No matter what aspect of today's healthcare environment you are talking about, the buzzwords you constantly hear are “access to care,” and orthodontics is not immune from this discussion. Although many of us try to make our services available to those who cannot afford the fees associated with orthodontic treatment, something more organized needs to be done.

A unique person who has tried to make a difference is Virginia Brown. As a child growing up during the Depression, Brown endured years of teasing and low self-esteem until receiving braces at the age of 16. This experience touched her so deeply that she decided to take action to help young people in need, and in 1997 she provided funding for orthodontic treatment for 48 youths in the Kansas City, Missouri, area. That same year also marked the formation of the Virginia Brown Community Orthodontic Partnership—a nonprofit entity serving children with severe dental problems.

The third National Health and Nutrition Examination Survey (NHANES III) estimated that 20% of the population across all racial and ethnic groups has substantial malocclusions. Many of these children come from working families living in poverty with no hope of getting the treatment they need to become healthy, productive, and engaged members of society. Brown wanted to expand the program to serve those who suffer from the social, emotional, and physical repercussions of dental deformities. She knew these children would never have a chance at a better future, free of peer ridicule, without her help. She did not want it to be a cosmetic program but rather a lifetime health benefit and an effort to give children a hand up in life, and it has done so beyond her wildest dreams.

From the inception of the Virginia Brown Community Orthodontic Partnership in 1997, Brown's dream has grown into a nonprofit organization now called Smiles Change Lives, which currently offers programs serving Palm Beach and Broward/Dade counties in Florida and communities throughout Kansas, Missouri, and Minnesota. Many other areas throughout the United States are in the process of starting a similar program. In 2005, Smiles Change Lives received the endorsement of the American Association of Orthodontists.

Smiles Change Lives manages the entire program, including outreach, marketing, applications and screenings, complete orthodontic treatment, case management, and evaluation. More than 800 children have been given new smiles, renewed hope, and restored dignity, and many more are currently in treatment.

So how does this unique program work? It works through collaborative partnerships with orthodontists; safety-net clinics; and other providers, community volunteers, businesses, foundations, and donors. Applications are available from Smiles Change Lives at 888/900-3554 or The completed application must include the family's most recent tax return and a statement from the family dentist as to the oral hygiene status of the potential patient. Applications are sent to the Smiles Change Lives office in Kansas City, Missouri, for the initial screening. If approved, applicants then receive an orthodontic screening to determine clinical need. These are usually completed at university-based orthodontic programs by orthodontic faculty and residents.

Smiles Change Lives provides orthodontic treatment for 11- to 18-year-old children of the working poor who have moderate to severe malocclusions for which treatment can be completed in one phase. Treatments are provided by orthodontist partners who have agreed to treat these children in their offices at a fee of $2000, significantly less than current orthodontic fees. The patient's parent or guardian must provide the first $250 of the treatment fee and agree to comply with all aspects of treatment such as keeping appointments and cooperating in treatment and oral hygiene.

One aspect of the program that has been challenging is obtaining funding. Many individuals, public and private foundations, and organizations—both orthodontic and nonorthodontic—have provided the necessary funds to date. However, as the program continues to expand, significant dollars are going to be needed. A new program, recently initiated to help fund Smiles Change Lives, is called Embrace Smiles. Embrace Smiles is a for-profit company, and 80% of its profits will go to the Smiles Change Lives program. Embrace Smiles sells the typical logo items that orthodontic offices buy today. But wouldn't it be great if all of orthodontic vendors purchased the logo items they give away from Embrace Smiles? Wouldn't it be even greater if every company, school, and organization bought their logo products from Embrace Smiles? It would provide substantial dollars to help treat the orthodontic needs of children throughout the United States. You can visit the Web site or call 877/415-5437 to view products and order supplies.

No, this is not the entire answer to the access-to-care issue in orthodontics, but for each child who benefits from the program it is extremely significant, and it is a start. Contact Smiles Change Lives to start a program in your area or, if there already is a program, sign up as a provider. You will make a major difference in someone's life!