A glimpse of community dental health in the rural setting
by Cheryl Ivy, RDH, CDA
I love small-town dentistry. When I started practicing dental hygiene in 1991, I was naïve to the unique relationships I would form with hundreds of my patients. Not only do I see them every two to six months at the office for routine or maintenance treatment, but I cross paths with them at sporting events, church, the grocery store, golf course, and post office.
I get a kick out of having a 6-year-old run up to me in the produce section of the grocery store and show me the space where her first tooth came out, or go to a game and cheer for the basketball player on the court wearing the mouthguard fabricated at our office. It's heartwarming to watch the local high school parade and see the Homecoming Queen flash the beautiful smile I've helped take care of for the past 12 years. Nothing is sweeter than having our local Brownie troop of 20 girls tour the dental office for an hour after work on Thursday and then watch with delight as they dig through the treasure box and try on gloves and masks. A future dental professional is surely in the mix of these little troopers.
There are football players, grade school kids, and Girl Scouts who frequent our office with items to sell such as Bulldog cards, Christmas candles, or Thin Mints, and they are always welcome. High school juniors and seniors interested in dentistry often job shadow and always bring a spark of excitement to the office, especially when they are accepted at the college to which they've applied.
There's our cleaning lady who already has several jobs yet faithfully takes care of our office twice a week to help pay off her dental bill. She also spoils us with homemade sweets. The modern day cobbler who insists on making a custom pair of cowboy boots for the dentist in exchange for a crown proves bartering still exists. A constant supply of toothbrushes are donated to patients who work with abused and battered people, go on humanitarian mission trips, send Christmas gifts to poor children, or support our troops. There's the bachelor who lives in the country, but always comes to town on Wednesday to bring us farm fresh eggs, tomato plants in May, and plum jam in August.
Sometimes the relationships can be emergent. I remember the knock on my door at home one January night when a 17-year-old high school student had been "night sledding" and took a chunk out of his friend's skull with three of his front teeth. He wondered if the blood all over his face and the fact that he can't bite into occlusion is a problem. This, of course, is the kid that until that moment had perfect teeth – no cavities and no need for orthodontics.
After a phone call to the dentist I work with, I was informed that we needed to get the displaced teeth back into proper occlusion immediately. I tried to persuade the doctor that he would do a much better job at the office, but he reiterated there was no time to waste. Through guided phone conversation this young man and I accomplished the task. Three root canals and crowns later, he is good as new and ready for his senior pictures.
Some days can be dramatic. There was the 9-year-old boy who knocked out his permanent maxillary central incisor in a bike wreck. He showed up at the office with a bloody lip, but no tooth. An assistant and I searched for the tooth in the dirt and rocks at the scene of the accident and eventually found the needle in the haystack. We plopped the tooth into a cup of milk and rushed back to the office. The tooth was reimplanted and survived.
Other encounters are very emotional.
When I discover a patient has cancer, just lost his wife of 53 years, or is recently divorced, I express great sympathy. I have shared tears and hugs with patients over the years in the office.
The most recent tears were with a man who has Alzheimer's disease and is scared and confused and failing quickly. Once, I sent a sympathy card to an elderly patient when his brother died and then received one a few years later from the same patient when my father died.
These are bonds that last.
The most unique patient I see can be described as an impulsive icon of the 1970s and a true rock-and-roll guru. At every appointment he tells me about the concerts he's been to in the past three months. He is a truck driver who called me from work one day to see if I would take some floss, sensitive toothpaste, and Stimudent samples and put them inside his barbeque grill at home since he had to work late and couldn't get by the office in time.
"Sure," I laughed, "I'll just drop them off on my way home."
That's the comfort level patients feel living in a small town, and it's endearing. Community dental health takes on a whole new meaning when you are truly intertwined in one another's lives.
Cheryl Ivy, RDH, CDA, completed the certified dental assistant program in 1985 at Mesa State College and assisted for three years. She received her dental hygiene degree from Colorado Northwestern Community College in May of 1991. The past 13 years she has been employed at Dr. Neal Fenton's general practice in Craig, Colo. She enjoys volleyball, golf, camping, hiking, and Christian ministry. Ms. Ivy has been married for 26 years and has two grown sons, a daughter-in-law, and two adorable grandchildren, all of whom are her pride and joy.