Dental hygienist Carly Clark doesn’t typically clean teeth in a dentist’s office. Instead, her office travels with her. Armed with a mouth mirror, a half-dozen scalers, and a folding table, Clark rolls into Portland hospices, nursing homes, and assisted living centers to provide dental cleanings. She’ll polish teeth as her clients lie in bed; she attacks plaque couch-side. And then she packs it all up and heads for her next patient.

Clark’s business, Mobile Dental Hygiene PDX, is one of a handful of mobile dental practices in the city, designed for people who cannot easily leave their homes. Some focus on hygiene and cosmetics—things like cleanings, whitening,
or fluoride treatments—while others go even further, offering in-home X-rays, root canals, crowns, and implants. 

In 2022, more than a third of Americans over the age of 65 hadn’t seen a dentist in the past 12 months, and it’s not hard to imagine why. Around 2 million American seniors are homebound, and 18.9 million seniors 65 and older have no form of dental insurance or coverage (traditional Medicare doesn’t cover dental services). Few assisted living facilities prioritize oral health: Of the 1.4 million people living in nursing homes in the United States, only 16 percent receive professional dental care. Not many assisted living staffers are trained in dental hygiene, and although federal mandates require senior care facilities to provide access to oral health care, there’s little oversight to make sure nursing homes are meeting those standards. With labor shortages and financial demands, toothbrushing and trips to the dentist can get pushed to the back burner. 

Clark witnessed this sidelining of dental health maintenance firsthand when she began her business in 2012. She started in nursing homes, but when she looked in people’s mouths she was shocked by what she found. “On the most part, they’re so well taken care of by the critical care team, but I was surprised by how unwilling people were to do oral care,” she says. “I was surprised to see how poor some people’s oral health is.” So Clark expanded her offerings: When she would visit patients in senior centers, she would also train employees on the basics of oral care, including toothbrushing tutorials. “Once they have more education and confidence doing it, they’re more likely to do it,” she says. “If I gave you a toothbrush, and had you brush your best friend’s teeth, it would be awkward, right?”

Growing up with a mom who worked in a dentist’s office, Clark knew she wanted to go into oral health. She became a dental assistant in 1997, then went back to school to become a hygienist in 2008. At a continuing education seminar, she learned about mobile dentistry, and the populations that needed it most. As someone who loved listening to her older patients tell stories from their childhood, she found it to be a natural fit. “I just have always had a heart and soft spot for seniors since I got into the industry,” she says. “Who doesn’t love a grandma and a grandpa?”