Unsettling Times: See a Dentist

By MIKE STARK of the [Billings, Mt.]Gazette Staff

Families lined up when Randy Reynolds came to town.

The dentist, based in Glendive then, used to make regular stops in outlying towns such as Jordan and Circle. He and his staff would start work mid-morning, skip lunch and coffee breaks and sometimes go late into the night.

"It was good for the patients and good for me," Reynolds said.

Five years ago, Reynolds, who has been a dentist almost 20 years, shut his satellite offices and concentrated his practice in Miles City. Reynolds now spends fewer hours behind the wheel of his car but his patients - scattered from Wolf Point to Sidney to Broadus and points between - log plenty.

"It's a vast area that we serve," said Reynolds. "Travel is definitely a burden."

In the eastern half of the state, 11 counties are without a resident dentist, leaving 14,500 people either to forgo care or drive somewhere else to get it.

"Some people call me and say, 'I had to take out my own tooth last night because I couldn't find a dentist,' " said Cheri Seed, an oral health consultant for the Montana Department of Public Health and Human Services. "It's dire straits for some people."

Many Eastern Montana dentists -it's hard to say exactly how many - are closing in on retirement age with few incoming dentists waiting in the wings.

Seed mentioned one dentist in Glendive who put his practice up for sale. When there were no takers, he tried to give it away.

"He couldn't even find someone to do that," she said.

Although there are loan forgiveness programs for new dentists who work in rural areas, it can be difficult to lure them to communities where the nearest urban amenities are hours away. Finding local work for a spouse also comes into play, especially in communities with struggling economies.

"For a lot of dentists who are new and coming to Montana, it's a lifestyle issue," said Mary McCue, executive director of the Montana Dental Association.

A shortage of dentists and of dental hygienists - and big distances between practices - can mean that routine preventive care gets ignored and some patients seek a dentist only in an emergency.

There are seven community health centers in Montana that provide dental care to low-income residents, but the two public health centers in Eastern Montana don't.

"When you have an abscess or something acute," Reynolds said, "that's definitely a problem."

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Robert Manion began his dental practice in his hometown of Anaconda in the late 1950s but when the economy there slumped, he started looking elsewhere.

He eventually came across an advertisement seeking a dentist in Circle.

"I wasn't even sure where Circle was," Manion said.

He came anyway and started a practice in the early 1960s that lasted until his retirement in 1995. He spent most of his career in the basement of the local hospital, serving local patients along with others who drove in from Jordan, Wolf Point and other places.

"There had been kind of an itinerant dentist that stopped once in a while, but I was the only one that settled here for any length of time," Manion said.

There were about 1,200 people living in Circle when he opened his office. Now there are about 600 "and it seems like it's going down all the time," he said.

Manion planted roots in Circle, raising a family and serving on local boards and in his church. He enjoyed small-town life but can understand the difficulty in getting other dentists to do the same.

"Dentists tend to go to Billings and Great Falls. There just isn't enough going on for extracurricular activities for a lot of the people today," he said.

For the dentists who remain, there is plenty of work, Reynolds said - many dental offices have all the work they can handle and a waiting list.

"I think everyone out here is seeing as many (patients) as they can," Reynolds said.

Some of Manion's patients were upset when he retired, leaving them to look elsewhere for a new dentist.

"I don't look for a very bright future for dentistry in little towns," Manion said.

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