Pualani Puaoi Dawson of Molokai was happy to see the dentist at the Waimanalo Health Center's new dental clinic, even if the news wasn't all good.

“;He said I might be looking at dentures, but not right now,”; she said, studying panoramic X-rays of her teeth. “;I have four teeth I need help with.”;

Dawson returned from Molokai to be with her mother, a Waimanalo homesteader, and she and her children—LeiIlimalani, 20, and David, 18—are taking advantage of the state-of-the-art Waimanalo Smiles! Dental Clinic.

She said the wait to see some Molokai dentists can be up to five months and residents often have to fly to Honolulu for dental emergencies.

Agatha Fontes at the Molokai Community Health Center's dental clinic confirmed that some Molokai dentists are booked far in advance. “;We're scheduled at least through August,”; she added.

Dawson said she hadn't been to a dentist in a long time—a story dental director Tony Kim hears daily in the Waimanalo clinic.

“;The need is tremendous,”; he said, describing patients “;who for whatever reason haven't been to a dentist in 10 to 20 years. We are serving everyone who comes in. Most have no insurance or (are) on Medicaid. But we are seeing a growing number with dental insurance.”;

He had a patient in his 60s who had never been to a dentist, he said. “;I was surprised he had most of his teeth, but he was suffering from chronic gum disease.”;

Kim was previously at the Waianae Coast Comprehensive Health Center and before that owned a practice in Oregon. He said he's had about 200 patients since the Waimanalo clinic opened April 20, and at this rate he expects the number to exceed 4,000 in a few years.

The 1,275-square-foot clinic, housed in a trailer, has four dental chairs and the latest technology. “;We're fortunate to be able to go all digital,”; Kim said.

May Akamine, the health center's executive director, said the clinic “;has been a dream of the community for many, many years”; and she “;wanted to make sure we provided full service.”;

After receiving a $250,000 federal grant last summer, she said, “;We decided we're going to go for it, even if we don't have all the money.”;

The 2007 Legislature provided a $125,000 grant; the rest of the $500,000 needed was raised by the community and donated by foundations.

The center's board approved a $49 minimum basic fee for dental or emergency services but some people can't afford even that, said Kathy Conner, a board member. She said she's “;very proud”; of the clinic. “;It ended up being such a great thing.”;

Her daughter took her grandsons, 2 and 4 years old, for dental exams and the 2-year-old “;came out with a big smile and a toothbrush,”; she said.

Kim said gum disease and dental cavities are significant problems in the Windward area. “;We push prevention ... I see adults every day who don't realize why flossing is important.”;

He said Dawson, who was experiencing headaches and toothaches, has severe gum disease and will need partial dentures for top back teeth that can't be restored.

He noted a case where a young man in great pain from a tooth told him to pull it out. “;I said, 'You can save it just by doing a root canal.' He left here happy.”;

Kim is asking other dentists, especially pediatric or other specialists, to volunteer at the clinic.

“;To me, it's not just real challenging if a person has a lot of money and wants to redo a smile,”; he said. “;The challenge is for someone without money. Almost every day I've taken teeth out for urgent dental needs.”;

Castle Medical Center's emergency room recently called upon him: He replaced a 10-year-old boy's permanent front tooth that was knocked out at school and preserved in milk by a teacher.