Shanda King pulled on a second pair of pants and a fleece sweatshirt before heading out the door Friday afternoon. She tossed a tent into her trunk, just in case she'd be required to wait outside in the cold. She grabbed a bucket, too, in case there wasn't a bathroom for those in line.

Then she got in her car and drove west, away from Baytown and, she hoped, all her problems.

King, 41, couldn't believe it when a friend told her about the two-day mobile clinic held Saturday and Sunday at the Chua Viên Thông Tu Buddhist Temple in west Houston. Free medical care. Free vision screenings and prescription glasses. And, most important to King, free dental.

This was the chance she'd been waiting for. To gain access to the Remote Area Medical clinic, she just needed to be one of the first 400 people in line before it opened 6 a.m. Saturday.

King wasn't taking any chances.

When she arrived at 4 p.m. Friday — a full 14 hours early — she was the first. Thirty minutes later, another car parked behind her outside the temple, a retired husband and wife who'd driven four hours from Dallas, hoping for new dentures. An hour later, another car pulled up, this one driven by a retail worker from Pearland who'd gone four years without new glasses. Then another, a 19-year-old construction worker from Dickinson who for more than a year had suffered the constant pain of an untreated toothache.

More Information RAM's free clinic will be open again Sunday at 17355 Groeschke Road in Houston. Services offered include dental cleanings, dental fillings, dental extractions, dental x-rays, eye exams, eyeglass prescriptions, free eyeglasses, women's health care, general medical exams and flu vaccinations. Patients can come as early as 3 a.m. to reserve a spot and should arrive no later than 10 a.m.

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By 3 a.m., a few dozen cars had lined up behind King, each carrying a story of despair.

Similar scenes play out every time Remote Area Medical arrives in a town. The Tennessee-based nonprofit, better known as RAM, has hosted similar clinics across the country, each time drawing massive crowds. In a country where more than 114 million people have no dental coverage — far more than the 28 million who lack medical coverage — RAM clinics and others like them are a lifeline for those most desperate for help.

"There are tens of thousands of people in Houston who lack access to affordable care," said Stan Brock, who founded RAM in 1985 and, of late, has made headlines by inviting President Donald Trump to attend one of his events. "No matter how much we talk about improving our health care system, unless we add vision and dental coverage, people will continue to be in pain and suffering."

King has endured her share of pain and suffering, but she didn't want to dwell on her past as she waited at the front of the line Saturday morning. She leaned back in her driver's seat and tried to sleep, but she couldn't. She distracted herself by reading on her phone or listening to the radio, but mostly she just sat in silence, daydreaming.

She thought about what her life would be like after RAM's volunteer dentists implanted bridges and crowns in her mouth to replace the teeth that she'd lost to tooth decay. She imagined how she'd look without the "ragged smile" that has made her embarrassed to even smirk in public. King described the hopeless cycle that's led her here: Without a steady job and dental coverage, she can't afford to see a dentist; as a result, her teeth look terrible, which makes it harder to land a job.

She doesn't blame employers for passing her over after they see the gaps in her teeth.

"A person's smile is like a window into their soul," King said around 4 a.m. "This is a chance for me to regain that and to start letting people see me for who I really am. This is my big break."

An hour later, she got out to stretch her legs and noticed a parking lot full of medical volunteers. She lifted a hand to hide the grin forming at the edges of her mouth, a self-conscious reflex she soon hoped to shake.

"I've just been sitting here thinking about the after," King said. "This isn't winning the lottery, but that's what it feels like to me."

At 5:45 a.m., a volunteer signaled for everyone to step out of their cars. After a night of waiting in bitter cold, the time had finally come: "May I have your attention please," he shouted. "The clinic is starting."

King swayed to stay warm as she stood at the front of a line outside the temple, where nearly 300 volunteers from all over the country had helped set up. Inside the temple's fellowship hall, dozens of dentists and dental hygienists stood at the feet of more than 30 portable dental chairs, waiting.

"What's your main dental issue?" a woman asked King at a registration table.

"I need bridges," she said, opening her mouth and pointing to one of the gaps.

Her teeth didn't always look that way, but that's what happens when you go years without dental care. The issue is more than cosmetic; without a fix, she's at risk of additional tooth decay and other structural problems that might soon make it difficult for her to eat.

"I'm going to get my old smile back," King told the nurse taking her blood pressure.

A minute later, a volunteer led her and several others to a staging area for those seeking dental work. King sat down. A few feet away, 19-year-old Joshua Valdivia opened his mouth and pointed to a decaying black molar that sometimes hurts so bad, he's had to call off work.

"It's been a year like that," Valdivia told one of the dental assistants. "Oh my God, I just want it out."

Soon, a volunteer dentist would relieve him of his suffering.

King was next. She sat with the woman screening patients and again pointed to the gaps in her teeth. The dental assistant frowned. Then she shook her head.

"What?" King said, with a look of panic on her face. A minute later, she stood up abruptly, biting her lip as she walked. The buzz of dental drills echoed through the temple as she rushed for the exit.

Outside, she leaned against a wall, and began to sob.

"They can't help me," she said, pulling her sweatshirt over her face to hide her tears.

She had been mistaken, filled with false hope after reading about more advanced dental services offered at previous RAM clinics in Tennessee and Virginia.

A charity organizer explained the confusion: While it's true that RAM offers free denture fittings and other dental services at clinics near its Knoxville, Tenn., headquarters, it's impossible to offer those multi-day treatments at its more remote events, like the one in Houston this weekend.

When more than 40 percent of Americans lack basic dental care, there's only so much one free clinic can do.

King sat on a cold bench as dozens of people filtered past her, filling the clinic's dental chairs. She cried as she talked about mistakes in her life, about her decades-long struggle with depression, about the renewed sense of joy and purpose she's felt since her grandchildren were born a few years ago.

She wanted her smile to match her new, happier outlook. She wanted to finally put her past behind her, she said, and start fresh.

"Oh well," King said, before getting up and heading for her car, after 16 hours of waiting.

"I guess some people don't get a second chance."

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Mike Hixenbaugh writes about health care and medicine for the Chronicle. Follow him on Twitter and Facebook. Send him tips at mike.hixenbaugh@chron.com.