Spring 2013 - Tufts University School of Dental Medicine

even among the 110,000 children enrolled
in the program, more than 53,000, just
under half, went without dental care in
2010, according to the Maine Department
of Health and Human Services.
That likely has to do with MaineCare’s
low dental reimbursement rates, which
rank 38th in the country. Desjardins
estimates the public insurance pays about
half of what she’d normally charge for many
dental procedures; for some dentists, the
reimbursement rate is as low as 25 percent.
Small wonder then that fewer than half of the
state’s dentists accept MaineCare, and twothirds
of general dentists who do so limit
the number of publicly insured patients they
treat. That’s part of the reason Maine ranks
34th among the 50 states and the District of
Columbia in the number of residents who
have seen a dentist in the last year.
the Big iDea
It was in 2009 that Desjardins first thought
about opening a clinic to serve children with
no place else to go. She had been asked to
serve on a health services advisory board of
the Aroostook County Action Program, an
umbrella organization that helps connect
low- and moderate-income families with
such services as health care, job training and
home repair assistance. Desjardins attended
one meeting that focused on the difficulty of
finding dental providers for local children
enrolled in Head Start, the federal program
that promotes school-readiness among toddlers
from low-income families. Federal law
requires all Head Start children to have a
dental exam within 90 days of enrolling in
the program. With the shortage of dentists in
Maine, that can be tough.
“There just aren’t enough hands to do the
work. It had really been that way for years,”
says Desjardins, a former Head Start child
herself. “Also, these little ones who have a
hard time getting into an office, they also
have the greater need.”
Desjardins was never one to shy away
from hard work—she was among the top
students in her dental class, even though she
gave birth to her two children, Emily, now 24,
and Gerard, 22, while she was in school. She
began laying the groundwork for the low-cost
clinic, writing grants for funding and making
presentations to local groups, including the
Rotary Club, the Kiwanis and the Knights of
Columbus, in search of donations.
Her big idea came along at the right time.
Years of doing lengthy dental procedures had
begun to take a toll on her health. The pain
she had been experiencing in her neck, shoulders
and arms began to worsen and affect
her legs. Eventually, she was diagnosed with
fibromyalgia, a nervous system disorder that
can result in soft-tissue pain well as fatigue.
“I went from somebody who had endless
energy to someone who couldn’t walk from
the bedroom to the kitchen without feeling
like I needed a nap,” she says.
Realizing she would have to limit the number
of hours she cared for patients, Desjardins
was devastated, at first. “I had worked with
pain for a long time. I was worried I wasn’t
going to be able to practice anymore. Now I’ve
learned I have something to offer besides the
way I was doing dentistry before.”
She began devoting one day a week to getting
the low-cost clinic up and running. After
teaching herself to write grant applications
to private foundations in Maine, she secured
$65,000. She created a PowerPoint presentation,
which she used with groups such as the
VFW and the American Legion. The clinic
became the Presque Isle Rotary Club’s special
project, which helped raise another $38,000.
“They presented us the check, and that’s how
that first operatory became feasible,” she says.
“From the beginning, this wasn’t going
to be ‘Norma Desjardins’ clinic,’ ” she says.
“This clinic is going to be the community
dental health clinic.”
Once St. Apollonia had an operatory,
Desjardins, needed to hire a dentist, and
one who embraced community service in a
big way. A native of upstate New York, Keely
O’Connell, a 2012 graduate of Creighton
University School of Dentistry in Nebraska,
answered the call. O’Connell moved to
Presque Isle eager to take on lots of responsibility
early in her career. “It has been wonderful
to have her as our inaugural dentist,”
says Desjardins.
“This year has gone by so fast. I have to
admit every day presents new challenges,”
says O’Connell.
A challenge for Desjardins is the reality
that her dreams for St. Apollonia require
dollars. She estimates the clinic needs an
annual operating budget of $350,000. She
wants St. Apollonia to become self-sustaining,
like a private practice, running off
income from the services provided—a lofty
Whilenearlytwo-thirdsofMaineresidents
liveinruralareas,just13.5percentofthe
state’s dentists practice in those regions.
goal, given MaineCare’s reimbursement
rates. To get there, says Desjardins, “we have
to create an environment where [patients]
are coming in with less decay.”
Amid all the new beginnings for Desjardins
in 2012, there were endings, too.
Between Thanksgiving and Christmas, her
mother-in-law, Lorraine, and her father,
Normand LaJoie, passed away. Now, more
than ever, she sees the clinic as a tribute to
the values her parents and her husband’s
parents instilled in their children.
“There are so many stories—so many
things us kids don’t know—about our parents
helping other families,” says Desjardins.
“Now that my dad’s gone, I feel even more of
a sense of responsibility to honor him and
my mom by continuing this work.
Both her and her husband’s mothers took
advantage of the Head Start program when
their children were small, and both women
remained deeply involved with the program
well after their kids were grown. That’s one
reason Desjardins remains committed to
providing dental care for Head Start preschoolers,
though she says she is equally
steadfast about helping “anyone who is trying
to make their way, anyone who is struggling
for whatever reason.”
St. Apollonia’s is “meant to be here as
long as these kids need it,” Desjardins says.
“Unfortunately, I think that’s going to be a
long time.” tDm
Jacqueline Mitchell, a senior health sciences
writer in Tufts’ Office of Publications, can be
reached at jacqueline.mitchell@tufts.edu.
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