Time after time, the school nurse refers pain-stricken children to a doctor or dentist but doubts their parents will take them.
"Many times, they don't," said Ellen Bordinhao, principal of Wynn Elementary School in a central Las Vegas neighborhood where 90 percent of students live in poverty and many are uninsured.
Dentist Steve DeLisle sees the proof of neglect in the gaping jaws of young patients.
"I've seen full-mouth decay," he said. "All 20 teeth with cavities."
He fixes all the cavities at once, putting patients under because the hours of drilling would traumatize children, who wouldn't have come to him if it weren't free.
Bordinhao is banking on that same incentive for the school's health and dental clinic that opened Thursday at 5630 Coley Ave. on the backside of Wynn's campus.
The Southern Nevada chapter of the NAIOP real estate association volunteered to cover the cost of the building. And it will cost the school nothing to run because the Foundation for Positively Kids is covering operating costs.
Neither DeLisle's dental work nor the doctor's medical attention will cost the uninsured a dime, which will hopefully eliminate the unfilled referrals, Bordinhao said.
For the Wynn clinic to break even, it will have to see a minimum of 20 patients a day and have two-thirds of them covered by health insurance or Medicaid, said Positively Kids founder and CEO Fred Schultz.
The clinic may solve Wynn's problem, but it also raises the question of where a school's responsibility ends. Should schools be providing health and dental care?
The Nevada State Health Division has issued a resounding yes. It has set a goal of opening 70 public school clinics across the state. About 59 of those would be in Clark County School District, where more than two-thirds of Nevada children go to school, said Diana Taylor, director of health services for the district.
Wynn's clinic is just the sixth in the district and open to any Clark County elementary student. The others are at Basic High School, West Prep Academy and Martinez, Kelly and Booker elementary schools. However, the cost is often little or nothing to the district, paying the utilities at most.
For example, the University of Nevada School of Medicine operates three of the school clinics. Demand is definitely high in Clark County, the nation's fifth-largest school district, where half of family incomes for the 311,00 students meet federal poverty requirements.
"We have a lot of kids who are underinsured or uninsured," said Taylor, noting that the exact number of uninsured students is undocumented.
For Principal Bordinhao, the clinic presents no dilemma about a school's responsibility. It's the culmination of three years of work.
"This is crucial," she said. "How do you expect a child to learn if they're ill and not getting any medical attention?"
Clark County School Board member Lorraine Alderman held the same stance.
"A child can't achieve if they're going to school in pain," she said but acknowledging there is a limit to how far a school should go. "That is the million-dollar question we'll have to decide as we move along."
Contact reporter Trevon Milliard at email@example.com or 702-383-0279.