Dr. Jeremy Simms Alexander and Dr. Adele Della Torre are both 2021 DentaQuest Health Equity Heroes.

Have you ever seen a dental office on wheels? Neither had Dr. Jeremy Simms Alexander.

But after coming across a mobile dentistry unit in Atlanta in 2012, he was so inspired that just three years later, he opened Miles for Smiles--becoming Louisiana’s first and only mobile dentist. 

“Mobile dentistry is a passion for me. It has reopened my personal passion for the profession. We’ve been very intentional about bringing access to care to those who need it most,” says Alexander, who serves three parishes and close to 80 schools in the Shreveport area through Miles for Smiles.

While Dr. Alexander may be the only mobile dentist practicing in Louisiana, he’s not alone in his passion for bringing care directly to those who need it. In Minnesota, where Dr. Adele Della Torre practices at Ready, Set, Smile in Minneapolis, she is focused on bringing preventive care to under-resourced children in schools.

After a year in which the pandemic exposed the deep inequities in our health system, their work is not only needed more than ever--it is at the vanguard of a shift in how families access oral health care.

Bringing Care Into the Community

“For some low-income families, dental care may not be as high a priority as getting other basic necessities,” Della Torre says. “Our target patients are Medicaid and uninsured children who would not otherwise have routine dental care, due to the social determinants that impact specific communities in Minneapolis.”

In fact, nearly 1 million Medicaid-enrolled children nationwide rely on school-based oral health programs as their primary source for preventive dental care. Without these programs, children are left without routine dental screenings and may be in pain for longer periods of time, which can impact everything from overall health to academic performance. And many families simply aren’t aware of these critical connections.

That’s why both Miles for Smiles and Ready, Set, Smile emphasize education as a core component of their programming--educating parents and families, as well as school leaders, on the importance of oral care.

“Education goes hand in hand with care,” Alexander says. “A lot of people don’t know the importance of oral health. Our society treats dentistry like an elective, but dental decay is universal. All kids can benefit from having someone coming in to look at oral health, to make sure they’re healthy, and that they can learn and be attentive in school.”

Impact of COVID-19 on Kids Oral Health

Unfortunately, after schools shut down last fall, many of these school-based programs did too. Providers were forced to get creative.

Ready, Set, Smile partnered with other community-based organizations to find open spaces where they could treat kids and their families. Della Torre says she saw some patients from partner schools and added a few new ones, but nowhere near the number of children that they reach during a normal school year. The consequences of reduced access to community-based care are already becoming apparent as children return to the dentist with more severe needs.

“We’ve noticed significant dental needs that tie back to diet and depression. We’ve been completely overwhelmed with the number of children who need treatment,” Della Torre reported.

“We’re still climbing out of where we were a year ago; there is a lot of untreated need, but schools should be opened back up 100% in the fall, and we’re ready to get back out there,” Alexander says.

Changing the Future of School-Based Care

While both Alexander and Della Torre are looking forward to getting kids and families back on track this fall, they also see this as a pivotal moment to shift the way people think about mobile dentistry and community-based care. Part of that, says Alexander, is combating stereotypes about mobile dentistry.

“I’m still knocking down doors and trying to wave my hands and show people the effectiveness of what we’ve been able to do--what can happen when you are committed to practicing dentistry in this way,” he says. “When people actually see our clinic, they’re blown away by it. It’s state-of-the-art--like nothing they’ve ever seen before. I went to one district in the beginning, and the superintendent called it a trailer. When he came in and actually saw it, he realized it was a real dental office.”

As that attitude continues to shift, Miles for Smiles is hoping to expand from Louisiana into Texas to reach even more families. Meanwhile, Ready, Set, Smile is expanding its community-based Saturday clinics to churches and community centers which they found to be extremely effective and convenient for families.

“The key to this whole approach is meeting children and families where they are, offering convenience and consistency of care,” Alexander says. “It should be part of the care ecosystem--it should be in every community.”

Dr. Jeremy Simms Alexander and Dr. Adele Della Torre are both 2021 Health Equity Heroes. Dr. Alexander is donating his award grant to  Holistic Youth Programs for Empowerment, Inc. Dr. Della Torre is donating her award grant to Ready, Set, Smile.