For 23 years, dental hygienist Nicole Brunelle watched frail seniors make the treacherous trek into the office and pondered how parents with young children made the long journey from Christian Island.

“I wondered ‘what did it take them to get to me today?’ It really bothered me. There’s got to be a better way,” she said.

Fast forward to 2008.

Thanks to a recent change in legislation, Brunelle will soon be offering a mobile dental hygienist service. Since the early 1990s, the College of Dental Hygienists of Ontario has been working to remove a provision in the Dental Hygiene Act, whereby hygienists must obtain an ‘order’ from a dentist to perform teeth cleaning.

Finally, in September 2007, an amendment to the act was proclaimed and, by mid-October, the first 250 dental hygienists were approved to self-initiate, opening the door for them to work outside of and independent from dental offices.

“Now the public has a huge choice in how they receive their dental hygiene care,” Brunelle said.

Thanks to a fiercely independent streak and a desire to better serve the public needs, Brunelle immediately applied to be approved to practise on her own and began the first steps of setting up her new business, Genesis Mobile Dental Hygiene Care.

She surveyed long-term care facilities, the health unit, friends and the public to gauge interest in a mobile service.

“There wasn’t one negative feedback,” she recalls. “They said that would be awesome. I was really encouraged with that.”

A mobile service provides access to dental care to those with limited mobility, residents of isolated areas or with transportation issues, and appeals to those without medical insurance or families with young children looking for a more convenient option than packing everyone up to visit an office.

“It’s about choice. People should have a choice about how they access dental care. The mission of the College of Dental Hygienists of Ontario is to regulate the practice of dental hygiene in the interest of the overall health and safety of the public of Ontario.”

She’s poised to pack up her rolling suitcase of tools and folding chair to serve clients in their own homes, and is booking appointments for July.

An in-home visit with Brunelle will involve an assessment, a medical dental history, charting of the mouth, a check for periodontal and gum disease, as well as scaling and polishing. All equipment will be sterilized and clients can expect the same quality assurance they would find in a regular office, she noted.  Brunelle can also do fluoride treatment, sealants and denture cleaning, but cannot do X-rays or diagnose.

“We cannot diagnose. I can’t say you have a cavity. We can’t see between the teeth. I can advise patients that seeing a dentist is highly encouraged. My service will not eliminate the need for care by a dentist.”

Brunelle sees three demographics as her potential client base – seniors, both at home and in long-term care facilities, young families without insurance, and isolated or transient clientele. In the past two decades, she’s run into a number of people working in town for a few months who are seeking services.

“They don’t have insurance, they don’t have a dentist, they just want their teeth cleaned. Hurray for them, but there are few choices available to them.”

While Brunelle’s fees follow the fee guide code of the Ontario Dental Hygienists, mobile service may turn out to be less expensive for those without insurance and is certainly more convenient, removing the stress and transportation costs of travelling with young children to the dentist’s office, she said.

She hopes to bring her services to Christian Island and to organize day clinics in communities, such as Lafontaine.

Christine Davis is one client who can’t wait for Brunelle’s mobile service to be up and running.

“I’m very excited. My husband doesn’t have benefits anymore. I have three part-time jobs and, with two kids, we need something cheaper. We have not gone to the dentist in one year and we use to be there every six months.”

Davis said it’s not just economics but convenience that make it an attractive option for her family.

“It saves us from taking time off of work, waiting in the waiting room then taking everyone back to school and work. It takes a big chunk of the day. We can be treated in the comfort of our own home. I think it’s a great idea.”

As more studies uncover the links between poor dental hygiene and disease, Brunelle said it’s clear dental care is about more than bright white teeth.

“There is a huge need out there. What goes on in the mouth certainly affects health,” she said. “It’s not just about clean teeth. The healthier one’s mouth is the healthier one’s body is going to be. It just goes hand-in-hand.”

Studies have linked decay and gum disease to cardiovascular disease, stroke, diabetes, and respiratory diseases such as bronchitis and pneumonia. Oral health is important for pregnant women too, as gum disease is being considered a factor in low birth weight babies with the associated complications of asthma, ear infections, birth abnormalities and behavioural issues.

Brunelle said she also has seen a reduction in pneumonia in seniors when oral health issues are cleaned up.

“They are more apt to have increased symptoms if the mouth is diseased with periodontal disease and gingivitis. The mouth is the gateway to the rest of the body. Bacteria in the mouth can get into the blood system.”

Brunelle is ready to make this dream come true.

“I’m so excited to get going. I’ve been waiting 23 years for this.”

Brunelle is open now to phone calls to field interest and questions and is booking appointments for July. Call Genesis Mobile Dental Hygiene Care at 796-