritized below other types of health care. That means oral health problems are common and can quickly become serious – and those sorts of issues can profoundly affect a person's quality of life.
"You're going to be in pain," Moore said. "You're going to miss school, school grades go down, you're not going to be able to function. You lose a job – where can you find a job right now?"
Self-esteem also comes into play.
"You'll see people – children, especially – if they are impacted by decay and teeth being missing, you'll notice they don't make eye contact," he said. "They'll look down. They'll look away. They don't want to engage other people. They're laughed at by other children, and so this can have an impact throughout their life."
Elvira Cordero, 43, knows all about that.
In 2 years, 8 teeth lost
Cordero, a lifelong southside resident, is a busy single mother who works two jobs: one in retail and one with the school district. After years of neglecting important – and expensive – dental work, Cordero started noticing changes.
"I had straight teeth to start with," she said. "But then I started noticing gaps. I started noticing that the teeth were separating. I started noticing that it wasn't as easy to bite into a – it sounds funny – but a cheeseburger, or a taco."
Then her teeth started falling out, and that scared her. So Cordero, who didn't have health insurance at that point, went to a dentist who told her how much it would cost to fix her mouth: $18,000. That wasn't doable, and so for two years, she looked for an affordable way to deal with her considerable dental woes.
While she was searching, eight of her teeth fell out.
"Had I taken a bite out of something incorrectly, had I maybe sneezed too hard – if I just did something wrong, there was a possibility of [my teeth] falling out," said Cordero. "And every morning, it was really scary because every morning I remember always checking to make sure that my front teeth were in. Because needless to say, that's the first thing a lot of people see."
She finally tried Watts Health Center. The clinic charges its patients on a sliding scale, based on their ability to pay. That means it's providing dentures for free sometimes. For Cordero, the extractions, the fittings, making the dentures – all of that didn't cost her more than $3,500.
Getting new teeth was life-changing.
"Every time I talked, it was usually the hand over the mouth, and it took me a long time not to do that. Now it's like forget it," she said, laughing. "You can't shut me up."
Watts Health Center is also quick, compared to the alternative for low-income patients.
Take L.A. County's Department of Health Services. It also provides dentures, but availability is extremely limited – and wait times can sometimes be measured in years. The department also sends its orders to an external vendor. At Watts Health Center, the entire process usually takes between three to four months, in part because their lab is on-site.
After Watts, said Cordero, she didn't have any options left. But now she's had her dentures for three years. She laughs more. She talks more. She makes eye contact. And she shows off her smile – something she'd thought was lost for good.
"It was something that I had never, ever, ever expected to see again," she said. "And once I did, it was amazing."
And while the dental team at Watts Health Center may only have worked on her teeth, it's clearly had another positive effect – on Elvira Cordero's energy, confidence and self-esteem.