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United We Smile providing 'life-changing,' trauma-informed dental care to kids, veterans

A young patient receives care from a dental intern.

United We Smile (UWS) feels more like an aquarium than a dental clinic. The walls are papered with colorful underwater scenes, stuffed fish dangle from the ceiling in the waiting area, and natural light streams through the windows. There are even quiet rooms—operatories that can be darkened to provide a more sensory-friendly experience. Patients can choose to wear headphones or listen to soothing music, and there are always fidget toys to keep anxious hands busy.

“We want it to feel like a safe, welcoming environment,” said Jen Kerns, United Way of Northwest Michigan’s director of health initiatives.

That’s important, because for hundreds of children in the 10-county region of Antrim, Benzie, Charlevoix, Emmet, Grand Traverse, Kalkaska, Leelanau, Manistee, Missaukee and Wexford, UWS is one of the only places they can receive affordable dental care.

According to the United Way of Northwest Michigan, almost half the children from the region are covered by Healthy Kids Dental, the children’s Medicaid program. Approximately 40% of children in Benzie and Manistee counties have never received dental care.

“For many people in Michigan, it isn’t that they can’t find a dentist—it’s that the dentists in their area won’t take their insurance, if they even have it,” explained Holli Seabury, EdD, executive director of the Delta Dental Foundation (DDF). “These challenges are compounded if you’re a patient who requires specific accommodations, such as a dentist experienced in providing care to veterans or people with disabilities.”

United Way of Northwest Michigan launched the UWS initiative with these factors in mind. The clinic, located in Traverse City, shares space with the United Way office. It has eight dental operatories, state-of-the-art x-ray technology, a sensory room and a community resource room (or “free” store) that provides dental hygiene supplies, clothing items, non-perishable food and more to patients in need.

Initial funding for the clinic came from the DDF and Delta Dental of Michigan, with more expected from additional funders in an ongoing capital campaign.

Group photo of people cutting a floss ribbon in front of a dental clinic.
A collective celebration as the United We Smile team cuts the "floss" for the clinic's grand opening. (Photo by Jen Anderson)

Meeting current and future needs

“Since opening, we’ve seen 709 patients, delivering more than $679,000 in care,” Kerns said. “There’s never a shortage of people who need help.”

One way they’re hoping to challenge those shortages in the future is by teaching the next generation of oral health professionals in a public health setting, where they can learn to provide trauma-informed care that centers patients with disabilities. At UWS, care is primarily provided by University of Michigan dental interns and Northwest Michigan College’s dental assistant students. Local oral health professionals serve as mentors and teachers.

Alyssa Evans, a fourth-year dental intern from the University of Michigan School of Dentistry, called the experience “invaluable.”

“Our pediatric experience at school can be light, so it’s been super helpful for me to do procedures like pulpotomies and stainless-steel crowns before I start [my pediatric dental] residency,” Evans said. She also noted that they’re developing critical chairside communication skills. “We are used to one adult patient in a cube for three hours—you build those relations over time and over long appointments. Here, you have to accomplish a lot in a shorter amount of time, and that means building trust with a kiddo and their family.”

Kerns echoed the importance of caring for the whole family.

“We aren’t just offering dental care—we’re offering life skills,” Kerns said. “Sometimes we give parents ‘homework,’ to help their children prepare for dental visits. This might mean giving them gloves and masks so that they can play pretend together.” Kerns calls these interventions lifechanging.

The key here is the care team’s commitment to meeting each patient where they are.

As a Center for Inclusive Dentistry (CID), UWS has the tools to do that. The CID program was created by the DDF to provide the training and resources necessary to deliver high-quality dental treatment to people with disabilities. Like all CIDs, UWS’s care team participated in virtual training, but they also received hands-on, immersive training at the NYU Dentistry Oral Health Center for People with Disabilities.

Group photo of an oral health care team learning how a papoose board works.
Jen Kerns and members of the UWS care team learn about papoose boards at NYU. (Photo by United We Smile)

“[The training] really changed how we felt about the care we were providing,” Kerns said. “We felt so incredibly empowered, even in the ways we talked to parents on the phone.” Kerns stressed that the training wasn’t just validating—it also gave them new ideas for what the clinic might need, such as the sensory rooms or papoose boards. “We revamped so much after the training, from our note templates to what we wanted the students to be doing and seeing,” Kerns said.

Since the training, UWS has treated all the local children who were on a waiting list for dental care in an operating room, in their office, all without pharmaceutical management. According to Kerns, it wouldn’t have been possible without the knowledge the CID training provided.

Kerns highlighted her point using the story of one of their smallest patients, a three-year-old girl who needed extensive dental work and the use of a papoose board to perform it. Although she cried during most of her initial appointments, one week she came in, got in the chair, received a numbing shot and had two fillings completed. As she walked out, holding her dental intern’s hand, she heard a young patient crying in another operatory.

“I used to do that. But not anymore,” she said.

Not just for kids

It’s worth noting that UWS isn’t just caring for children—they’re providing much-needed dental care to local veterans. On Fridays, UWS hosts Victors for Veterans, a program out of the University of Michigan School of Dentistry, which has provided more than $2.2 million in free dental care to veterans statewide.

Dr. Howard Hamerink, director of the Victors for Veterans Program at the University of Michigan School of Dentistry, started the program in 2012.

“What most people don’t realize is that the military doesn’t cover dental visits for most veterans,” Hamerink said. “As a result, you have a whole population, many of whom with complex needs, with active decay or other oral issues and no way to get care.”

To qualify for dental treatment, veterans must have a service-related dental problem (such as an orofacial injury from combat), have been a prisoner of war, or be totally disabled. Nationally, these qualifications don’t apply to around 85% of veterans, leaving many—especially those who are in lower socioeconomic groups or who are under or uninsured—without regular dental care.

Victors for Veterans is helping to fill that gap.

A glimpse into two dental operatories where dental interns wearing white coats are hard at work.
Dental interns and their instructors, hard at work. (Photo by United We Smile)

Evans, who noted that she was most excited to work with kids during her clinical rotation, also felt deeply connected to the work with veterans.

“It was impactful to have the chance to work with the veteran population,” Evans said. “My dad is in the Air Force, and my grandpa was a Navy SEAL, so it felt really good to be able to play a role in giving veterans the care they deserve.”

According to Kerns, UWS has seen 72 veterans since opening, with a total value of $175,124 in care provided—not a small number.

“I don’t know what the best part is—the fact that we’ve given out that much care for our community or the fact that our students are now starting to come around and report a whole new confidence with these [patient] populations,” Kerns said. “It’s truly a dream come true.”

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