Seeing the same disease rate year after year always struck me profoundly. I knew in retirement I wanted to truly empower the community to learn to teach themselves about dental disease. I also want to plant the seed to inspire a career in dentistry, to continue having an impact on the next generation of AI/AN dentists. You have to think outside the box! My open door for those interested has led to several current mentees from the Navajo Nation who may someday become dental professionals right here.
Retired from the IHS for all of two weeks, Darlene agreed to help maintain Nizhóní Smiles, a family dentistry and orthodontic clinic on the Navajo Nation in rural Shiprock, New Mexico – about 200 miles from her home outside of Albuquerque. Access to adequate dental care in Shiprock and the very rural surrounding areas was challenging before COVID, and access has become even more limited since then. The pandemic strained the financial status of Nizhoni Smiles. Missed appointments, patients no longer scheduling appointments and more COVID-related issues meant worse oral health for residents and less revenue for the clinic. With less revenue, the clinic had to reduce its days open, which led to even less revenue. Darlene’s primary goal is now to increase the number of days the clinic is open and available to provide care for all those in need.
At least once a month (and sometimes more), Darlene drives three hours one way to spend three or more days at the clinic providing dental services. She is president of the clinic’s board and, alongside former colleagues and friends, is developing an on-the-job dental assistant training program, as well as mentorship and shadowing, to grow staff and opportunities at the clinic.
And she has a history of taking on this type of work. In 2000, reduced federal funding threatened the closure of the clinic where she was chief dental officer. Determined, Darlene made difficult and innovative decisions that kept the doors open and ultimately allowed the clinic to thrive and expand. Darlene focused the clinic almost exclusively on children and youth, with emergency visits for a limited number of adults daily. She added a Medicaid enrollment specialist and a dedicated Medicaid biller to increase revenue generation at the clinic level. Through partnerships with local organizations, a postcard was mailed to approximately 5,000 AI/AN families whose children were enrolled in local schools. The postcards encouraged families to bring their children to the clinic for dental exams and cleanings. In the six months after the postcards were mailed, the clinic saw more children than they had seen in many years and was able to generate enough revenue to remain open.
- The Navajo Nation is roughly the size of West Virginia, with a population of 300,000 to 400,000
- In 2020, Shiprock had a population of 8,590 people, of whom 92.8% are American Indian and Alaska Native (AI/AN)
- It will take 105 new dentists graduating each year to meet the need in AI/AN communities while only five will graduate in 2023
- When gas prices go up in New Mexico, prices rise roughly one-third more on the Navajo Nation, making commuting costly and often prohibitive
Nizhoni Smiles Stats
- Five individual prospective dentists (high school or dental students) from the Navajo Nation are shadowing and doing dental assisting with Dr. Sorrell
- Only dental clinic that provides braces on the Navajo Nation
- Pre-pandemic, averaged 6,000 patient visits per year (just over 500 per month)
- Post-pandemic, averaging 3,600 patient visits per year (just over 300 per month)
Health Equity Heroes
Meet the 2023 Health Equity Heroes
Bridget Saffold, MSN, MPH, RN
Founder, Focus on Diabetes
Executive Director and CEO, Sacramento District Dental Society and Foundation
Christina T. Rosenthal, DDS, MPH
Founder, Determined to be a Doctor Someday (DDS)
Gail Tessier Brown, JD, MSW
Director, NH Oral Health Coalition
Joel Bervell, MD Candidate
Social Media Medical Educator, Washington State University
Vice President of Integrative Program Development and Clinical Innovation, Commonwealth Care Alliance
Richard C. Black, DDMS, MS
Rick and Ginger Francis Endowed Dean, Woody L. Hunt School of Dental Medicine & Texas Tech University Health Sciences Center El Paso
Tammy Simmons, MS, CCC-SLP
Co-Founder, Executive Director, ACCESS
The newsletter designed for anyone who wants to improve oral health for themselves, their families, customers or communities.