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Reasons Why Folks Sleep Outside

Rita Grant has new teeth.
For someone whose mouth was filled with broken, brown stumps for much of
the past decade — the typical result of the ravages of drug abuse and
sleeping in the streets of San Francisco — that’s a very big deal.
“The sun is shining. My smile is pretty again,” Grant, 54, said by phone
from her home in Florida. “Life is good.”
Her newly gleaming mouth represents the latest chapter in an odyssey that
brought the former homecoming queen and high school gymnastics Olympics
hopeful from near death on the city’s downtown sidewalks to redemption
with her family 3,000 miles away in Florida.
Two years ago, Grant was profiled in The Chronicle as part of a colony
living on what was known as Homeless Island — a traffic median in San
Francisco where colony members shot dope, panhandled and slept every day.
An old high school friend read the story online and called Grant’s family
in Florida. In March 2004, Grant’s sister, Pam Johnson, and daughter flew
out to rescue her.
And now, with the help of two dentists, Dr. Tom Jacobs of San Francisco
and Dr. April Flutie of Florida, Grant has the final thing she needed to
make her feel she had finally left the street behind: a full set of
dentures, custom-fit into her jaw, which had to be surgically repaired to
accommodate them.
“It was a big step for Rita to take, and I’m very glad I was able to
” said Flutie, whose husband is the cousin of veteran NFL quarterback Doug
Flutie. “I always like to help when I can, and this was a perfect
Why do homeless people like Grant lose their teeth? There are three
The first is obvious: Living in the street makes regular dental hygiene
and care next to impossible. Second, teeth get bashed or chipped in
beatings or when a homeless person falls down drunk or drug-addled.
Then there are the effects of the drugs themselves.
Smoking crack or methamphetamine and shooting heroin so compromise the
body’s chemistry that dentists have a term for the result: “Meth mouth.”
The main damage comes from the way drug abuse reduces saliva, making it
easier for acid to eat away tooth enamel. The dry mouth also increases an
addict’s sugar craving, which further rots teeth.
Of all the hurdles homeless people face if they try to rebuild their
lives, toothlessness is one of the biggest. It makes it harder to get jobs
or easily blend back into society, let alone go out without drawing
unwanted notice — as Grant can painfully attest. The mere mention of the
problem, before she got her new look, made her wince and look away.
Grant was on the street in San Francisco for seven years. She used nearly
every narcotic she could get her hands on, mostly crack and heroin.
By the time her family took her to Johnson’s home in Florida, Grant’s 28
teeth were so chipped or rotted that the raw nerves were exposed.
“I don’t know how she wasn’t in constant pain all the time,” Flutie said.
Grant’s relatives helped her shake her addictions and find the right
medications to stabilize the AIDS she contracted living in the street. By
last winter, she was a new woman: head clear, body strong, goals set on
staying clean and becoming a nutritionist.
The only trouble was that mouth of broken teeth, an irritating reminder
her past every time she looked in the mirror. So Grant started saving bits
of her $550 monthly disability check to pay for dentures, which she
estimated would cost $3,000.
That’s when dentist Jacobs of San Francisco stepped in.
He read The Chronicle’s story Jan. 9 on Grant’s rescue, noticed the need
for teeth, and called the paper. He and Grant soon were talking, and he
agreed to help.
Then he called the dentist Grant and her sister were talking to about
doing the dentures — Flutie. The two agreed to pool their resources and
fit Grant with new teeth.
The cost of pulling the old stumps and installing dentures: $7,000. The
cost to Grant: Nothing.
Jacobs and Flutie both have helped poor people with dental work before.
And for Jacobs, the charity has extra poignancy.
“My wife has cancer, and we talk to our priest about what directions God
leads you in,” Jacobs said. “I guess this was just one of my directions.
“Sometimes you don’t know where to offer charity, but Rita was an obvious
case,” he added. “We could really see how she was working hard on her
Grant said she feels like she won a lottery.
“It’s like God is continuing to bless me after getting my life back,”
Grant said.
The dental work was done in March, but until this month the new dentures
did not feel natural in her mouth. Her jawbones were so decayed they had
to be chipped and filed to fit the new teeth, and over the coming weeks
Flutie will adjust the fit as the bones continue to heal.
“Already, she has her old smile back, and she goes around showing it off
to everyone she can,” said Johnson. “It’s wonderful to see. It’s so good
for her confidence.”
The sisters are a testament to what can happen when families step in to
help a homeless person in need — and how hard it is to get that done.
A little luck helps, too.
“I always say now that it was fun getting high all the time, but when you
finally stop and realize the consequences — oh, my God,” Grant said. “I
look around where I am now, and I am so grateful.”

More homeless people using city’s program to return to families
Reuniting the homeless with their families would seem a practical way to
help them off the streets, with caring relatives to nurse them back to
health. But it’s a rare and tough thing to pull off, social workers say.
Most hard-core homeless people have used up all their safety nets —
friends, family, jobs, social programs — before landing on the sidewalk,
and relatives and their homeless loved ones find it difficult to give
things another try. Often, things have to hit a crisis point with the
homeless person, and enough time has to have passed for resentment on both
sides to have cooled.
For more than two decades, the city welfare department has given free bus
tickets to any homeless person wanting to reunite with relatives, provided
counselors call those relatives and make sure they will care for the needy
person. And usually there were only a handful of takers — until this
year. In the past three months, the city streamlined its policy, and about
150 people have gotten Greyhound tickets, said Ben Amyes, an outreach
worker involved in several of the cases.
Homeless people no longer have to be accepted for welfare to get the
transportation. And outreach workers and officers on the city’s special
police homeless outreach team say that, as word went out on the street,
more homeless people asked for reunification tickets.
“We’ve come to the realization over the years that there are a lot of
people who don’t want to stay on the streets and want to go home,” Amyes
said. “But we make sure they are clear to go before we do anything. We
don’t just give blank one-way tickets — that would do nothing productive,
and we’d just see them back here again before you know it.”

Kevin Fagan

E-mail Kevin Fagan at