When you imagine your dentist’s office, chances are you think of the typical clinic in a strip mall with its taupe walls and hallway full of identical check-up rooms. I’ve been a patient in five different dental offices, and each one had the same aesthetic.
So when I was on my way to visit Dr. Chris Bryant’s clinic in Sooke, I first walked right past it.
The clinic is in a small, converted white house just off Sooke Road, with a manicured lawn and a welcoming wooden front door. The clinic may not be in the most conventional location, but “conventional” was never Bryant’s goal.
His latest project is in the parking lot behind the clinic: an old HandyDART bus, stripped of its logos and rows of seats, awaits transformation into a mobile dental clinic. For the past few years, Bryant has been gathering supplies and equipment — ordering extra, watching for bargains, or keeping older equipment he’s replaced at his own company — to outfit the bus into a fully-fledged, one-chair traveling clinic. functional. It won’t just be a stripped-down space for routine exams and procedures; in it, he will be able to do everything he does in his regular practice, just with an extra range.
“Every piece of equipment in there is equipment that I had in my own office,” Bryant said. “That’s really the purpose of equipping this van. Whatever’s in it, we want it to be the best.
As you travel west on Highway 14, the last dentist office is in Sooke, leaving a whole host of communities – Shirley, Jordan River, Port Renfrew and the smaller communities in between – underserved. With the bus, Bryant wants to bring good dental services to residents who live in the Juan de Fuca area and don’t have easy access to dental care. Bryant currently has Port Renfrew clients who must travel over an hour for their appointments, which is only really possible if they have a vehicle or can find someone to take them.
Bryant says he’s already received interest in his mobile clinic idea from nation trustees T’Sou-ke and Pacheedaht. (Capital Daily contacted the nations, but could not arrange an interview before press time.) According to the Sooke and Juan of Fuca Health Foundation, although they do not collect information on access or dental use in the area, mobile service would be a benefit not currently offered by Island Health or the First Nations Health Authority.
“It’s a new approach, but I’d like to think anyone and everyone can do it,” Bryant said. “There is nothing special in what I do. We need to provide our communities with antidotes…to the corporate world.
It’s a project he calls “the Volkswagen Beetle version of a dental practice.” As Canadian dental practices are increasingly taken over by companies undergoing consolidation, reduced competition and increased prices, that’s Bryant’s way of pushing back. Dental care is essential, he said, and it is totally incomprehensible that it continues to be unavailable to so many people due to accessibility barriers.
So it converts the bus.
The first step was to adapt the electrical system so that it could meet the demands of the machines and that it could be connected to a generator or a shore power supply. The next step is to design the layout of the mobile office and start working on its assembly. He is scrambling to find people to help him through the process, and he hopes to have it up and running by next spring.
The Hornby and Denman Bus
The idea of a mobile dental clinic is not new. There are a handful of providers in British Columbia, primarily in the Lower Mainland, that offer mobile dental services to long-term care residences and other locations. In Greater Victoria, wheely clean– staffed by dental hygienists – provides dental hygiene services to residents of Greater Victoria from its vans.
Further north, on Hornby and Denman Islands, the only dentist who has practiced there for decades operates from a mobile clinic.
Dr. Peter Walford is ready to retire and is in the process of finding a buyer for his mobile dental clinic. In 1986 he began operating the clinic on Hornby and Denman Islands after realizing that residents did not have easy access to a dentist.
Having previously worked at a government-funded mobile clinic for a year in the remote village of Tahsis, he knew the mobile model could work. So, with the help of community members, he transformed a rusty, partially converted old school bus into a functioning clinic.
At the time, he also practiced in a space on the upper floor of Cumberland, and he carried all his gear up the stairs on his bus and traveled to the islands for a week every month. Over time, these trips grew to a week and a half, then to two weeks. He finally decided he no longer needed his clinic in Cumberland.
“The choice was to continue along conventional lines or to seek what I wanted,” he said. “And I can’t say I really knew what I wanted, I just wasn’t happy with what I was doing.”
He will thrive in the mobile clinic. He drove that old bus for almost 20 years until the rusty spots got more rusty, then he bought another bus for a theft and spent four years fixing it.
“It’s classy,” Walford said with a laugh. The bus is a Hornby work of art: it’s finished in birch plywood and yellow cedar with accents of teak and pieces of 500-year-old yew wood. It has two dentist chairs and underfloor heating. When the weather is nice, Walford opens windows and doors to let in the fresh air while he works on patients’ teeth.
Before Walford began practicing on the islands, there was no regular dental service. Each island has a population of around 1,000 people; typically, it takes 3,000 people in an area for a dental practice to be feasible, he says. But running the mobile clinic with very little overhead and supplementing her income with a few days of work at a Courtenay clinic was enough for her.
“My sympathies are with the ordinary person,” he said. “I mean, if I was in big bucks, I would never do this. I am not a financial dentist.
Walford has also been able to keep its prices reasonable because it can afford it. As an independent practitioner, he says he doesn’t have to perform a number of expensive procedures every month to meet quotas or satisfy management, which he and Bryant both agree becomes a bigger issue.
The mobile model works and is essential in the most remote communities, Walford said, but it only really works in coastal regions with mild winters. Being frozen in your mouth is bad enough, but it’s worse if your body freezes too, he jokes. On average, Walford only loses about four days a year to inclement weather.
Walford’s cabinet has been for sale for four years now, and it hasn’t gotten many bites yet. Recently, a promising deal hit a snag because the interested party works with multiple left-handers, which is a problem in a small space designed by a right-handed dentist.
As he retires from his mobile dentistry practice and searches for a like-minded person to take over, he is encouraged to see other like-minded people trying their own unconventional approaches to dentistry.
Focus on prevention from the start
With his bus, Bryant particularly focuses on the proper care of children and young families. Preventing tooth decay in children is more about education, Bryant said. If parents learn the importance of oral hygiene for their children and their children develop good habits early on, many expensive dental procedures can be avoided.
“When you start early with kids, you prevent disease processes, you prevent cavities, you talk to kids about injury prevention,” he said.
In his current practice, Bryant allows parents to bring their children for their first check-up for free for this reason. He said the bus would also help provide this education in communities where access to a dentist is limited, so avoiding costly travel is important.
Island Health has several programs and initiatives to help children get dental care and early detection, but there is little in terms of providing ongoing and regular access.
Once Bryant is done with the bus, he hopes his project can serve as a model for others who may be interested in starting similar initiatives elsewhere. Many other regions could benefit from a service like this, he said.
“The job isn’t done until everyone needs [are met],” he said.