This story by Tommy Gardner was first published in The News & Citizen on Oct. 10.
The dentists at Lamoille Health Partners are hitting the road.
The organization recently rolled out a new mobile dental unit, which looks a lot like an RV on the outside and quite a bit like a dentist’s office on the inside. It even has that new dentist office smell.
The truck, which the dental team has christened Flo, features two operating rooms, fully set up to handle basic dental procedures — cleanings, fillings, extractions, X-rays and “everything to sterilize and run the day,” Sara Davis, the dental director for Lamoille Health Partners, said.
According to Lamoille Health president and CEO Stuart May, instead of trying to get folks in more rural parts of the county to drive to Morrisville, it just made sense to bring the services to the people.
“This is an easier way to get to those medically underserved communities, to get to those that have transportation issues, etcetera,” May said.
Last week, the crew, including Davis and driver Scott Droney, visited Waterville Elementary School.
According to principal Jan Epstein, the dentists were able to tend to nine kids on the initial visit, with a few that the dentist team will get to on the next visit. And here’s something you might not hear very often about a trip to the dentist.
“The kids had a great time,” Epstein said. “I was waiting for the crying and the tears and there was none of that.”
Epstein said smaller communities don’t have adequate access to public services or things like banks and grocery stores.
“It’s been a real struggle for folks,” she said.
None of the small handful of dentists’ offices in the greater Lamoille County area — including in Waterbury and Hardwick — are open on the weekends, which makes it even more difficult for working parents to get their kids to an appointment.
“Parents have to take off work and then drive a half hour, and the kids are usually out of school for the whole day. Same as the parents, they just take the whole day off,” Davis said.
Flo’s visits aren’t just novelty one-off events, either. Davis said the team plans to have regular three- or six-month rotations at the schools.
“We can keep track of them that way, and it can be their permanent home for some of the services that we do,” she said.
Miles for smiles
Flo was funded through $550,000 in federal American Rescue Plan Act funds. Droney said it gets almost 10 miles to the gallon.
May said the idea of a mobile dental unit was hatched in 2022, when the organization began offering hygiene services at Johnson Elementary School.
“I remember conversations with Sara and just hearing the stories of the amount of decay,” May said. “Clearly, on the medical side and the oral health side, there’s that multi-generational education issue.”
He said most people living in smaller towns have well water at their home and are not hooked up to municipal drinking water systems, which usually add fluoride to the water.
Jessy Breault, the service line administrator for Lamoille Health’s family dentistry branch, said parents are more likely to keep up with their kids’ — and their own — regular check-ups with their primary physicians or pediatricians, but other services are often viewed as luxuries.
“If there’s something they’re going to let go of, that’s the one, a lot of times,” Breault said of dental health.
But May and the Lamoille Health team frequently refer to whole-patient care, and doctors and nurses in the various departments — primary health, dental, behavioral — can make referrals to the other departments if they sense a patient needs those services, too.
“It’s that cross-pollination, if you will, of information,” May said.
Breault said whenever Flo hits the road, it does pull some resources from the brick-and-mortar dentist office in Morrisville, but there are plans to add more staff as the mobile service grows.
“But we have three dentists now, so we are in a good position to be able to send Sara out on the unit and still have dentists back in the office. Same with hygienists,” Breault said.
Davis said the initial mission of the traveling dental unit is to get into the Lamoille County schools, first the elementary schools, then the older grades.
“Starting their oral education early is important,” Davis said.
Breault said the team brings Flo to school open houses, too, which provides great exposure for parents who are already there touring the campuses.
The billing is handled just as it would be at the office, Breault said. If a patient has insurance, they will get billed that way; if not, Lamoille Health Partners offers a sliding fee they can apply for to help cover the costs.
Epstein said she was impressed that, during the trip to Waterville last week, someone at the dentist’s office had already handled the legwork — with help from school nurse Alyssa Fuller — on billing.
“Someone was in the office getting all that taken care of behind the scenes, which I also think is really amazing, because whoever can figure out health insurance and make that work, that’s a miracle, right there,” Epstein said.
Health for life
Flo’s maiden voyage, last month, was to the Lamoille Community House, the homeless shelter that opened its doors at an expanded location off Center Road in Hyde Park earlier this year.
Shelter manager Nicole Chauvin said when people come to Lamoille Community House, staff there have a “needs sheet” with the myriad services available that the organization is connected to.
“Dental care is always at the top of the list,” Chauvin said, saying that Medicaid for adults is very limited when it comes to dental services. Many dentists’ offices require people to pay up front, even if they have dental insurance.
“Then finding a dentist that takes it, that has openings, that doesn’t have a waitlist of 600 or 700 people, is just crazy,” she said.
Chauvin said folks without adequate housing or income or access to transportation or basic services often must make decisions between very basic needs.
“Do I pay my rent, or do I get my teeth cleaned? Do put food on the table, or do I get my teeth cleaned?” she said. “You have to make these decisions, and they aren’t always easy decisions to make.”
Folks like Epstein and Chauvin, in the education and social services professions, are familiar with what are known as adverse childhood experiences (ACEs). They just see it from different parts of a person’s life — the educators try and address them early on, and the social workers try to do so later in life, after they’ve affected a person’s adult life.
“There has been scientific research done that having a certain number of ACEs as a child can affect your physical health as you grow in life,” Epstein said. “So, any type of medical screening that young children can have, and an eye kept on any things that pop up, certainly can only benefit them.”
As important as getting an early jump on good oral health may be, it’s a very different scenario for adults who either neglected it for much of their lives, or simply didn’t always have to means to take care of it. May said that was evident in the trip to the Lamoille Community House.
“It allows us to break barriers,” May said. “Some of the residents in the county don’t have the self-confidence, depending on what’s going on, to walk into a traditional office. Here, we’re meeting them on their ground, so to speak.”
Read the story on VTDigger here: Dentists log miles to improve smiles.