Estimated reading time: 5 minutes
A growing number of dental professionals are bringing high-quality, portable care directly to patients’ homes. By Angela Tufvesson
When dentist Dr Mark Wotherspoon began noticing that some of the older patients he’d looked after for 20 or 30 years had stopped coming to his Wagga Wagga practice in regional NSW for regular appointments, he was concerned. It turned out that many people either could no longer get to the practice or were worried their additional needs could not be met.
“We’d bump into our patients’ families, and they’d say, ‘Dad really wants to come in but he’s just not able to anymore’ or ‘Mum’s at home looking after Dad and just has so much on her plate’,” explains Dr Wotherspoon.
Seeing an opportunity, he decided to purchase a portable dental unit and was soon making house calls to those unable to visit a regular dental practice—cancer patients, people who’d been in car accidents, people with special needs, and older people with chronic illnesses.
It’s a model of care that experts believe is set to change the way Australian practitioners deliver dentistry to an ageing, independent and increasingly savvy client base.
Dental hygienist Brenda Fry has witnessed firsthand the growing demand for at-home dental services. She started Bright Smiles Mobile Dental almost three years ago, a portable service that provides preventative and minimally restorative care in Canberra and regional NSW, and now employs a team of six, including dental hygienists, oral health therapists and a dentist.
“We’re finding our work in private homes is increasing more and more,” says Fry.
In Melbourne, dental prosthetist Rachael Starr and oral health therapist with an Adult Scope Dr Victoria Perchyonok are also servicing an expanding client base. They see a wide range of patients, including people who are bedbound or in wheelchairs, have neurological conditions or are vision impaired. “There has been an increase over the years that I’ve been in dentistry,” says Starr, who has 25 years’ experience seeing patients in their homes.
As do both Dr Wotherspoon and Fry, the Melbourne duo use portable dental units. “It’s not a van, so all of the equipment comes with us,” Dr Perchyonok explains. “The majority of the treatment that can be done in a conventional dental clinic can be done at people’s homes.”
Dr Wotherspoon believes portable dentistry has been possible for more than 50 years, but it’s now far more practical thanks to “revolutionary improvements” in lightweight portable dental units. “These units are all electric and allow zero compromise to infection control and patient safety. The unit I use is little more in size and weight than a decent box of groceries.”
To complement her mobile practice, Fry has a full sterilising room set up in her home. “My infection control processes are inspected and overseen by ACT Health, just the same as any other dental practice.”
We’re coming back from three days where we haven’t had access to a steriliser, so we have to have a large number of handpieces and ultrasonics and so on. That is a big outlay of cost.
Brenda Fry, dental hygienist, Bright Smiles Mobile Dental
Except for surgical procedures and deep treatments that require a local anaesthetic, Dr Wotherspoon says most services, including oral health examinations, preventive care, basic restorative and removable prosthodontic services, can be carried out in private homes. “Complex treatment still needs to be completed at a fully equipped surgery.”
For Fry, the focus is on “maintaining comfort, function and dignity. If a tooth needs restoring to keep the person comfortable and functional, we’ll do fillings, but we’ll refer on if they need extracting.”
Despite not working out of a traditional bricks-and-mortar practice, Fry says the running costs of a mobile-only practice can be high, particularly due to the volume of instruments. “We’re coming back from three days where we haven’t had access to a steriliser, so we have to have a large number of handpieces and ultrasonics and so on. That is a big outlay of cost. I’ve increased my prices a little bit since I started because I wasn’t meeting costs.”
Dr Wotherspoon says home visits are only financially viable if the travel time is no more than 30 minutes. “I can really only afford to travel 15 to 30 minutes, and then I charge a $95 or $138 travel fee.”
Dr Perchyonok says she doesn’t charge a travel fee for home visits in metropolitan Melbourne but will collaborate with other mobile providers for patients living further away in the city outskirts and regional areas.
Mobile dentistry can also carry a heavier administration load. “In surgery, you typically talk to the patient or family member during the appointment. For a mobile appointment, there is a lot of time spent on the phone to family members discussing the situation, expectations and what may or may not be realistic,” Fry says, adding that the time is also often spent updating families after
the appointment.
All four practitioners believe at-home dental services will play an increasingly important role in the future as demand rises across Australia. Dr Wotherspoon highlights two main intersecting factors: an ageing population and that people are keeping their teeth for longer.
“A lot more people want to stay living at home in their own private residence, and because people want to keep their teeth, dentistry is becoming more complex. There are a lot more implants and crowns and bridges. In order to do that, we need timely and consistent active maintenance,” he says.
Fry says older people now have a more sophisticated understanding of the important connection between oral health and general health. She also notes higher demand for at-home services since the pandemic. “People are more used to the idea of services coming to you, so why not dentistry?”
Dr Perchyonok notes that at-home dentistry is no different to home visits provided by GPs and should be available to everyone. “Individualised oral health care provided in a person’s home is not a luxury; it’s a necessity.”
