Dental and medical go hand-in-hand

Bread was on sale on the Saturday that Dr. Jennie Hennigar broke her foot. She was stocking up, pulling her groceries into her house in a wagon, when her cat got under her feet and she went down.

Ask how many days of work she missed after the injury, and she just smiles. Zero days.

Christina Ferraro, director of clinical services at the Tri-County Community Action Program’s Tamworth Dental Center, drove from Alton to Conway to pick Dr. Hennigar up on Monday morning and then drove her to Tamworth so she could treat patients.

Now, Dr. Hennigar is propelling herself backwards on a mobility scooter through the horseshoe-shaped hall at the clinic (it’s easier to navigate that way, she explains), wheeling between people who need extractions, fillings, root canals and more.

Tri-County CAP, based in Berlin, is the only Community Action Program in New Hampshire that operates a dental clinic.

“We are a poverty-fighting organization,” says Tri-County CAP CEO Jeanne Robillard. “By supporting people’s overall health, we are helping them overcome obstacles to live quality lives.”

Some 4,000 people a year drive from up to two hours away to get dental care here. Once a month, a “Mobile Medicaid unit” sets up in the parking lot, providing additional care. This clinic never closed during Covid — because the staff here understood that by staying open, they were keeping people out of emergency rooms, and easing burdens on hospitals. This clinic operates 10-hour days, four
days a week. The phone does not stop ringing.

“We make sure that uninsured and under-insured folks are getting accessible and high-quality care that is easy on their pocketbook,” Robillard says.

Hennigar is a McGill University and University of Pennsylvania-trained dentist who was in private practice for decades and has worked around the country providing dental services in Hopi, Choctaw and Ojibwe communities.

“I was going to retire,” she says, shooting a grin at Ferraro, “but then I keep getting these phone calls.”

Even with insurance that covers it, dental care can be hard to come by for people on Medicaid and Medicare. “We see everybody,” says Ferraro. Ferraro, who received dental training at Tufts University, is sort of a Jane-of-all-trades here — assisting Hennigar, repairing equipment, scheduling staff and more.

Rhonda Canillas drives an hour to the Tamworth clinic. She first showed up in significant pain, with loose teeth, and able to eat only a limited diet. She said another dentist had proposed pulling all her teeth and making her full dentures — at a price tag that there was no way she could afford. She was scared.

“Dr. Hennigar gave me the lowdown and said ‘No, we are not going to take all your teeth.’ She was warm and comforting, and I had to go every week for a while,” she said. She needed extractions and fillings — and will get crowns and lower dentures. Her pain is gone, she can eat, and her bill is calculated on a sliding scale, based on her ability to pay. “I actually looked forward to going, because I knew I was being taken care of.”

Dental health, Dr. Hennigar has been saying for decades, cannot be arbitrarily separated from  overall health.

Consider, she offers, this recent patient: A 50-year-old woman who needed open-heart surgery, but who could not be cleared for the procedure because of infection in her mouth. She came to the clinic multiple days in a row as Hennigar extracted an abscessed tooth, put in four fillings and provided periodontal care — so her patient could get cleared for life-saving heart surgery.

That case, she said, was not unusual. “Dental and medical go hand-in-hand.”

Fundholders at the Charitable Foundation recently combined grants to get this clinic some critical equipment and assist with staffing needs. That equipment allowed the clinic to perform more oral surgeries so patients did not have to have those procedures done in hospitals.

Dental “externs” from the University of New England vie to drive here from Portland, Maine for their clinical experience and to learn from Dr. Hennigar. “We are able to do a variety of procedures here,” said fourth-year dental student Igor Ibragimov, who is also in the U.S. Army. From here, he will take his training to Texas to care for fellow servicemembers.

This clinic also does oral-health education and outreach in schools and provides oral-health kits to food pantries, meals-on-wheels programs and more.

Hennigar will do the full ten-hour shift from the mobility scooter, treating patients, conferring with students, barely stopping to eat. This clinic, Hennigar said, has been a “godsend” for people who have, for years, struggled to find a dentist.

“I want to make the patients feel like they are worthy.”