My part of Alaska, the Yukon-Kuskokwim delta, is a vast expanse of tundra and mountains that is about the size of the state of Oregon. Twenty-five thousand people live here, in fifty-six scattered villages. From the air, in the summer the tundra resembles varicolored moss, laced by the two enormous rivers and their tributaries and dotted with sloughs, ponds, and small forests of spiky spruce trees. In winter it’s all ice and snow.

I’m based at the Clara Morgan Subregional Clinic, which is part of the Yukon-Kuskokwim Health Corporation, in Aniak, but my dental assistant and I spend every other week “on the road.” Actually, we travel by air because there aren’t any roads to get us where we need to go. We rotate among a total of twelve villages, providing basic dental services such as screenings, exams, x-rays, fillings, sealants, and uncomplicated tooth extractions. One of the villages that we visit is Grayling, home to 173 residents, which lies ninety-three miles north of Aniak on the Yukon River.

Most of the villages, including Grayling, have modern health clinics equipped with dental suites. Even so, we have to pack and load 500 pounds of gear into a small plane, including air compressors; a small unit fitted out with hand pieces and suction; supplies; and a sterilizer. We take extra clothing, sleeping bags, and food. We sleep on inflatable mattresses on the clinic floor.

On a January day with temperatures far below zero, we load up the eight-person commercially operated plane. The pilot makes routine announcements about where to find survival gear and how to activate the emergency signal if the need arises, and we take off for the fifty-minute ride.

Arriving on the runway strip in Grayling, we are met by village residents, who help us unload. We haul the equipment to the clinic in two sleds pulled by a snowmobile and set up for patients. Then we walk five minutes to the David Louis Memorial School, which has about forty students from prekindergarten through twelfth grade in a building with five classrooms, a small gym, and a little library.