The Explorer Winter 2018 Explorer Winter 2018 | Page 6

TEETH CARE ON THE GO : MOBILE DENTISTS , HYGIENISTS TRAVEL TO YOUR DOOR ( CONT .)
Boothby , who visits 50 to 70 patients a week from Yuba City to Jackson , sees an endless variety of cases . She ’ s treated patients in their 20s with multiple sclerosis and young children with autism . She ’ s had patients with dementia , Alzheimer ’ s and Lou Gehrig ’ s disease . She ’ s had women in their 80s who want their teeth whitened for a grandchild ’ s wedding . And in three cases this year , Boothby said , she found evidence of oral cancers , which were referred to a dentist for treatment .
“ The worst thing to see is an elderly person with $ 5,000 worth of crowns and bridges , but their gums are bleeding and infected . They end up losing all that expensive dental work because nobody is brushing or flossing their teeth ,” said Boothby .
Recently , an assisted living facility called about a new resident who wasn ’ t eating , she said . An exam revealed part of his denture had broken off and was imbedded in the roof of his mouth . In such cases , where care goes beyond routine oral hygeine , RDHAPs like Boothby refer to traveling dentists like Kanas for further treatment .
Kanas , now semi-retired and without the overhead and staffing of a conventional office , said he enjoys his mobile practice , Mobile 1 Dental , primarily because of the patient camaraderie and flexible scheduling .
“ I don ’ t make as much as I did , but the happiness factor is what I ’ m interested in . I ’ m much more relaxed than I was with a full practice and the pressure of trying to keep up the patient volume ,” he said .
Technology has made mobile equipment lighter and quieter , helping the profession ’ s growth and acceptance .
“ It ’ s definitely enabled by technology . Mobile dentistry just wouldn ’ t be possible without the technology we have today ,” said Dr . Masood Cajee , owner of SmilesAhead Dental Care , based in Manteca . “ We can take X-rays with a handheld X-ray gun that didn ’ t exist 20 years ago .”
Cajee , whose mobile visits represent about 5 to 10 percent of his overall practice , said , “ It takes dentistry beyond the four walls of the practice and serves populations that were really difficult to serve before .”
Boothby keeps a rolling cart filled with sterilized packets , ultrasonic cleaner and a suction vacuum for cleanings . Kanas found his 15-pound X-ray machine in Washington state , part of surplus military equipment used by dentists who parachuted into remote areas to treat soldiers . His equipment is batterypowered , so he ’ s never hunting for cords or plugs .
Despite technical improvements , mobile dentistry clearly isn ’ t for everyone .
“ In a nursing home environment , it ’ s very difficult . You don ’ t know if they ’ re available or agreeable to be seen because their day-to-day health or mental status may change daily ,” said Cajee , who worked several years for a dental practice that provided care to Sacramento skilled nursing facilities .
Other issues are the ergonomics of leaning over bedridden patients and those in wheelchairs . Incontinence , aggressive Alzheimer ’ s patients and other issues that residents struggle with on a daily basis also can be off-putting .
In some cases , after an initial visit to assess a patient ’ s needs and mental state , Kanas will prescribe a Valium to relax a patient before an upcoming visit .
Despite these challenges , Kanas said he often walks out from appointments “ with a smile on my face ,” buoyed by the personalities and stories from his clients . Boothby recalls a husband who hired her for several years to regularly clean the teeth of his invalid , homebound wife . In thanking Boothby , she said he told her : “ I always know when you ’ ve been there . She always has her lipstick on , her breath smells better ... and I can kiss her .”
It ’ s a bit of giving back . “ We ’ ve all had parents , grandparents or even young people who are unable to help themselves ,” said Cajee . “ Sometimes it ’ s the small things you ’ re doing that can provide some comfort . It fulfills the best of this calling we call dentistry .”
MOBILE DENTISTRY : AT A GLANCE
What it is : House calls made by dentists and dental hygienists , who travel to a patient ’ s home , a skilled nursing facility or residential care home . Carrying their own portable equipment , they do routine cleanings , X-rays , extractions , fillings and denture fittings .
What they charge : Varies by individual practitioner , but fees are typically comparable to conventional office charges . Mobile hygienists generally charge $ 135 to $ 200 for a deep cleaning . Mobile dentists may charge $ 90 to $ 150 for an initial consultation , then $ 80 to $ 175 for a regular exam , $ 25 to $ 29 for single X-rays or $ 1,400 for a single , custom-fitted denture . For a mobile dentist ’ s exam , X-rays and cleaning in a private home , it ’ s about $ 300 ; slightly less in a residential care facility . Fees include cost of travel .
How it ’ s paid : Some patients pay directly ; others have mobile practitioners bill their insurance or Denti-Cal .
Who uses it : Generally elderly patients who can ’ t , or prefer not to , travel , or younger patients with physical or mental disabilities that prevent them from easily going to a dentist ’ s office . Mobile dentists and hygienists treat those in hospice care , as well as patients with agoraphobia , autism , Alzheimer ’ s , dementia and physical disabilities .
How to find it : For mobile hygienists , search for a Registered Dental Hygienist in Alternative Practice ( RDHAP ), listed by name and geographic region at the California Dental Hygienists ’ Association website , cdha . org �
Los Angeles Dental Society Explorer