New dentist adds much-needed option for clinic, sets up shop for now in Chelsea

Dr. Colleen Anderson, left, and Tammy Marshall-Paquin, HealthHub dental division manager and public health dental hygienist, unpack and set up equipment in a temporary HealthHub restorative dental clinic at the Chelsea Health Center in Chelsea, Vt., on Wednesday, August 23, 2023. Anderson and Marshall-Paquin said they hope to start seeing patients at the clinic in September and will continue operating out of the health center until HealthHub’s mobile restorative clinic is ready. “The demand is so great because there are so many access to care issues,” Marshall-Paquin said of the constant inquiries they are receiving from people searching for affordable dental care. (Valley News / Report For America - Alex Driehaus) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

Dr. Colleen Anderson, left, and Tammy Marshall-Paquin, HealthHub dental division manager and public health dental hygienist, unpack and set up equipment in a temporary HealthHub restorative dental clinic at the Chelsea Health Center in Chelsea, Vt., on Wednesday, August 23, 2023. Anderson and Marshall-Paquin said they hope to start seeing patients at the clinic in September and will continue operating out of the health center until HealthHub’s mobile restorative clinic is ready. “The demand is so great because there are so many access to care issues,” Marshall-Paquin said of the constant inquiries they are receiving from people searching for affordable dental care. (Valley News / Report For America - Alex Driehaus) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. valley news / report for america photographs — Alex Driehaus

Dr. Colleen Anderson unpacks equipment, including sunglasses for patients to wear during procedures, in a temporary HealthHub restorative dental clinic at the Chelsea Health Center in Chelsea, Vt., on Wednesday, August 23, 2023. (Valley News / Report For America - Alex Driehaus) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

Dr. Colleen Anderson unpacks equipment, including sunglasses for patients to wear during procedures, in a temporary HealthHub restorative dental clinic at the Chelsea Health Center in Chelsea, Vt., on Wednesday, August 23, 2023. (Valley News / Report For America - Alex Driehaus) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Alex Driehaus

Dr. Colleen Anderson, left, and Tammy Marshall-Paquin, HealthHub dental division manager and public health dental hygienist, talk about where to set up equipment in a temporary HealthHub restorative dental clinic at the Chelsea Health Center in Chelsea, Vt., on Wednesday, August 23, 2023. All of the equipment in the clinic is designed to be mobile and will eventually be moved to the mobile restorative trailer when it is completed. (Valley News / Report For America - Alex Driehaus) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

Dr. Colleen Anderson, left, and Tammy Marshall-Paquin, HealthHub dental division manager and public health dental hygienist, talk about where to set up equipment in a temporary HealthHub restorative dental clinic at the Chelsea Health Center in Chelsea, Vt., on Wednesday, August 23, 2023. All of the equipment in the clinic is designed to be mobile and will eventually be moved to the mobile restorative trailer when it is completed. (Valley News / Report For America - Alex Driehaus) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. valley news / report for america — Alex Driehaus

By NORA DOYLE-BURR

Valley News Staff Writer

Published: 08-27-2023 2:04 AM

CHELSEA — Amid a dearth of oral health care options in many communities, a dentist is setting up a temporary office in Chelsea for the first time.

Dr. Colleen Anderson, who until recently was working as dental director for the Boston Health Care for the Homeless Program, this week became the first dentist employed by the White River Valley nonprofit HealthHub, which provides medical and dental care using mobile clinics in schools and other settings across the White River Valley, including in the Upper Valley communities of Randolph, Bethel, South Royalton, Sharon, Strafford, Tunbridge and Chelsea.

“We really feel that things have fallen into place,” said Dr. Becky Foulk, a retired pediatrician who was one of HealthHub’s founders and is its current president.

With Anderson on board, the nonprofit is setting up a temporary dental clinic in the Chelsea Health Center while it awaits the completion of its second mobile unit. It fills a space previously occupied by a pharmacy, which has closed. The Randolph-based Gifford Health Care rents out other space in the Chelsea Health Center for medical offices. HealthHub also now has two part-time hygienists on board who plan to visit each of the schools in the nonprofit’s catchment area twice this coming year, Foulk said.

The nonprofit continues to search for a dental assistant, who will be key to optimizing Anderson’s time and being able to reach the most people.

“People are in high demand,” Foulk said, adding that she hoped a dental assistant could be found soon.

To begin with, at least, Anderson, 41, who lives in Bethel, will be working for HealthHub two days a week. She also is working part-time for a Bristol, Vt.-based federally qualified health center.

Even with the vacant dental assistant position, the nonprofit is in a much better position than it was last year at this time. A previous full-time hygienist had retired, and just one part-time hygienist had stepped up to fill her place. As a result, the nonprofit wasn’t able to offer as many visits as it previously had, even though it had sufficient equipment to expand the care it was providing.

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“It’s an ambitious project,” Anderson said in a Wednesday phone interview. “To be part of that at this early point, they already have such a well-established school program (and) wonderful relationships with these towns. Building off of that seems like such an amazing opportunity.”

When she starts providing care next month, Anderson plans to begin with adults in need of restorative treatments, such as fillings or removing infected teeth, on a list maintained by the hygienists. Once the school year starts and the hygienists begin seeing children, she also will be providing restorative care to young patients.

While Anderson said she hopes to be able to offer dentures and crowns in the future, at first she will be offering fillings and pulling teeth as they will be “most impactful for folks.”

Pointing to Anderson’s work with homeless people in Boston, Foulk said, “She’s just perfect for us. Her heart is in public health dentistry.”

Foulk also said she’s hopeful that Anderson tires of the commute to Bristol from Bethel and increases her hours with HealthHub in the future.

Tammy Marshall-Paquin, a 57-year-old Charlestown resident who became one of HealthHub’s part-time hygienists at the end of March, said the list of patients waiting for Anderson’s care fills five pages on a legal pad, and it’s still growing. Marshall-Paquin, who moved to New Hampshire from Connecticut where she worked in private practice, was surprised by the level of need she has encountered in the White River Valley.

Between April 1 and June 30, HealthHub’s hygienists saw 164 people, mostly children and teens, Marshall-Paquin, who is also HealthHub’s dental division manager, said. They placed silver diamine fluoride, a treatment aimed at preventing the growth of cavities, on 276 teeth. Most of those teeth had more than one cavity, she said. SDF, as its called, cannot be placed on all cavities. If they are very deep, the substance can irritate the nerve, Marshall-Paquin said. Patients with more severe decay have to be referred elsewhere.

“If I had a kid who didn’t have cavities, I was like, ‘Wow!’ ” she said.

Marshall-Paquin, who left clinical work during the COVID-19 pandemic to work on a book project, said she didn’t expect to return, but she was inspired by HealthHub’s mission.

“I’m passionate about what I do,” she said. She described spending an hour cleaning stains on one child’s teeth and being rewarded with his grin at the end: “Seeing him smile it was fantastic.”

Most of the children served by HealthHub are covered by Dr. Dynasaur, Vermont Medicaid for children, Foulk said. HealthHub also accepts other insurances and if a patient doesn’t have insurance, it is able to offer a sliding-scale payment program through a partnership with Gifford.

HealthHub, established in the 1990s, has long sought to fill a gap in care in the White River Valley. While the state Legislature passed an increase to the Medicaid rates for dental coverage this past session, HealthHub’s expansion comes at a time when dental care is difficult to access.

To Foulk’s knowledge, there’s never been a dentist in Chelsea and, of late, HealthHub has “had trouble finding places to refer” patients in need of treatment beyond what the hygienists can provide.

There’s also promising news from elsewhere in the Upper Valley. The Mascoma Community Health Center in Canaan, which halted dental services in July 2022 when its dentist left, is planning to resume that care beginning Oct. 2. In October, the clinic is planning to have two dentists and two hygienists ready to go. At the time of the program’s suspension, it was serving as a dental home to 1,500 patients.

“We have been focused over the past six months on not only overcoming a statewide shortage of dentists but on also recruiting at least two highly competent dentists that have a wide range of skills across the entire field of dentistry, who will focus on preventive care and provide all the services that our individual patients need, no matter what the patient’s insurance or income status is,” according to information provided Friday by Mike Samson, the health center’s interim director. “We are now ready to reopen.”

Marshall-Paquin urged would-be clients to have patience with HealthHub staff as they expand their services.

“Our phone is ringing off the hook,” she said. “It does take time and a lot of energy.”

In addition to getting the necessary equipment in place, ensuring it works and it’s registered with the state, the clinic also has to make sure it’s set up to bill insurance companies and that it’s triaging patients appropriately, making sure that Anderson sees the patients who need her time the most.

“This is an example of what we term ‘rationing’ in health care,” Marshall-Paquin said. “We do not want to think that we are rationing health care, (but) there is a shortage of providers.”

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.