When Kate Mills returned to her hometown of Bainbridge Island after working for several years as a direct access dental hygienist in California, she knew it was a type of dental practice she wanted to start up in Washington.

“I saw what kind of difference it could make,” Mills said.

“Dental care is a very under-appreciated need. There’s a certain attitude about it that isn’t always accurate.”

Mills is the co-founder of Washington State Smile Partners, a Bainbridge-based organization that offers direct access, preventative dental care to low-income school children and seniors.

It wasn’t easy.

Mills moved back to Bainbridge just after the state of Washington passed laws to allow off-site dental care in schools and senior centers. Direct access dental care was still a budding practice in Washington.

It hadn’t gathered much support yet and many private practitioners feared it threatened the industry.

Nonetheless, Mills began building Smile Partners in 2004 along with fellow hygienist Nan Bucklin-Hawkes.

“It was pretty difficult when you’re a hygienist, and you don’t really have the experience of running a business,” Mills said.

“We decided early on that we wanted to be a nonprofit,” Mills explained.

“I didn’t want it to be a dash for the money. I wanted it to be something that is for the good of the community.”

First the two had to put foot to pavement, with outreach efforts to schools, principals and community groups.

Second, they had to purchase their own equipment.

They mortgaged their houses, liquidated their retirement funds and worked 70-plus hours each week.

It started out with just a few schools, but every year the organization grew.

Fast forward to today, and the hard work has paid off.

Smile Partners will celebrate their 10-year anniversary, Saturday, March 22.

Over the years, the organization has grown to serve some 6,000 patients in 77 schools across Kitsap and King counties where at least half of its students receive free or reduced lunches. It also now provides services to several senior and immigrant centers.

On a yearly basis, Smile Partners provides oral screenings, cleanings, fluoride varnish applications, sealant placement, scalings, palliative care and temporary fillings. Most important to their young patients, they also provide oral health instruction.

The organization’s purpose is to both direct patients to private practices if additional work is needed and to altogether prevent tooth decay.

“What we’ve learned is that if we have a consistent presence in the schools from year to year, we have the good fortune of seeing many of the same patients,” said Imbert Matthee, the executive director of the organization.

By also starting with preschool, Matthee said, the students will likely have fewer cavities as they get older.

“This concept of continuation of care is really important,” he said.

Tooth decay is an epidemic for children and especially children in low-income families, both Matthee and Mills noted.

According to the organization, children from low-income homes can have three times the number of cavities as their peers. It’s because many of these children are either not covered by dental insurance or have limited coverage through Medicaid, officials said.

“Poor kids don’t always have bad parents,” Mills said. “Sometimes it’s just hard to find a dentist that will see low-income students.”

Smile Partners works around this by pulling from three pots of income: insurance reimbursements, offering a low co-pay on a sliding scale depending on the family income, and community donations.

“We’re based on being as inclusive as we can,” Matthee said.

This inclusiveness extends to a second age group for Smile Partners. Being based in a community that includes a substantial senior population, Smile Partners works to provide care to elderly who face a different challenge.

While it is not uncommon that seniors also cannot afford basic preventative dental care, their needs surround conditions like dry mouth and maintaining overall oral health.

One of Smile Partners’ key clients to meet this need is Bainbridge Island’s Waterfront Park Community Center.

With its 10-year anniversary happening this month, Smile Partners has decided to embark on another goal: 10,000 smiles by 2015.

It’s ambitious, said Matthee, but with 6,000 patients and counting, the organization is optimistic.

To help the nonprofit meet its goal by donation contributions, visit www.smilepartners.org.

Smile Partners will be celebrating 10 years of serving low-income youth and seniors from 4 to 7 p.m. Saturday, March 22. Those who are interested in attending may also visit www.smilepartners.org to RSVP.