Out came the teeth, 12 in all. The extractions would at least temporarily stop the pain of one Filipino man, but it was emblematic of a nationwide crisis that yanked at the heart of an American dentist.

“He’s 28. He has two children, and this was the first time he had been to a dentist,” said Dr. Kordie Reinhold, a Minneapolis dentist. “I removed 12 teeth that were basically decayed to the gum line. That was the most I felt he could tolerate today.

“This is way worse than I expected,” Reinhold said of the patients she has seen in her first medical mission to the Philippines. “There is rampant decay — children have their teeth decayed off to the gum lines. I’m removing adult teeth on 9-year-olds, and they’ve only had those teeth for three years.

“It’s a big public health issue.”

National statistics back up her assessment. One survey says more than 92 percent of Filipinos have tooth decay and 78 percent have gum disease. That same report said 74 percent of 12-year-olds have gingivitis.

Reinhold, 58, is the only U.S. dentist with the Philippine Minnesotan Medical Association mission group of about 100 Minnesota doctors, nurses and others who are spending the week in the Philippines.  She is joined at Mariveles District Hospital each day by anywhere from seven to 12 dentists from the region.

Jerico Avila, a Delta Airlines employee, and Cathy Boland, a St. Paul hotel worker, work with Reinhold in the dental division. They each have six medical missions under their belt, all spent in dental work.

“They are amazing,” said Reinhold, who credits them with keeping the entire operation flowing.

That’s no small task, given Reinhold and her associates are treating an average of 250 patients daily. They have a their wide-open office space where plastic-lined garbage cans serve as spit sinks. There are only four dental chairs so many of the patients sit in regular chairs and just tilt back their heads as the dentists work.

Extractions are the main order of business.

“I almost never do just one per patient. It’s always multiple. I try to do most of what each patient needs, but with so many people needing attention, you kind of get to the point where you have to address pain,” Reinhold said.

It’s a complete reversal of her dental practice in Minnesota.

“I live in this nice neighborhood in Minneapolis where people have their teeth checked every six months. Their issues are so minor. It’s almost mind-boggling to compare the two.”