by Aneesha Dhargalkar, MD; © 2024 Aneesha Dhargalkar, MD
Photos by HealthLink Dental Clinic
Imagine enduring dental pain so terrible that it affects how and what you eat daily. This was the case for Leah, but visiting HealthLink Dental Clinic in Hatboro, Pennsylvania changed her life.
Leah and her husband live in Bucks County. They both work multiple jobs to support themselves and their two daughters, one of whom has special needs. Due to her many obligations, Leah suffered for many years with horrible tooth and jaw pain.
Finally, she couldn’t take it anymore.
She scheduled a visit with HealthLink Dental Clinic. During the visit, she discovered that she had a long-standing dental abscess that required a tooth extraction. Soon after receiving this procedure, Leah sat down at dinner and noticed an amazing thing — her worries about which side of her mouth she could chew on were gone. She could eat whatever she wanted, whenever she wanted. Leah and her husband are now regular patients at HealthLink Dental Clinic.
“When we are in oral pain, we are constantly worried about what we can eat,” explains Ms. Jennifer “Jenny” Salisbury, the executive director of HealthLink Dental Clinic. “If you are unable to chew due to pain, you move to only soft foods — or no food — and your nutrition suffers, because you can’t really eat anything to give you the nutrients you need.”
HealthLink Dental Clinic envisions a community where dental care is accessible to all. They strive to improve adult dental health by offering free preventative and restorative dental services and comprehensive oral health education. HealthLink Dental Clinic is the sole member of the Pennsylvania Association of Free Clinics which provides dental care only.
From the Beginning to Now
Eugene Jackson is the visionary behind HealthLink Dental Clinic. When Mr. Jackson sold SpringHouse, his medical publishing company, he started the Fourjay Foundation and began his philanthropic career.
During this time, Mr. Jackson learned the need for healthcare for low-income individuals who often work many jobs but cannot access medical or dental care. He envisioned a free healthcare clinic modeled after a neighboring county’s medical center. Mr. Jackson’s medical and dental clinic opened in 2001.
As the years went on, changes in the healthcare landscape forced the Board of Directors to reassess the clinic’s services. The Affordable Health Care Act, the Health PA Program, and the creation of additional local free or low-cost medical clinics led to the board’s strategic decision to close the medical clinic to focus efforts and resources solely on dental care. The medical side of the clinic closed in 2016.
This is when Jennifer Salisbury, the clinic’s current executive director, began her journey with HealthLink Dental Clinic. She graduated from Elon University in 2005 with a degree in corporate communications and public relations. She chose a non-profit path, and she started working in Bucks County in 2008.
In February 2020, Ms. Salisbury joined HealthLink Dental Clinic as the major gifts officer. This role became much more difficult when COVID-19 came to the scene, making it much harder for her to form relationships with major donors. Not one to avoid a challenge, Ms. Salisbury leaned into her role with much success. She moved forward within the organization soon after, becoming the interim director in January 2022 and the official executive director that July.
A Clinic for All
To be eligible for HealthLink Dental Clinic, patients must be 18 or older and live in Bucks or Montgomery County, PA. The patient or spouse/domestic partner must be employed (full-time, part-time, seasonal), or the patient must be a military veteran. Family household income must be at or below 250% of the federal poverty guidelines. This equates to around $75,000 or less for a family of four.
Patients who meet these requirements often suffer from the “cliff effect,” according to Ms. Salisbury. “They don’t necessarily qualify for government subsidies to pay for their medical care, but they can’t afford to pay for insurance. There is no bridge to cover that gap between those who get government assistance with their medical aid and those who can afford to pay for it. There is a group in the middle that falls through.” HealthLink strives to serve this group.
Although they do not offer dental care to children, they do provide oral health education to the community as a whole, including children, because fostering good dental hygiene habits early on leads to better oral health outcomes in the future.
The clinic provided care to 879 patients in 2023 but had seen over 2,000 patients in 2019. Reasons for the drop in annual patients include the impact of COVID and lack of community awareness of the existence of HealthLink. Over 60% of the patients are primarily Spanish-speaking, which explains why most of the clinic’s staff is bilingual; all educational materials are available in English and Spanish.
Military veterans have difficulty accessing dental benefits through the VA healthcare program. In fact, due to the stringent requirements, only 15% of veterans qualify for the VA dental care program. As a result, many veterans have worse health outcomes due to their dental health compared to non-veterans. This is why Ms. Salisbury strongly supports the continued inclusion of veterans at HealthLink. About 8% of the patients are listed as veterans, although many more could.
Staff and Services
A combination of employed staff and volunteer providers operates HealthLink. A credentialed staff dentist works every Thursday from 9 am – 7 pm. Her unique schedule allows for a guarantee of evening hours, since the clinic requires that patients work. since one of the ways a patient would qualify for the clinic is by working. Two part-time dental hygienists and one full-time dental assistant round out the employed provider coverage. An eligibility coordinator handles patient eligibility and schedules appointments for patients every 3-6 months, depending on their oral health. A marketing and communications manager also works closely with Ms. Salisbury.
Around 12 volunteer dentists work at the clinic, varying in frequency from once a month to once a week. Most of these dentists are later in their careers or are retired.
The clinic offers various dental services. These services include dental exams, x-rays, basic and deep cleanings with quadrant scaling and planing, fillings, extractions, root canals, crowns, oral cancer screenings, and patient education.
Also, all clinic staff understand the connection between dental health care and medical health. Diabetes mellitus and coronary artery disease are just two of the medical conditions linked to oral health. As a result, staff at the clinic provide diabetes screening via a hemoglobin A1C test and blood pressure testing as part of every patient’s first exam of the year. If there are any concerns based on the results, the clinic refers patients to a local primary care physician at a neighboring free medical clinic.
Community Connections
HealthLink Dental Clinic has worked hard to establish a solid local and regional network. It maintains relationships with community dental offices that provide needed services to clinic patients. For example, one of the dental centers nearby performs complicated root canals. It does this free of charge for any clinic-referred patients. Dental clinics at Temple University and the University of Pennsylvania manage patients’ more complicated dental procedures. They offer a sliding payment scale for these services.
The clinic also maintains relationships with Manor College and Montgomery County Community College. Dental hygiene students at these two schools participate in the dental care of clinic patients since HealthLink Dental is one of their rotation sites.
Ms. Salisbury works hard to foster connections with individual, business, and private foundation donors. Nearly 70% of the clinic’s budget comes from grant funding, and a big part of Ms. Salisbury’s job involves applying for these grants. The clinic receives grant funding from private foundations such as Delta Dental, United Concordia, and the Highmark Foundation. Ms. Salisbury sends quarterly fundraising newsletters and arranges fundraising events to raise money through individual and business donations. In 2024, the PA Department of Health and Human Services honored the clinic with a hefty $100,000 grant for the first time.
Looking Towards the Future
While Ms. Salisbury is grateful for all the excellent care HealthLink Dental Clinic provides, she understands there is room to grow and obstacles to overcome to achieve that growth.
One of those obstacles relates to the issue of “dental anxiety.” When regular dentist visits are missed, patients fear what might be found during an exam, such as the need for a tooth extraction. It is understandably easier to ignore potential problems related to dental pain and hope any issues will go away.
At the start of the Covid pandemic, the clinic closed for three months. Once they reopened, there was a significant drop in the number of patients. Many patients had their regular dental care interrupted. Now, the clinic is discovering that it is hard to get patients back into the habit of routine oral care. HealthLink Dental Clinic continues working to re-establish care with its patient base.
A second obstacle involves eligibility paperwork. The mountains of red tape needing to be climbed to become a clinic patient can be overwhelming. Ms. Salisbury has made significant inroads in tackling this challenge.
She recently worked with Bucks County Opportunity Council and created a streamlined application for the organization’s clients. The council focuses on issues involving food insecurity and housing. Each client of the council has their own case worker. The organization’s new application allows case workers to sign off on eligibility for HealthLink Dental Clinic for clients who qualify for the council’s services, eliminating extra paperwork. According to Ms. Salisbury, “We’re coming to them; we are making it accessible to them instead of requiring them to do more work to access us.”
Ms. Salisbury also hopes to secure funding for additional dental services. Of particular interest to her is the addition of prosthodontics to the clinic’s services, including partials, dentures, and bridges. Since the clinic performs extractions, she feels it only makes sense that it provides a follow-up solution that allows clinic patients to regain some of their teeth.
Conclusion
HealthLink Dental Clinic works hard to provide its community with the best dental care possible. This is important because, as Ms. Salisbury states, “Once you are in oral pain, it’s really hard to get out of. It is not a luxury to get that taken care of—it’s a necessity.” With Jennifer Salisbury at the helm, HealthLink will continue to serve the Bucks and Montgomery County populations to the best of its ability through its dedicated staff and committed group of volunteers.