SALT LAKE CITY — Branden Jenkins used to hide his teeth.
At age 13, he was introduced to drugs. It turned into an addiction, escalating to painkillers and later to heroin or whatever he could get, Jenkins said.
After getting kicked out of his parents' house, he found himself in a downtown Salt Lake City homeless shelter until he got arrested Aug. 23, 2017, during Operation Rio Grande, and spent about a month and a half in jail.
"By that point, I really needed help. I just didn't know how to get help, pretty much," Jenkins recalled Tuesday in his apartment near the Gateway.
Jenkins described signing up for the Odyssey House program because he'd heard "it's hard to get through." He really wanted to overcome his addiction.
"Out here in this front green, I've been arrested out there so many times. And it's just so cool to think that I live here now and I don't live there now," he said, pointing out his window at the grass below.
Jenkins, 35, says he found support at Odyssey House. He also found a different, unexpected kind of help that would also change his life.
In the first study of its kind, the University of Utah School of Dentistry provided dental care to 286 people undergoing substance abuse treatment at First Step and Odyssey House from 2015-2018. It was called the FLOSS study, and it helped student dentists learn to treat those with substance abuse disorder by replacing missing teeth, performing root canals, providing dentures and a variety of other procedures.
"Basically all I had in my mouth were like two teeth that were any good," Jenkins explained.
The program accepted him. Treatment, though, "was kind of rough. I mean, I was excited, really excited, because I always wanted to get my teeth fixed," according to Jenkins. Having all of his teeth pulled was a painful process. And because he was in rehab, he couldn't take any painkillers to treat the pain.
However, he says it was worth the pain.
During the first month with his new set of teeth, it was hard for him to talk.
"It's like I had to learn how to smile again, because I was always just trying to hide my mouth. Like, a lot of people didn't even know that I didn't have teeth because I would hide it so well."
He says he can't explain exactly how it felt, but "I couldn't be more happy."
As with Jenkins, the researchers saw significant outcomes, with those who received the dental care staying in treatment two times longer and an 80 percent increase in them completing their programs, as compared to those who did not receive the dental care.
The research was published May 20 in the Journal of the American Dental Association.
"It's the first time anyone has tried it in this country, or in any other country that I'm aware of," said lead author of the study, Dr. Glen Hanson. He and his group have presented the program at national conferences, where "they've started to call it the Utah Medicaid model, so we've got our name associated with it."
Funds received from the Health Resources and Services Administration paid for the program. When it began, Odyssey House and First Step started reporting "very dramatic" improvements in the dental patients. Their disorder treatment was exactly the same as others' — but they were getting comprehensive dental care, Hanson said.
Researchers also discovered that those who had their oral health issues addressed were two to three times more likely to get jobs after treatment and were much less likely to be homeless, he said.
Jenkins, who graduated from Odyssey House and Rio Grande drug court, has been off drugs for two years now and was recently promoted to yard foreman at the company where he works.
A lot of the people he knows who went through the FLOSS program with him are "still doing really good," he said.
Other substance abuse treatment centers became aware of the program and said they wanted to get as many of their patients enrolled as they could because the outcomes were so much better, according to Hanson.
After FLOSS ended last September, the program's success led the researchers to go to the state Legislature and ask for targeted adult Medicaid recipients to receive dental care at the U. Legislators approved the proposal, and the federal government later approved its 70 percent funding match. The dental school started seeing those patients in March, Hanson said.
Inspiration for the research came to Hanson, who was originally trained as a dentist and later went on to receive his Ph.D. in pharmacology. He studied pain and opioids, narcotics and drugs used to treat pain, which led to studying addiction.
While returning to dentistry to help the U. start its dental program, Hanson said he "started putting the pieces together." Addicts often have major oral health problems, Hanson said.
Medication is a common way to deal with drug abuse, Hanson said, and if you find a medication that improves outcomes by 20 percent, "that is a dramatic outcome. That medication will probably become a blockbuster medication because 20 percent in the world of treating these patients is pretty impressive."
"Well, we have a non-medication strategy that is 'Let's do comprehensive care for these patients and take care of an issue that seems to be related, and that's oral health.' And all the sudden your improvement in outcomes is 2(00) and 300 percent."
While the research itself didn't delve into why those with the dental care had a higher rate of success, Hanson said he believes it's because it improved their confidence and general quality of life.
"They remove the pain, because dental pain for these patients oftentimes is 24/7, it never goes away. And they restore their function so they can eat normal and improve their social abilities. They feel confident now, they can talk, they're not hiding their mouth," according to Hanson.
"And our students have come to appreciate working with these patients. When we first started it, you know, they first thought, 'Do I really want to be working on a person that has drug abuse problems?' They've imagined these very negative things about these people and they were concerned, and so we trained them, both our students as well as our faculty as to what these people look like, and convinced them these are normal people. They have normal desires."
The U. dentists are now doing assessments on current patients like they did with FLOSS patients. They're hoping if they can repeat the results, the "discussion becomes 'look at the savings,'" in terms of lives and money.
The program costs an average of $1,200 per patient for treatment at the U. That cost is much less than it would be out in the community, Hanson said. If a high percentage of them are able to get off drugs and get jobs, that could save the government $30,000 per year per person to keep them in jail or in treatment programs, according to Hanson.
For Jenkins, getting a new smile "made all the difference in the world," he said.
"Because, like if I got out of treatment and did all this stuff, and I still had to feel like I was ashamed of myself, or ashamed of how I looked, it would just be a lot harder to deal with everything … and the way people look at you, treat you. It makes all the difference in the world to people if they see you have no teeth in your mouth ... they treat you totally different," according to Jenkins.
"And it just feels good to be able to smile again."