William Evatte receiving care at Coös County Family Dental. (Photo by Cheryl Senter.)

William Evatte receiving care at Coös County Family Dental. (Photo by Cheryl Senter.)

Meeting a community’s dental needs

Coös Family Dental, on Berlin's Main Street, is open to anyone in the community who needs care. The clinic is filling a need that is particularly acute in the North Country, where more than two in ten adults have not seen a dentist in the past five years, and very few dental practices are accepting new Medicaid patients. The Neil and Louise Tillotson Fund of the New Hampshire Charitable Foundation has supported the clinic with a grant to upgrade equipment

William Evatte of Gorham lost most of his bottom teeth in a logging accident.

Evatte is 72 and now retired. His only income is Social Security. He has Medicare, but Medicare does not cover dentures, or almost any other dental care. From his very modest income, Evatte had been saving up for dentures.

“I was going around with just three bottom teeth,” Evatte said. “I knew I didn’t have the money for dentures.”

Then he heard about Coös Family Dental — a dental practice on Berlin’s Main Street that is part of Coös County Family Health Services. His daughter made him an appointment.

Services are provided here on a sliding fee scale. That meant that Evatte could afford to get dentures.

“My teeth came out beautiful,” he said.

A grant from the Neil and Louise Tillotson Fund recently helped Coös Family Dental upgrade its equipment. The practice has new dental chairs, lighting, dental instruments and computers.

Two years ago, Coös Family Health Services purchased the practice from a local dentist who was retiring. The clinic serves everyone — insured and uninsured alike. Everyone who comes through the door gets the same standard of care.

The need for dental care for uninsured adults and those with Medicaid insurance is pernicious statewide, and particularly acute in the North Country. More than two in ten adults in the North Country have not seen a dentist in five years. That is twice the statewide average. And Coös Family Dental is one of the very few dental practices in the area accepting new Medicaid patients.

“There is always an imbalance between the number of dentists and the need — especially in the North Country,” said dentist Keith Batchelder, who retired to the area and spends one day every week treating patients here. The clinic also has a full-time dentist and a full complement of other staff who are working at capacity, treating patients five days a week. This practice has been strategic in its staffing, including offering advanced training for a hygienist, who is now able to provide some services formerly provided only by dentists — and provide care for more people who need it.

Loretta Morrissette coordinates operations at the clinic. Too often, she said, people without insurance put off dental care until it becomes an emergency. Dental-related emergency visits at the Androscoggin Valley Regional Hospital have decreased significantly in the two years that this clinic has been in operation. And dental care affects every aspect of people’s health and lives.

“It’s a pent-up need,” Morrissette said.

Many patients come in having not seen a dentist in decades.

Morrissette tells this story: A single mom, who worked as a waitress in a ski lodge, came in concerned about decay in her front teeth. The young woman was worried that she would lose her livelihood if she lost the teeth that people saw when she smiled.

What she did not mention was that she also had painful decay and an infection in a rear molar. She never thought she could get it all fixed — and was ready to prioritize her front teeth for job security.

The staff at Coös County Family Dental fixed the molar and the front teeth — and only charged her what she could afford to pay.