Editor's note: This story is part of Southwest Michigan Second Wave's On the Ground Eastside series.  

When people think of a mobile dental service, they might picture a large tooth-colored van parked near a school entrance.

But Eastside resident Tiffany Burns is a mobile hygienist who doesn’t drive a van. She drives a Mazda. And she arrives to see clients with all she needs in her aqua blue suitcase. 

Inside the suitcase are a suction machine, polisher, hand scalers, curettes, hand mirrors, mask and gloves, almost everything you would expect to see in a typical hygienist’s office.

“My equipment is portable,” says Burns, who has been taking her hygienist skills on the road for the past five years, but in a full-time capacity since May as the director and operator of her nonprofit, Smile Savers. “Being mobile allows me to access more people, including seniors, so that I can go into their home and service them.”

Tiffany Burns took her calling for dental health and created a mobile dental nonprofit business, Smile Savers.Whether she’s headed to the Kalamazoo Gospel Mission, the Kalamazoo County Juvenile Detention Center, or to local nursing homes, Burns has a smile on her face and she hopes to put a smile on someone else’s--and not just any smile, a healthy, freshly cleaned one.

Because she knows how important dental health is to overall health, she wants to spread the word. Recent studies have demonstrated that oral health, particularly related to the bacteria that grows when teeth are not clean, can spread through the bloodstream to other areas of the body, and can potentially influence diabetes, Alzheimer’s, cardiac, digestive and mental health, just to name a few conditions.

Unfortunately, not enough people are yet aware of the impact of oral hygiene, and particularly for seniors, it’s often an afterthought in a healthcare plan.

“What I’ve experienced being out here in the public is that dental health is low on the totem pole,” says Burns, who has worked in the dental field since she was in high school, as an assistant and then for years in an office as a hygienist. “You see mobile nurses, doctors, podiatrists, obstetricians, even mobile opticians, but few mobile dentists.

“And dental health is so important, especially as it relates to systemic diseases. That’s why I’m drilling this message home. Teeth are important.”

Pun intended?

After years of dental office work, she’s gone mobile

Because of growing awareness among insurance companies about the relationship of dental health to overall health, dental insurance coverage for most people is slowly improving. This is particularly true for seniors who now have dental coverage under Medicare.

“A lot of seniors are living longer and keeping more of their natural teeth,” says Burns. “But due to the fact they didn’t have insurance in the past or it wasn’t affordable to them, they didn’t get the care they needed.”

Strong teeth at any age make for a stronger body.

“You need your teeth to chew your food, especially the molars. If you don’t, your digestive tract is working harder to grind up that food and that can lead to other issues,” says Burns, adding, “Dental care is often so neglected until there is a problem.” 

She says she sees a large part of her work as “just getting people educated so they know the importance of taking care of their teeth.”

Burns has clients who are homebound, but also treats those in nursing homes, and the homeless through the Gospel Mission. Since many of this population often have other pressing medical issues and needs, dental health can easily get left behind. 

“Not everyone knows what their dental insurance is,” says Burns. “You might have to investigate it, but most people have some type of coverage.”

Medicaid has expanded its dental coverage, as well, which means more children have more access to dental services. Burns, who has many young clients, says she is disheartened to see how many toddlers already have a significant amount of dental caries (cavities). 

Untreated cavities can be the underlying cause of many conditions, including those related to poor behavior, Burns says.

“For preschoolers, and even older children, a dental issue may be the contributing factor to poor behavior or even depression,” says Burns.

“I’m seeing three or four year olds now with rampant decay, holes in their teeth,” says Burns, “which is so disheartening because no one is putting together oral health with the reasons this child has behavior problems, this child is not eating, or this child is misdiagnosed. Let’s see their teeth are healthy before we go off saying the child has this or that.”

Burns offers preventative care but can also do some diagnostic work. For clients who need more intensive work, she refers them to family dentist Dr. David VanSlambrouk or pediatric dentist Dr. Ryan Basler.

In addition to her regular clients, for the past eight years, Burns has been visiting the Kalamazoo Gospel Mission to treat patients, some who do not have any insurance.  According to Rachel Villanueva, coordinator at the Mission, Burns' help is vital because it’s difficult for Mission residents to find transportation.

“She’s good with everyone, adults and children,” says Villanueva. “She has a great personality to handle our group of people here because they’re definitely different. She even sees clients who don’t have insurance.

“Keeping up with hygiene is so important. Otherwise, you’re dealing with urgent needs, which become a bigger issue because not everyone is compliant when they get a referral,” Villanueva adds. “It can just snowball into something the client can’t handle emotionally or financially.”

Dental dreams started young

Burns can remember the exact moment when she uttered aloud the words to her mother: I want to be a dentist.

She was 6 and jumping rope outside when her mother casually asked her, “What do you want to be when you grow up?”

Her mother was encouraging, and Burns was motivated. “Most young kids work fast food,” says Burns. “I always worked in a dentist office.” And she’s been in the field since high school.

“I wanted to become a dentist, but I got pregnant, and life changes.” At 36, however, after having mostly raised her son and daughter, Burns enrolled in Kalamazoo Valley Community College, one of the top five dental hygienist schools in the state, where she became even more convinced she had chosen the right field.

Most of the cleaning equipment you would see at a dentist's office fit in Tiffany Burns traveling hygienist suitcase.Upon graduation, she worked both in a private office and in public health with a traveling dental company. “And I decided that public health was where I wanted to go,” she says, because she could see the most impact if she worked in that field. 

“That’s where I really saw there was a need for people who couldn’t get out,” Burns says, adding that often her clients either didn’t have insurance, didn’t realize they had it, or had insurance that wasn’t accepted by most providers.

Burns wanted to offer these clients another way. 

Toothy Man saves the day

Even hygienists need mascots, and Burns has Toothy Man, a small friendly-looking caped and masked tooth. Not only does he warm up to children and encourage good dental habits, he also provides adults with tips. Did you know that there is such a thing as proper mouth posture?  According to the Smile Savers Facebook page, your tongue should rest at the roof of your mouth, back teeth barely touching and lips slightly parted.

This posture is the best for optimal jaw structure and teeth placement. And doing it regularly can actually improve your dental symmetry, according to specialists in orthotropics, an alternative way to treat and prevent abnormal alignment of teeth.

February is Children’s Dental Health Month, and Burns has coordinated with her church, Mt. Zion Baptist, to do an informational session with parents and caregivers about why baby teeth are important. She also plans on two sessions for children so they learn to properly brush and floss.

While it’s only been seven months since Burns has operated Smile Savers full-time, she is steadily getting more requests for her services. Funding for her nonprofit comes from sources such as Delta Dental, the State of Michigan, Henry Schein, a nationwide distributor of dental, medical and vet supplies,  and individual contributors through the Smile Savers website.

“My goal that I see in the future is establishing a stable location just in case someone needs to come and see me. And also for that location trying to contract with a dentist who will be able to come to a site once a month to contract with anyone I see that needs further work.”

While Burns may not be the dentist she once dreamed of becoming, being a mobile hygienist has helped make her dreams come true, which at the core, were all about helping people have healthy teeth.

“For me, it’s rewarding because I feel like I’m helping someone,” says Burns. “When I see someone and they smile and say, ‘Oh I started flossing,’ that encourages me because I changed a habit.

“A clean mouth definitely helps everything.”

Wherever Burns goes, suitcase in hand, you can be sure she’ll be saving smiles and giving them away, too.