Door-to-Door Smile Delivery for Children and Seniors

Dr. Michael Helgeson could only stand and watch from his office window as the father of one of his youngest patients crawled underneath Helgeson's Toyota Tercel and changed his oil. Neither his gestures of protests nor his words, "That's okay, you don't have to pay me back," registered in the smiling faces of his mechanic benefactor as he pointed to his toolbox and then to his car in the clinic parking lot. The little patient, a three-year-old daughter of Romanian immigrants, had suffered from severe baby bottle tooth decay. Tooth by tooth, Helgeson had revitalized her smile and chewing power with stainless steel crowns and tooth-colored fillings so she would be like all the other kids when she started preschool. Unable to pay for his services, these grateful people would make sure that he, in turn, would never have to pay for theirs.

This was for Helgeson, a National Health Service Corps (NHSC) dental Scholar, his first experience with how the underserved could pay back in an immeasurable and much more gratifying currency of their own. In fact, it was a currency that addressed the very reasons he had chosen to turn his talents to those who traditionally shunned the dentist's office for lack of money or ability to get there.

Several years prior to this, he had decided to pursue a Doctor of Dentistry (D.D.S) with a specialty in geriatric dentistry, rather than a Ph.D. in physics, as a result of impressions gained while working as a dental assistant in a mobile clinic serving a nursing home. He was shocked "that the services being provided were really designed based on the dentist's economic goals rather than what people needed." So, with the NHSC partially paying his way through dental school, he was able to set himself on track for doing "what I love to do-provide services to those who really need them."

Grace Hill Neighborhood Health Clinic in St. Louis, Missouri, turned out to be much more than just a satisfying job experience for Helgeson. As one of the several clinicians who actually started the clinic from scratch, he gained the experience that he would apply directly to his next project-founding a nonprofit network of mobile dental practices called "Apple Tree Dental."

Apple Tree Dental, whose motto is "Bringing smiles to people with special dental access needs," is a service that provides dental services and clinicians in mobile dental offices to Head Start centers, schools, and nursing homes. So far, Apple Tree operates mobile clinics in Minnesota, North Carolina, California, and Louisiana. In 2001, Apple Tree's two main Minnesota-based programs provided more than 30,000 dental visits worth $1.7 million in care without payment. In total, it is estimated that this organization has delivered more than $9 million in uncompensated care to society's most vulnerable populations-children in day care centers and at schools, and nursing home-bound senior citizens too infirm or too poor to make the trip to a dental office.

Now the chief executive officer of Apple Tree, Helgeson points out that his service fills the gap left by Medicare, which doesn't cover most dental costs to seniors, and Medicaid, which is designed to provide stopgap emergency dental services to low-income people.

Beyond vehicle repair and the smiling faces of his patients, Helgeson readily acknowledges another unexpected benefit of providing his creative form of dentistry. "I get to see every possible permutation of dental disease, a range much bigger than you could expect to see in a suburban dental practice."

But the real motivation to provide long-term services to those who would otherwise never be able to afford them runs much deeper than that for this extraordinary dentist. "The NHSC gave me the opportunity to do something for my country, for my community."

Learn about other NHSC success stories.