Small Towns, Big Smiles

Health, Home & Family
on October 3, 2004

An early-season snow in Bristol, Maine (pop. 2,644), doesn’t bother dentist Kerry Ransdell. He shovels his way to his dental clinic in a renovated carriage house near the 200-year-old farmhouse he and his family call home.

It’s a far cry from the practice he left in sunny Phoenix. “Moving to a small town is the only decision I’ve ever made that doesn’t have a downside,” Dr. Ransdell says. “The air here is clean. There’s undeveloped land. It feels comfortable. People appreciate what we do.” His appointment book was full just two days after opening his practice in Bristol two years ago.

“Having a dentist here draws our community together,” says Allison Eddyblouin, one of Dr. Ransdell’s patients, who eagerly gave up her family’s hour-long drives to a dentist in a neighboring town for visits a few minutes from home.

“Living in a small town is about building relationships and supporting each other,” Eddyblouin adds. “The Ransdells fit right in. I’d feel comfortable calling them any time, and I know they’d help us.”

In a small town, the arrival of a new dentist is a reason to smile. That’s because most dentists opt for city practices, believing they have to be in urban areas to be successful and have the lifestyle they want for themselves and their families. But some dentists look beyond the bright lights to find the kind of lives that bring its own rewards.

Open wide, please

For Dr. Joanne Brown and her husband, Craig Sandlin, practicing in a small town was always a priority. “We knew we wanted to go rural,” Dr. Brown says. “I grew up in Salem, Ark., which had 600 people when I was a kid. It was the kind of place I wanted to practice.”

She and her husband researched locations in Arkansas and Kansas before settling in the west Kansas town of Leoti (pop. 1,598). The attraction—the community’s joint effort to recruit a dentist and its ability to help with federal grants and low-interest and no-interest loans to fund a state-of-the-art dental practice. For the couple who love to ski, another attraction was the community’s proximity to the Colorado slopes.

“The main thing about having people like Joanne in Leoti is that it keeps business in town,” says Anne Miller, who lives in Lakin, Kan. (pop. 2,316). She regularly drives 42 miles past wheat fields on State Route 45 for her appointments with Dr. Brown. “You keep your business in the town where you live, and that supports your community. Then people like Craig and Joanne give back to the community by being part of what goes on. It’s like a big circle.”

It’s been two years since Dr. Brown opened her Leoti practice, which draws patients of all ages from 17 counties in Kansas and nine in Colorado. It’s a busy, thriving office employing a hygienist, three assistants and Sandlin as office manager. But brisk business isn’t what bonds them to the place they plan to stay.

“When we leave, we know our house is being watched,” she says, explaining that the hour-long drive to the nearest Wal-Mart is more than compensated by the sense of community and the rewards of being on a first-name basis with patients. “When someone is sick, everyone pitches in,” she says. “When I go out, every third person I see knows my name. We love it here.”

Crossing the dental divide

Drawing dentists to small towns can be challenging. That’s why people in some rural areas have trouble getting an appointment when they need dental care.

To bridge that gap, government programs such as the National Health Service Corps (NHSC) place dentists like Pete Perez in small towns and rural areas across the nation in exchange for helping repay dental school loans.

While taking a quick lunch break in his office in Sunland Park, N.M. (pop. 13,309), just across the border from Juarez, Mexico, Dr. Perez says providing dental care through NHSC is rewarding. “I get a lot of satisfaction from this work,” says Dr. Perez, who sometimes finds the toothbrushes he gives at the end of a visit are the first patients have owned.

“People come to see me who are very ill with infection, and I’m able to relieve it,” says Perez, a native of Corpus Christi, Texas, who has been affiliated with the NHSC for 12 years, working in small communities in New Mexico and Nevada. “I spend a lot of time with patients teaching them that many dental problems are preventable,” he says. “I can have a direct impact on someone’s life.”

Impact also is important to Bert Westin of Hastings, Neb. (pop. 24,064). Both Westin, a physical therapist, and his dentist, Anne Heckman, are graduates of Chadron (Neb.) State University. The university, in cooperation with the University of Nebraska Medical Center, provides tuition incentives and early admission to medical education programs for budding health care professionals who commit to practicing in small towns in the state.

“I feel a camaraderie with Anne,” says Westin, a native of Springview, Neb. “When young professionals return to small towns, they contribute to the growth and livelihood. Its important that people in towns like Hastings not have to drive 40 miles to get care from someone they don’t know.”

Knowing your patients first as community members is just one of the benefits to small town dentistry, says Dr. Heckman, a Hastings native. “Dentistry has a lot to offer small communities,” she adds. “Patients are loyal, and they’re not looking for the best buy.”

When Westin and his wife had their son, Tristan, two years ago, Dr. Heckman’s gift to the couple was a baby-sized toothbrush. “I have patients who knew me when I was growing up here and know my family. My biggest fear at first was to mess up on someone I knew, but I’ve found once I start the exam, I get focused on doing my best, no matter who it is.”

West Virginia University School of Dentistry actively encourages graduates to consider a rural practice via interactions with practitioners such as dentist Chip Perrine. A native of Cowen, W.Va. (pop. 513), Dr. Perrine moved his practice from Gettysburg, Pa., to his hometown in 1987.

“One day, I woke up and realized everything I liked to do involved coming back here,” recalls Dr. Perrine, an outdoorsman who jumped at the chance to move home by purchasing a retiring dentist’s practice. The chance to raise his children near their grandparents, to live among people he had grown up with and to practice in a place where his skills were much needed was irresistible to him.

“We didn’t give anything up to move back here. My kids are happy. They’re well adjusted. I credit that to having family around and peers and people in town who pay attention to them,” he adds. “It’s about quality of life, family and friends.”