Dental hygienist Holly Jorgensen remembers the calls to her dental office in Owatonna a decade ago. Over and over, worried voices on the other end were asking: "Does your office accept medical assistance for dental services?"
And over and over, the answer was no.
In 2012, Minnesota's medical assistance reimbursement rates to dentists plummeted to levels lower than most other states, according to a legislative audit. The shift forced many dentists to limit or even cease the treatment of low-income people — people who already tend to be at high risk of developing dental disease due to lack of health care, transportation or language barriers.
Jorgensen understood the difficult choice facing dentists: "to continue treating low-income patients or cover overhead and operating expenses." But at night, a worried Jorgensen would ask her husband, Curt, "Who is going to take care of these children?"
On one particularly weepy evening, Curt looked at her and said, "Go do something about it."
Jorgensen, 51, and the mother of three young adults, quit her job and founded Let's Smile, a nonprofit provider of free dental services to children and teens with state insurance in southeastern Minnesota. Services include basic screenings, plaque removal to prevent cavities and infections, and fluoride varnish treatments to strengthen the enamel, for children from 6 months up to age 19.
"I don't want families to have to make the decision between buying food, paying the heating bill or getting preventive dental services for their children," she said.
Meeting kids where they are
Because many of the parents don't have the luxury of taking a half-day off from work to get their kids dental care, Let's Smile (letssmileinc.com) goes to the kids. Twice a year, Jorgensen, two other dental hygienists and a patient coordinator go into 26 schools in southeastern Minnesota, pulling kids out of class for 20 minutes or so and delighting them after their exam with take-home bags containing a new toothbrush, toothpaste and floss.
She's also tapped her talents as a community theater performer, planning oral health "pep rallies" and sending the "Smile Fairy" into classrooms.
After each visit, Jorgensen and her team send kids home with a report of what services were provided. If a follow-up appointment with a dentist is warranted, she said, "We explain that to parents so they know what to do next."
She's quick to point out that she is not a dentist. "I'm not diagnosing cavities," Jorgensen said. "We assess. If we assess and see, for example, actual breakdown in the enamel that may indicate a cavity, we always refer out to a dental office for the diagnosis."
The Let's Smile team also sees children and teens at Owatonna's Community Pathways, a vibrant community center offering food, clothing and other supportive services. Their clinic will quadruple in size at the Pathways location this summer, adding separate dental hygiene and dental therapy rooms, a sterilization room — "and my home office," said Jorgensen, who currently operates out of her college-age daughter's bedroom.
"It's going to be fantastic!"
The expanded clinic comes at a critical time. Two years into COVID-19, Jorgensen and her team are seeing the fallout from dental offices shuttering and teens at home "snacking all day and not brushing their teeth. We saw a lot of infections," she said.
"We're trying to play catch-up and get these kids healthy again."
Word is getting out. Families from Mankato and surrounding communities are reaching out to schedule dental appointments due to the lack of dental offices accepting state health care plans in their areas.
"I love what I do," said Jorgensen, a dental hygienist for 28 years. She especially loves it when a certain type of patient hops into her hygienist chair.
"When children are in the schedule," she said, "I know I'm going to have a good day."