PHS provides a lifeline to a marginalized and under-served community, providing services that go far beyond the housing and harm reduction we’re known for.
There is a critical need for affordable and accessible dental care in the DTES and the Portland Community Dental Clinic has been meeting those needs for more than two decades.
The cost of everyday dentistry effectively puts it out of range for most in our neighbourhood.
This is an urgent health issue in vulnerable communities like the Downtown Eastside.
The PHS clinic provides more than emergency work to overcome the pain of a cavity or infection: it also gives dignity and quality of life to vulnerable people. If you can’t bite or chew, you are going to live on a very limited diet, and broken dentures or missing teeth can make talking difficult.
The bulk of the clinic’s work is preventative check-ups aimed at keeping people’s teeth and gums healthy to avoid problems in the first place.
Much of this has fallen under the gaze of PHS Dental Hygienist Brent Wager, who retired at the end of December after 20 years in the role.
Word of mouth
Brent joined us June 2002. The clinic had been officially launched the previous year, but it took a while to nail down the funding. Back then the PHS dental clinic was based in the old Sunrise Hotel (since renovated and renamed Irving Hotel), moving to its current location at Carrall & East Hastings in 2015.
Brent got the PHS job through word of mouth, having originally met the Community Dental Clinic team during his studies on under-served communities. One of the team members reached out to suggest he apply.
He’d previously worked in Vancouver’s West End through the HIV crisis and knew a thing or two about working in a stigmatized community.
“It’s important to me to work with people in under-served communities,” said Brent. “The thing about this clinic is that it’s a welcoming space where people feel invited.
“The difference between working for PHS and working in other parts of town is that patients here are perhaps a little more apprehensive, but they thank you, and tell you how glad they are that you’re here. General practice patients are more demanding.
“There’s an honesty down here. You first have to build trust with people, and then they will come back.”
People in the neighbourhood talk of having been treated with derision by the medical profession, and are naturally wary of authority. Trust is earned in the Downtown Eastside, it’s never to be taken for granted.
“I’ve always treated everybody as a person,” said Brent. “I feel out their anxiety level, and some have more than others. In general, people come in with trauma.”
It’s a myth that methadone and Suboxone directly cause tooth decay – other than through dry mouth, which can lead to increased plaque – but Brent feels the main issue in the neighbourhood is limited opportunities to brush teeth in SROs and shelters with shared bathrooms.
Another myth is that drugs used in the dentist’s chair won’t work on people with opioid tolerances, leaving them in pain. In fact, the agent used for freezing for a dental procedure isn’t an opiate. While Brent has noted that people who use drugs seem to process the anesthetics through their systems faster, the anesthetic will still be effective.
Clinic staff know the importance of talking patients through what to expect with their procedures and with their care. People become frustrated and circumvent their care when they aren’t carefully told, for example, that antibiotics prescribed for a painful mouth infection will always take around 24 hours to begin showing results.
Affordable dental care available
After a 30-year career, with 20 spent with PHS, Brent is leaving the profession and moving to Victoria. PHS and the community he has served so well and for so long send him off with many thanks and good wishes.
His are big shoes to fill, and we are looking for his replacement. Contact us if you are a hygienist looking for this kind of deeply rewarding work in the community.
And if you are looking for affordable dental care in a low-barrier setting, check out our clinic. The dental clinic is mandated to prioritize the DTES community, so you’ll be front of the line.