A new dentistry program for the poor is so concerned about being swamped on opening day that the staff won't say when that day will be.

Project Access Dental plans to treat uninsured, low-income adults who are suffering with agonizing toothaches, infections or other forms of dental distress.

In a stark illustration of the shortage of dental care in the Roanoke Valley, organizers aren't revealing an exact start date for the new program.

Nor are organizers advertising its phone number, which is 344-0086.

It's not that Project Access Dental isn't interested in helping the community. Organizers have spent months lining up dentists who will treat patients for free.

But organizers are hoping for a quiet launch. They know that if word gets out that a newly formed team of dentists is fixing teeth for free, more people will apply than the fledgling program can handle at first.

That would produce more disappointment than anything else.

A sure way to draw a crowd in the Roanoke Valley is to advertise free dental care.

Bradley Free Clinic in Roanoke, well-known for its dental services, always has a full house on Thursday evenings when dentists treat those in pain. Other services are available at other times.

The clinic admits about 18 people for each Thursday night session, and because of limited resources routinely turns away another 60 to 80 people who phone in asking about treatment. Project Access Dental might start out helping another three or four people per week, but the number could grow during the second year.

Project Access Dental will strengthen the region's health care safety net, but won't by any means end suffering among those with dental problems in Western Virginia. Thousands of people need help, officials say.

Project Access Dental is being modeled after Project Access Medical, which enlists physician volunteers to treat patients in their own offices. Both are creations of the Roanoke Valley Academy of Medicine, an association of active and retired physicians.

Launched in 2004, the medical program has dramatically expanded physical health care to the Roanoke Valley's working poor.

In addition to about 500 current enrollees, another 600 people have used the services and left the program, usually because they recovered or obtained insurance, program officials said.

Project Access Dental will work the same way, and after initial treatment, patients will be referred to a dental clinic at Virginia Western Community College for cleaning. If necessary, patients can then go to Bradley Free Clinic for restorative care. Bradley Free Clinic will fill prescriptions at no charge.

"They're going to get the whole realm of dentistry," said Debbie Byrd, coordinator of Project Access Dental. Like the free clinic, Project Access Dental will admit only uninsured, low-income, Roanoke Valley adults ages 19 through 64 who work, go to school or take care of a parent, spouse or child, potentially leaving out many who are unemployed and disabled. Low income is defined as a gross household income at or below 200 percent of the poverty level.

Project Access Dental is starting out with restrictions on who can get care and what kind of care will be available, but "the more dentists that sign up, the more successful it will be," said Roanoke Valley dentist Fred Coots, who has pledged to see four Project Access patients a year.

As of late September, Project Access Dental had pitched the program to about a third of the valley's estimated 100 dentists and received enthusiastic support. Nearly all signed up to see from one to a dozen Project Access clients a year, and more are joining.

People with urgent, untreated dental problems often turn to a hospital emergency room. If it's not life-threatening, the problem is addressed with an antibiotic and a painkiller.

But this approach is far from ideal. Mouth pain may signal a cascading medical event that can compromise vision or major organs. In addition, it can be unbearable to live with.

Ernest Ciafardini, 35, of Roanoke said he lost a filling four months ago. At the time, he was in jail for a parole violation following 17 years in prison for armed robbery.

After he got out of jail, he didn't have money or insurance to see a dentist.

His tooth hurt so badly, "I was going to get a pair of pliers and just jerk it out," he said.

After two trips to the emergency room, where he received medication only, he saw a free-clinic dentist who finally extracted the tooth Thursday.

In the dental chair before him was April Fitzwater, a Roanoke County single mother of two who said she lives on child support. In pain since March with an infected wisdom tooth, she lacked the $400 a private dentist would have charged to treat it.

"You feel neglected," Fitzwater said.

Minutes later, she left the clinic with a wad of gauze bulging from her mouth.

Often, the extraction or repair of a problem tooth brings relief from pain the same evening, said Ashley Hanson, who runs the free clinic's dental program. She's excited to have a second program open in the Roanoke Valley, and only wishes Project Access Dental could help more people more quickly.