Dentistry on a Bus

Posted Oct 04, 2023

Wendy Gaudet & Kate Brouwer

This article was originally featured in the September 2023 issue of FOCUS Magazine.

CMDA Canada’s Dental Ministries Manager Kate Brouwer spoke with Wendy Gaudet from White Rock, Surrey, B.C. Wendy is both the office manager for her husband, Dr. Ron Gaudet’s dental practice and the manager for City Care Dental, Mobile Dental Care. This is under the umbrella of City Dream Centre Society, founded by Loretta Hibbs.

Wendy, you captured my interest as soon as I heard, “dentistry on a bus”. What does providing dental care on a bus look like?

We work out of a 38-foot Winnebego, custom designed by ADI Mobile Helth in Taulatin, Oregon, specifically to used as a mobile dental clinic. The bus has one hygiene and two restorative operatories. Typically we have one or two Dental Assistants that are familiar with the bus and a dentist can bring their own Assistant if they want. We have a mobile X-ray unit and sterilization, just as a regular dental office would. We show our volunteer dentists how to use the space and where to find things because it’s a whole lot like coming into someone else’s kitchen and trying to cook a gourmet meal.  

Did you and Ron start out thinking, let’s do a mobile dental clinic? Or did you stumble upon it? 

We 100% stumbled onto it. Ron and I have done multiple missions trips, including India, Nepal, South America, Mexico, with different organizations. Someone challenged us when they said, “You do this dentistry overseas, but what about the disadvantaged people in your own backyard?” And I thought, we do a lot of pro bono in our practice, but this was a different group to help.

Loretta Hibbs from City Dream Center had a vision for using a bus to deliver healthcare and she’d been praying about this when she got a call from the Alberta Dental Association saying they had two dental buses available. Loretta was sitting at a pastor’s meeting beside the pastor that I was involved with in my overseas missions and the pastor suggested Ron and I might be interested in helping. We agreed to be directors and to help them get things up and running with the buses. We started it from the ground up and jumped through all hoops to qualify the work as a non-profit. We did our first outreach clinic with a transitional home for women and then word got out and there’s not been a shortage of opportunities since. We receive both private and some government funding. I volunteer 100%, in terms of administrating the bus ministry. 

Did COVID-19 interrupt delivery of care on the bus?

 Actually, when COVID-19 started we paid for our team to come out to the bus and provide dental treatment. We put all the necessary COVID-19 measures in place and we were able to operate as an emergency dental bus during the early days of the pandemic. 

Wendy, how is working on the dental bus different from working in a private clinic?

We are not on that same time frame on the bus as when we’re in our private clinic. We book an hour and a half for each patient. We tell dentists when they come on board, you do what you can, in the time you need to get it done, and patients won’t leave or be upset because they had to wait. We’re here to give our best to each patient that walks in. I try to talk to all patients, about their history and their situation. Most of the time my job is to make sure that they get heard and I try and evaluate what they need.

I usually give our volunteer dentists more time than less and that allows patients enough time to talk to the dentist and have the dentist feel connected to them. Our volunteers are not just there to do dentistry, but also to connect and hear stories from our patients and to feel inspired to use what they can to change these people’s lives, because smiles transform lives.

On the bus, dentists may only get two appointments with certain clients and for some clients it’s just one. You have to maximize what you’re able to do for them in that time frame, to give them the best shot at changing their life. 

Does a lot of the dental care provided involve extractions?

We try to avoid patients having their teeth removed, when that’s possible. My husband Ron does a lot of endodontic treatment and a lot of composite resin build ups. Sometimes we have to go with dentures. We’ve done a lot of dentures.

Private practice looks different than dentistry for the disadvantaged but we’re still trying to do the most we can to avoid pulling teeth. The big challenge for us is keeping people encouraged to come out and help. Treating the patients and getting patients – that’s the easy part. 

Tell me about your volunteer dental team members.

You’ve got to have a heart and a desire to make these patients feel accepted and comfortable. There are all sorts of psychological challenges that patients have had and it’s rewarding, very fulfilling when you see success coming from that. That’s what keeps us doing it. 

And because we are a clinic on wheels, we can go wherever the funding takes us. 

Wendy, can you tell me a little about the patients that you and Ron and the rest of the team see on the bus?

Let me tell you about Dave. He had a job at a hardware store and one day he came in and said he’d just been fired. He was working in the back of the store and came to the front just when a male customer came storming through and bumped a female customer’s purse. David went up to the lady to help her get her purse back and she started to freak out. She thought David was a homeless person trying to steal her purse instead of a helpful employee. David’s boss fired him because of this incident. I said, “Oh, Dave, we’re getting you teeth, that’s it.” He had dental phobias and fears, but we finally talked him through treatment and now he’s got full dentures and he can get a job. His whole image was changed.

There are so many people with different issues, like a single mom who was self-conscious because she was missing her laterals and had other chipped front teeth.  We rebuilt her smile and it gave her so much more confidence and those are the kind of stories that just keep us going. It makes us realize, the dental team has an incredible ability to transform people’s lives. It’s remarkable, it may seem to a dentist that it’s just what they do every day, but it really does make a difference for people who otherwise couldn’t afford to have that kind of care. We’re trying to step in and say, “we’re not going to pull a tooth out, we’re going to save it.”

We also do educational sessions with some of our seniors because a lot of our clients are low-income seniors. We try to help them manage coverage but often they don’t have benefits anymore, they’re not working, so they don’t have any dental insurance. 

There are a lot of people with different combinations of needs. If dentists can be willing to try to help in whatever way they are able by volunteering on the bus, they can make a difference. And they don’t need to be able to do everything.

Probably one of the big disconnects for a dentist like myself in a regular family practice is that we’re not even seeing the Daves, so that would be part of the problem. We are not aware of some of the more severe dental needs in our own communities because they may never walk through our clinic doors. But the idea of someone not being able to get a job because they are missing some top front teeth – that’s a big deal. Wendy, how does your Christian faith impact a day on the bus?

As Christians, our faith is part of what we do and I believe that God will be faithful in providing us with whatever skills we need to get through the challenges of that day. He will provide, as we’ve seen every single time we’ve had a clinic. That’s the beauty of His provision, and when we have volunteering dentists who don’t have faith, it gives them an opportunity to see the peace that Ron and I can have when we work with all these different clients. If there’s a challenge with a particular patient, I always ask their permission, I’ll say “would you like me to pray?” And I’ll pray right there in the chair with them.

So has being a Christian influenced your interest in helping people in this practical way?

My husband and I have been Christians since we were teenagers, and we’ve always been involved in some sort of volunteerism or ministry. I meet lots of people that don’t have a Christian faith system and they want to help. I don’t want to say being a Christian is what motivates me. Obviously it gives me the strength for when things don’t go right. I don’t stay discouraged when we face challenges. It’s definitely not for the faint hearted. 

Is dentistry on the bus noisier than in a regular dental office, because it’s a small space?

No, it’s not. My husband Ron keeps it very light-hearted and so there’s always chatting with the patients and we’ll put some music on in the background, sometimes it’s Christian, sometimes it’s not. Because we’ve done a lot of missions work, we’ve learned how to interact with many different people and situations. So, we just roll with it. We want our volunteers to leave feeling like they’ve had fun and a lot of them do feel that way.

And Ron makes sure our volunteer dentists feel comfortable. He makes sure they don’t feel like they are alone in an unfamiliar environment.  If they want to discuss treatment with Ron, he enjoys that dialogue but he’s also happy to leave the dentist alone who is happy to just get in there and work. 

Where is the bus usually parked for a treatment day?:

We are often “hosted” by churches. We can then use the kitchen area or a church library, which means that patients have a place to sit while they’re waiting for treatment. We do not have patients lining up outside the bus and we give patients appointments. We want them to feel hope and dignity as they wait. They’re coming onto a bus where they will be treated as well as patients are in any private practice. And we keep the bus sparkling clean, it’s beautiful. Our equipment and everything we use is top notch.

Wendy, you and Ron became interested in overseas missions early on, so that would have really shaped you because you got used to working in a different environment right from the start instead of falling into a pattern of predictability and comfort, which is what a lot of us are looking for.

That’s an interesting point. I think those early trips did shape our ability to look at things through a different lens and it gave us an ability to “MacGyver it” when we need to. 

And I think that the younger you are, the more easily you adapt outside your comfort zone of private practice. One of the challenges for somebody who’s been working for 20-25 years and never done anything like this, is to get the courage to give it a try.

On the bus you don’t have to feel like you need to be a hero. If you don’t feel comfortable doing something, you don’t have to do it. There’s always enough other work,  Ron can help a volunteer find a different procedure to do. 

Is there any opportunity to help these patients improve their home care and reduce their risk of tooth decay and gum disease? 

For sure, we do provide oral hygiene instruction counseling. We have a hygiene chair and the dental hygienist gives oral health instruction to every single client.  Each client receives helpful information about diet and how to clean their teeth and gums. We aim to give each client that comes on the bus a cleaning and they also receive a complete exam by the dentist. I think hygienists love that because in their own practice, they’re so pushed for time whereas with this they get to spend plenty of time talking to the patients and teaching oral hygiene care.

I really appreciate you taking the time to share about the great care that you and Ron and your team of volunteers provide to the disadvantaged in your province. In closing, can you share a little about how you to strive to find the right balance in giving of yourself this way. 

I do work a lot but I’m always thinking that we can be doing more. And that’s my challenge. As Christians, I do believe we’re called to serve and give. And not necessarily in dentistry, you may feel called to serve in another way. I also want to make sure I recognize also that if you’re doing pro bono in your office, you’re meeting a need. 

I know that there’s always room to challenge yourself, to look for other opportunities. And to get uncomfortable because I think that’s the sweet spot. That’s where we see our faith coming into action. That’s where we see people noticing something different so just start somewhere and keep your reasons and your ideas as your focus so that it’s not about filling just yourself, but as a Christian it’s filling the mandate that we’ve been called to serve.

Kate, thank you for listening, sometimes we feel like we’re an island out here.

Wendy, you and Ron are doing something so special, ministering in a way that God has clearly prepared you for. But you leave me and our readers with a challenge too – to take that step out of our comfort zone and see how God can use us to help others. Thanks for that, Wendy. May God help us figure out what that looks like for us as individuals.