Sooke dentist going mobile to bring dental care to underserved Juan de Fuca communities

When you picture your dentist’s office, it’s likely that you think of the typical strip mall clinic with its taupe walls and hallway full of identical checkup rooms. I’ve been a patient at five different dentist offices, and each has had the same aesthetic.

So, when I was on my way to visit Dr. Chris Bryant’s clinic in Sooke, I initially drove right past it.

The clinic is inside a small white converted house just off Sooke Road, with a well-manicured lawn and a welcoming wooden front door. The clinic is perhaps not in the most conventional location, but “conventional” has never been Bryant’s goal.

His latest project sits in the parking lot behind the clinic: an old HandyDART bus, stripped of its logos and rows of seats, awaits its conversion into a mobile dental clinic. For a few years, Bryant has been gathering materials and equipment—ordering extra, watching for good deals, or holding onto older equipment he’s replaced in his own business—to outfit the bus into a fully functioning, one-chair travelling clinic. It won’t be just a bare-bones space for checkups and routine procedures; in it he will be able to do everything that he does in his regular practice, just with a further reach.

“Every piece of equipment in there is equipment that I’ve had in my own office,” Bryant said. “That’s really the goal of outfitting that van. Whatever’s in there, we want it to be the best.”

When travelling west on Highway 14, the last dentist’s office is in Sooke, leaving a whole host of communities—Shirley, Jordan River, Port Renfrew and the small communities in between—underserved. With the bus, Bryant wants to bring good dental services to residents who live in the Juan de Fuca area, and who don’t have easy access to dental care. Bryant currently has clients from Port Renfrew who have to travel over an hour for their appointments, something that is really only possible if they have a vehicle or can find someone to give them a ride.

Bryant says he has already received interest in his idea of a mobile clinic from administrators from the T’Sou-ke and Pacheedaht nations. (Capital Daily reached out to the nations, but could not arrange an interview by press time.) According to the Sooke and Juan de Fuca Health Foundation, while they do not collect information on dental care access or utilization in the region, the mobile service would be a benefit not currently provided by Island Health or the First Nations Health Authority.

“It’s a novel approach, but I’d like to think of it as anybody and everybody can do it,” Bryant said. “There’s nothing special about what I’m doing. We need to provide our communities with antidotes… to the corporate world.”

It’s a project he calls “the Volkswagen Beetle version of a dental office.” As Canadian dental practices increasingly get bought out by consolidating firms, shrinking competition and increasing prices, this is Bryant’s way of pushing back. Dental care is essential, he said, and it is completely incomprehensible that it continues to not be accessible to so many due to barriers of accessibility.

So, he is converting the bus.

The first step has been adapting the electrical system so that it can handle the demands of the machines and can be connected to a generator or shore power. The next step is to design the layout of the mobile office and start work on putting it together. He’s working on finding people to help throughout the process, and he hopes to have it running by next spring.

The Hornby and Denman bus

The idea of a mobile dental clinic isn’t new. There are a handful of providers in BC, primarily in the lower mainland, that bring mobile dental services to long-term care residences and other locations. In Greater Victoria, Wheely Clean—staffed by dental hygienists—offers dental hygiene services to Greater Victorians out of its vans.

Further north, on Hornby and Denman Islands, the only dentist who has practiced there for decades has operated out of a mobile clinic.

Dr. Peter Walford is ready to retire, and is in the process of finding a buyer for his mobile dental clinic. In 1986, he started operating the clinic on Hornby and Denman Islands after realizing residents did not have easy access to a dentist.

Having worked on a government-funded mobile clinic for a year in the remote village of Tahsis previously, he knew that the mobile model could work. So with help from community members, he turned an old, rusty, partially converted school bus into a functioning clinic.

At the time, he was also practicing in an upper-floor space in Cumberland, and he would carry all his equipment down the stairs into his bus and drive off to the islands for a week every month. Over time, these trips grew to a week and a half, then two weeks. He eventually decided he didn’t need his Cumberland clinic anymore.

“The choice was to keep going along conventional lines or to seek what I was wanting,” he said. “And I can’t say I really knew what I was wanting, I was just not happy with the thing I was doing.”

He would find fulfillment with the mobile clinic. He ran that old bus for nearly 20 years until the rusty spots got rustier, then he bought another bus for a steal and spent four years fixing it up.

“It’s swank,” Walford said with a laugh. The bus is a work of Hornby art: it’s finished in birch plywood and yellow cedar with teak accents and 500-year-old bits of yew wood. It has two dentist chairs and in-floor heating—and on nice days, Walford opens the windows and doors to let fresh air flow through as he works on patients’ teeth.

Dr. Peter Walford works on a patient's teeth in his mobile clinic. Photo: Michael McNamara

Before Walford began practicing on the islands, there was no regular dental service. Each island has a population of about 1,000 people; typically there need to be 3,000 people in an area for a dental practice to be feasible, he says. But running the mobile clinic with very little overhead and supplementing his income with a couple of days working out of a Courtenay clinic has been enough for him.

“My sympathies lie with the common person,” he said. “I mean, if I was into big dollars, I would never do this. I’m not a money dentist.”

Walford has also been able to keep his prices reasonable because he can afford to. As an independent practitioner, he says he doesn’t have to perform a certain number of expensive procedures each month to meet quotas or satisfy management, something he and Bryant both agree is becoming a larger issue.

The mobile model works and is essential in more remote communities, Walford said—however, it really only works in coastal regions where the winters are mild. Getting freezing in your mouth is already a bit unpleasant, but it’s worse if your body is freezing too, he jokes. On average, Walford only loses about four days per year because of harsh weather.

Walford’s practice has been for sale for four years now, and he hasn’t gotten many bites yet. Recently, a promising deal hit a roadblock because the interested party works with multiple left-handed people—something that is an issue in a small space designed by a right-handed dentist.

As he retires from his mobile dentistry practice and searches for a like-minded individual to take over, he is heartened to see others with similar visions try out their own unconventional approaches to dentistry.

Focus on prevention early

With his bus, Bryant is particularly focused on getting adequate care to children and young families. Preventing dental decay in children is more about education, Bryant said. If parents are taught about the importance of oral hygiene for their children, and their children develop good habits early on, a lot of costly dental procedures can be avoided.

“When you start kids off early, you’re preventing disease processes, you’re preventing cavities, you’re talking to kids about injury prevention,” he said.

At his current practice, Bryant allows parents to bring their children in for their first check up for free for this reason. He said the bus would also help provide that education in communities where access to a dentist is limited, and therefore avoiding costly trips is important.

Island Health has multiple programs and initiatives to help children get dental care and early screening, but there is little in terms of providing continued, regular access.

Once Bryant is done with the bus, he hopes his project can serve as a blueprint to others who may be interested in starting similar initiatives elsewhere. There are many more regions that could benefit from a service like this, he said.

“The job’s not done until everybody’s needs [are met],” he said.