Anthony Molina thought he would have to live with bad teeth for the rest of his life.
After 18 years of drug abuse, his mouth was full of cavities. His teeth began to rot, with only the root remaining in some places, he said.
"It was terrible," he said. "I was self-conscious, and I was hesitant to open my mouth in front of people. It wasn't any way to live."
Molina said he's been sober for three years thanks to his involvement with the Denton Freedom House, a residential ministry program that helps men fight addiction. But it wasn't until he was referred to the First Refuge Ministry dental clinic that he saw some hope for his smile.
In five appointments over the span of four months, dentists did thousands of dollars worth of work on Molina for free. They were able to extract teeth, perform root canals and fill his cavities, he said.
"It's been a huge encouragement and waived a lot of that self-consciousness," Molina said. "[First Refuge] is full of believers, which is great. They treat you like a decent human, even if you're not."
Molina is far from the only person to receive services from the First Refuge dental clinic. Since Lewisville's Christian Community Action clinic closed in 2016, First Refuge has been the only clinic in Denton County to offer free, comprehensive dental care to adults. But operators are worried they won't be able to keep up with the growing demand for services at their current funding levels.
"It's a David and Goliath situation," First Refuge Ministries executive director Paul Juarez said. "We're putting our focus on people in severe pain and backing off of the comprehensive care. It's not something we want to do. It's something we need to do."
Before the CCA clinic closed, Juarez said his clinic saw about 30 patients every month. Today, that number has more than quadrupled, he said. The First Refuge clinic saw 137 patients in March, and it has a six-month waiting list.
Juarez thought the clinic might see some relief when Health Services of North Texas announced plans for four dental treatment rooms to be put into Serve Denton spaces. However, HSNT CEO Doreen Rue said those plans have been delayed due to a lack of funding for the project.
"We've not scraped the dental project," she said. "It's still coming. We just need more time and resources."
In the meantime, Juarez said he reached out to the Denton County commissioners for emergency funding. The dental clinic has received several grants over the years, but Juarez said those grants pay for equipment, not personnel or operating costs. Right now, the clinic employs one dentist and two dental assistants while other dentists perform work on a volunteer basis.
Juarez said if the clinic could get an extra $12,000, it could pay its rent for a year. An extra $25,000 would pay for another dental assistant and expanded hours, which means the clinic could increase its patient load by 25 percent, he said.
Even as county officials delve into budget talks and declare this week Public Health Week, they say it's tough to stretch their already limited money.
Kate Lynass, the director of administration for Denton County Judge Mary Horn, said the county does not have the authority to grant emergency funding, but it does give money to certain social services agencies through its health care relief fund.
That pot of money was set up in 1999 when the county started receiving payments from a $4.8 million tobacco settlement lawsuit. A citizen's committee was formed to make a recommendation to commissioners on which agencies should get funding. In the 2017-18 fiscal year, seven organizations were awarded $335,000 collectively.
The CCA clinic in Lewisville used to get a portion of that money, but the county stopped funding it once it closed and distributed their share to the remaining agencies, said Matt Richardson, the director of the county health department.
But the funds from the tobacco settlement have been declining over the years, Richardson said. Because of that, he said, the commissioners have frozen the number of agencies that can receive funding in the next budget, limiting their scope to only the seven agencies that were funded in the past and continue to meet the county's criteria.
Lynass said part of the criteria for funding is that the agency must provide services to everyone in the county. The First Refuge clinic serves only people who live north of Lewisville Lake. Lynass also noted First Refuge has never applied for county funding, but Juarez said no one has told him how to apply despite his ongoing conversations with county officials.
"If there is a way to apply for county funds other than asking [Richardson] or the commissioners court, I am not aware of it," he said.
Lynass said there could be opportunities for organizations to apply for funding in the future as the citizen's committee restructures itself and forms new bylaws.
"We understand the need, but we have limited funds," she said.
Dental care for adults has remained an overlooked need in the county, even as other health factors improve.
The latest County Health Rankings & Roadmaps report ranked Denton County No. 1 in health outcomes, which measure the length and quality of life. In the dental category, though, the report found Denton County had one dentist for every 1,870 residents, a higher ratio than the state average and the top national performers.
The United Way of Denton County also identified dental care for uninsured adults as a community need in its 2017 Community Needs Assessment. Research has shown links between poor oral health and other illnesses including heart disease, something Richardson said the county is always looking to improve.
The Denton Kiwanis Club operates a free dental clinic for children, while Texas Woman's University runs a hygiene clinic that offers low-cost cleanings and X-rays. If any major work is needed, it refers patients to First Refuge.
Richardson said the county health department's dental services are limited mostly to tooth extractions and pain alleviation for jail inmates and people who qualify for indigent care. Robyn Reed, the staff dentist at First Refuge, worries about the clinic limiting its own services.
"Things that aren't emergencies now will be next year," she said. "If we don't get any help, it might be in our best interest to stop the dental program."
CAITLYN JONES can be reached at 940-566-6862.
FEATURED PHOTO: Anthony Molina is all smiles Tuesday, showing his teeth that were repaired at First Refuge Ministry dental clinic. Jeff Woo/DRC