Audrey Lambert of China Grove said if it had been allowed, she would have given a monetary tip to the dentist who extracted two of her teeth Friday and relieved the pain that had been killing her for weeks.

Lambert attended the free Missions of Mercy dental clinic held Friday and Saturday at Goodman Gymnasium on the Catawba College campus. She hadn’t been to a dentist in almost 10 years, giving priority instead to her 2-year-old twin daughters and 7-year-old son with Down syndrome.

Her husband works, but they can’t afford dental insurance, so the free MOM clinic, an outreach program of the N.C. Dental Society, was a godsend for Lambert. She couldn’t wait to get into a dentist’s chair.

Lambert is a case study of a dental crisis in America, something outlined three years ago in a report from the U.S. Senate Subcommittee on Primary Health and Aging. Much of the crisis deals with access. The people needing dental care the most aren’t getting it, though they want it desperately.

The 2013 report said: “Individuals who are low-income or racial and ethnic minorities, pregnant women, older adults, those with special needs, and those who live in rural communities often have a much harder time accessing a dental provider than any other group of Americans.”

Just a sampling of the people attending Salisbury’s MOM clinic revealed people traveling long distances to get there — Raleigh, Denver (N.C.), Rocky Mount and Ashe County were mentioned in interviews. Likewise, their reasons for attending were quite similar: They had recently lost jobs. They didn’t qualify for Medicare or Medicaid. They couldn’t afford dental insurance or going to a dentist.

“The issue of lack of access to dental care is extremely serious because untreated oral diseases can lead not only to pain, infection and tooth loss,” the 2013 Senate subcommittee report said, “but also contribute to an increased risk for serious medical conditions such as diabetes, heart disease and poor birth outcomes.”

More than 47 million Americans live in places where access to dental care is difficult. About a fourth of adults in this country who are 65 and older have lost all of their teeth, and low-income adults are almost twice as likely as higher-income adults to have gone without a dental checkup in the previous year.

There seems to be a great divide. Many of us have access to the best oral health care in the world, while just as many of us do not. The hundreds of dental professionals and community volunteers in Salisbury Friday and Saturday saw this crisis up close in patient after patient.

They kept being reminded that a smile is a terrible thing to waste.