BY FRANK DELANO

Kenneth C. Van Deusen is a 32-year-old Westmoreland County laborer with bad teeth. He lives with his mother, sister and nephew near Montross.

Van Deusen is also poor. He takes work when he can find it. He reckons he earned $2,000 doing odd jobs last year. He lacks medical and dental insurance.

In September, a toothache sent Van Deusen to the Northern Neck Free Health Clinic in Kilmarnock.

It was the first 50 miles of a medical ordeal that cost nearly $44,000. He received rapid, lifesaving care, but most of its cost will be paid by everybody in one complex way or another.

His journey also illustrates the plight of the poor in obtaining dental care. Health care reforms now being debated in Washington appear to offer little hope for better dental care for the millions of people like Van Deusen.

At the Kilmarnock clinic, Van Deusen paid $25 to see a dentist, who outlined a plan for 10 of his teeth, including extractions and root canals. He said the dentist told him each tooth would require two or three visits at a cost of $25 per visit.

"It ain't a lot, but it is a whole lot when you ain't got nothing," Van Deusen said. "It just started adding up to the point that I couldn't afford it."

The clinic asked him to pay $25 in advance for a second dental appointment in October. "I didn't have it, so I didn't make the appointment," he said.

Van Deusen's toothache worsened. He woke up Sept. 27 with painful swelling in his jaw and neck. The swelling in his throat made it hard for him to breathe. His sister drove him to the emergency room at Riverside Tappahannock Hospital.