Dentists bring smiles to South Dakota reservation

Photo of Sandra Diamond Fox

Her name is Angie, she’s in her 50s, and she lives on the Rosebud Reservation in South Central South Dakota.

On a day in October, over the course of several hours, Angie had four people work on her mouth: a hygienist, endodontist, oral surgeon and general dentist.

She had a cleaning, four root canals and all of her six teeth filled.

Angie was just one patient treated by Darien dentist, Dr. Maryann Lehmann, 57, who volunteered for four days at the St. Francis Mission Dental Clinic on the reservation.

Lehmann treated people from the Lakota tribe of Native Americans.

The clinic, which began operating in 2013, is a private, nonprofit organization operated by volunteers. It serves Native American communities who have limited access to care and high dental disease rates.

Lehmann’s team of five, which included hygienists and an endodontist and oral and maxillofacial surgeon, provided over $51,000 of free dental care.

Those living on the Rosebud Reservation have the highest dental decay rate in the nation, according to Lehmann. “Sixty percent of the adults and 40 percent of the children have moderate to urgent dental needs.”

According to Lehmann, aside from the St. Francis Mission, the only other facility in the area that provides dental services is the Indian Health Service Clinic, where there is one dentist for over 30,000 people.

“That is ludicrous because a normal population ratio in America should be one dentist for 1,500 people,” she said.

The mission

The team paid their own costs to get to the mission.

“We raised money to donate to the clinic, thanks to the generosity of friends and patients, and also solicited donations from dental companies for supplies,” Lehmann said.

During their stay, Lehmann’s team slept in complimentary guest houses on the mission, bought groceries and cooked for themselves.

Different dental groups from all over the United States travel to the mission year-round to volunteer their time. However, there are gaps where there are no dentist teams for months at a time.

“This population is so underserved,” Lehmann said.

It has one of the highest unemployment rates and highest dental decay rates in the United States, according to Lehmann.

During their time volunteering, they pulled a total of 62 teeth. On one day, the endodontist did 10 root canals.

Some patients had Medicaid or dental insurance. Patients who don’t have an income were treated for free.

The clinic “gets some reimbursement, and that’s how it keeps buying their supplies and paying their electricity,” Lehmann said. Additional funding comes from benefactors and donations.

The patients who came to the clinic live in prefabricated modular homes that resemble trailers on foundations. Some work at the mission as teachers or in the administrative office, according to Lehmann.


Angie had no upper teeth and all her bottom teeth were brown.

When treating Angie, “I called the endodontist and oral surgeon over and we made a plan.”

Their plan was to keep as many of her teeth as possible.

“In the winter, there’s going to be a team that goes back there to make her a denture and a partial to give her more teeth,” Lehmann said. “She’ll be able to keep those really important teeth and she won’t have toothaches or infections through the winter.”

At the end of the day, Angie “stood there smiling and happy,” Lehmann said. “She was so thankful.”

In addition, the team spent a lot of time educating patients about dental hygiene.

“There was a lot of plaque and tarter buildup because they didn’t know about practicing good oral hygiene,” Lehmann said.

Many patients told them they only brush their teeth once a week or once a month.

“One patient, at 33 years old, had his teeth cleaned for the very first time,” she said.

Lakota customs

On one occasion, an older man came into the clinic and told the team a custom about the Lakota people for which they weren’t aware.

“He said, ‘Something you should know is that we don’t look people in the eye,’ which set me so back because for our culture, that is something we all do here. We teach people to do that.”

The man told Lehmann that looking into someone’s eyes is almost violating them since “you are looking into their soul, you are intruding,” she said.

Instead, he said they should look to their side, their shoulder, or down.

Lehmann quickly shared this with her team.


Even though the team members were at the clinic for only a short period of time, they got to establish relationships with many of their patients.

“This experience wasn’t just a day. You get to be around the people longer since many came back the day after their treatment, bringing family members with them,” Lehmann said.

At the end of the week, the table in the breakroom was covered with handmade pieces of jewelry.

“They are all thank-yous made by patients we treated,” she said.

“There was one lady who would come in every day we were there and bring us things she made,” said Lehmann, who wore a necklace made by a patient.

In a telephone conversation from the mission, Rodney M. Bordeaux, Rosebud Sioux tribe president, said he was very impressed with the quality of care Lehmann’s team provided.

“I can’t say enough about the work they have done. They were very professional. They helped a whole lot of people,” he said.

“This was higher level dentistry,” he said, adding that the clinic really depends on volunteer dentists coming out to the reservation.

Quality health care including dentistry is hard to come because of the remoteness.

“We don’t have any specialists come here,” he said. “People who don’t have the resources or transportation end up either losing their teeth or having them fall out by decay, so the dental clinic helps them get services to save their teeth.

“They are always welcome back,” he said.

“Life changing”

Lehmann said the experience was “life changing” for her and added that she and her team “have only scratched the surface of what needs to be done.”

“As with most volunteer opportunities, you go into it thinking ‘What am I going to do for somebody else?’ but you walk away doing a whole lot more for yourself,” she said.

“I found I had a whole lot more energy and compassion and a whole lot more life in me and my future being a dentist,” she added. “Instead of slowing down, I’m just getting started.”

To donate to the St. Francis Mission Dental Clinic, visit and designate that the donation be made to the dental clinic.

For Christmas, Lehmann’s dental practice, at 5 Brook Street, Suite 1B, in Darien, has set up a Giving Tree in its waiting room to collect sweatpants and sweatshirts for the women and children’s shelter at the St. Francis Mission.