James Bennett hadn't seen a dentist in a decade. He had other priorities, like scoring heroin. Even if he'd been of a mind to do something about his rotting teeth, he wouldn't have known where to go or whom to call.
Now, at long last, he sat in the blue exam chair in the Southwest Baltimore office of Dr. Larry Bank, a cramped space with a bucolic wallpaper scene of a waterfall. At 45, Bennett is trying to restart his life. That means getting a grip on his addiction through a residential rehab program - and fixing his ragged mess of a mouth.
Time to lose the jack-o'-lantern look. The man in the blue jeans and gray hoodie wants to smile again without embarrassment.
"I'm nervous," he said with a slight lisp as Al Greene's crooning floated from a boom box. Doletta Thomas, Bank's effervescent assistant, assured him he had no need to fret. Today was just a preliminary step toward removing four wobbly lower teeth and the root remnants of 24 others, so he could get dentures.
Before Bank even peeked inside his patient's mouth, the dentist did something remarkable: He handed him his home phone number for after-hours emergencies. As he jovially put it, "it's a journey we're going to be going on together."
Larry Bank knows journeys. He's been on one for 36 years. It started right after graduation from the University of Maryland Dental School, when he set up shop in an empty dental office in a poor neighborhood nearly 20 blocks west of Camden Yards.
Ever since, he's been catering to the dental needs of people with few if any options. Some of his patients are prostitutes or drug addicts. Close to a quarter have HIV and the mouth problems the virus can foster. Many are retirees struggling just to pay their electricity bills. All are poor.
"It breaks your heart," he said of the desperation he sees. "You just keep trying."
Bank is a lanky man of 62 with a mustache and thinning hair. His shoulders slump a bit as he glides between the two exam rooms in tasseled loafers, chit-chatting and projecting enthusiasm. He uses words like "crazy" and "stupid" to describe the financial aspects of his practice. He praises his wife, Lana, for putting up with a schedule that has him treating patients Saturdays and Sunday mornings.
But he also says, mantra-like, that "it's fun."
Oral health care for adults in Maryland is "atrocious," he says. The Medicare program for the elderly does not cover dentistry. While the state-federal Medicaid program for the poor provides dental coverage for children, it does very little for adults.
A bad mouth can cause major problems. It can kill a person's confidence. It can cost someone a new job. It can lead to grave medical woes and even death. Last year, a 12-year-old Maryland boy named Deamonte Driver died after a tooth infection spread to his brain. His death spurred efforts to boost children's dental care.
Bank is not the only dentist committed to treating low-income adults, and adult programs exist here and there. But Bank's single-focused dedication has won him admirers at high levels.
"He's in rarefied air; he really does care," said Dr. Harry Goodman, director of the state's Office of Oral Health. "He feels it's his mission. I don't know where it comes from."
Where it comes from, Bank says, is his Uncle Sam - Dr. Samuel Rubin, a doctor who made house calls with his little black bag. On Christmas morning, young Larry would tag along on patient visits. The emotional bond between the healer and the healed made a lasting impression. And Uncle Sam left Bank an inheritance that has effectively subsidized his years of charitable dental care.
Some of Bank's patients have dental coverage through the state's Division of Rehabilitation Services. The federal government pays Bank for seeing HIV-positive patients under the Ryan White Care Act. A salesman at the Sullivan-Schein dental supply company donates materials.
But Bank figures that of the 51 patients he saw Wednesday at his office at 2116 W. Pratt St., two-thirds paid nothing or lacked coverage for what they needed. Even the fees he does charge are low compared to most dentists'. He's happy to get just $250 for a set of upper and lower dentures, including five dental visits.
Still, he has to earn a living and pay wages to the close-knit office staff, which is made up of two sisters and a mother and daughter. So he asks patients to pay what they can, if they can.
"If we end up even, it's a good day," Bank said with a shrug. "Usually we're a little behind."
That doesn't stop him from handing out food coupons that he buys for redemption at nearby Kim's Grocery and springing for antibiotics and pain medicine at a neighborhood pharmacy.
Shelly Koerick, 29, traveled all the way from Dundalk to see Bank at a friend's urging. She was among those headed for the surgeon. Two abscessed teeth needed to go.
"Thank you so much, Dr. Bank," she said as she rose from the chair. "God bless you." Threading through the waiting room packed with eight more patients, she exclaimed: "They should have a bigger place for the man with a big heart!"
"Sweet," Bank replied as he led her to a taxi.
In a minute he was back in the exam room where 66-year-old William Jackson awaited. A couple of years ago his upper dentures broke. He'd been resigned to eating soft food until he heard Bank would not deny him for lack of money.
Bank examined the dentures. An easy fix.
"I'll get these back by Saturday," Bank said.
"Don't worry. Just knock on the door Saturday."
Bank will be there, as always.