Forty-one-thousand dollars: That’s how much money Phil and Sarah Hallstedt, owners of Northport’s Hallstedt Homestead Cherries, are trying to raise to help one of their employees address severe dental issues. After six months and hundreds of donations, Phil Hallstedt tells The Ticker the campaign is finally nearing its goal. Now, though, Hallstedt is working to generate more awareness about the prevalence of dental issues in northern Michigan, with hopes of starting a broader conversation about how the region’s wealth inequality affects health outcomes.

Hallstedt noticed this spring that HH Cherries Orchard Manager Dick McCulloch was visibly in pain. By that point, Hallstedt recalls, McCulloch was having difficulty eating, sleeping, or speaking, all due to severe pain in his mouth. The two sat down and discussed the situation, and McCulloch explained how a lifetime of teeth grinding and minimal access to dental or orthodontic care had left him with substantial tooth decay and infection.

“I remember him saying to me, ‘Phil, there’s just no way anything can be done; it’s just way too expensive [to get the dental care I need],’” Hallstedt recalls of that conversation. “And I committed to him right then that I would get help and get a treatment plan.”

So began a lengthy journey. Conversations with local dentists and periodontists showed that McCulloch’s issue couldn’t be resolved with dentures or other more simple solutions. To fix the problem and resolve McCulloch’s pain, he would need extensive tooth extraction and reconstruction, including dental implants and crowns. The final treatment plan came back with an estimated cost of $41,000.

Soon, Hallstedt launched a GoFundMe campaign and started talking with local dentists, healthcare providers, and nonprofit leaders with two big questions in mind: First, just how common are situations like McCulloch’s? And second, what resources – if any – are available in northern Michigan for people facing similar barriers to care?

The first question proved easier to answer than the latter. “It became very clear very quickly that there are many cases like Dick’s,” Hallstedt says. For instance, in talking with Mary Stanton, executive director of Leelanau Christian Neighbors (LCN), Hallstedt learned local residents regularly contact that organization seeking financial assistance for dental care. “When I talked to Mary, she told me she’d just had two requests of over $4,000 for dental treatments in the space of a couple days,” Hallstedt says.

Dr. Jacob Sorber, owner and dentist at West Bay Family Dental in Suttons Bay, confirms that dental issues are common in Leelanau County – a problem he says has been exacerbated by the COVID-19 pandemic.

“It’s supposed to become a routine to go to the dentist,” Sorber says. “You come through for your six-month checkup, and then you make an appointment for your next checkup. That cycle got broken by COVID, and it took a lot of people a long time to feel comfortable going back to a healthcare setting. When you're used to having your teeth looked at and cleaned every six months, and then all of a sudden that turns into 2-3 years, it’s not surprising [to develop more dental problems].”

With that stated, Sorber – who is overseeing McCulloch’s six-month treatment plan – is quick to classify McCulloch’s case as an “exceptional” one. Even for patients that do require more involved dental work, he says the cost will typically be much less.

“I don’t want people to see Dick’s story and say, “‘Oh, if it’s going to cost $40,000 to fix my teeth, I’m not even going to bother,’ Sorber stresses. Instead, he encourages everyone to consult with a dentist, talk treatment plan options, and have honest conversations about cost and affordability. If McCulloch’s case is proof of anything, Sorber says, it’s that no expense need be insurmountable.

“We are lucky, in that we have people in this community that have stepped in and helped patients that couldn’t afford care,” Sorber says. Beyond what the Hallstedts are doing for McCulloch, Sorber has worked with patients who received financial assistance from local churches, from nonprofit organizations like LCN, and more.

More local patients now have options for dental care thanks to United We Smile, the Traverse City-based dental clinic United Way of Northwest Michigan (UWNWMI) opened in September. Open five days a week, United We Smile offers free dental care services to children, pregnant women, veterans, and “those with developmental or cognitive disabilities.” Two months in, the clinic has already given away more than $200,000 in free dental services to local community members.

While United We Smile isn’t able to help everyone – McCulloch, for instance, doesn’t fit any of the four categories – UWNWMI Director of Health Initiatives Jennifer Kerns says the clinic is a substantial step forward.

“We’ve focused specifically on these target populations because most dentists say ‘No’ to those people,” Kerns explains. Many dental providers in the area, she explains, refuse service to the demographics United We Smile serves, whether because of liability risk (pregnant women) or stigma (people experiencing homelessness). Meanwhile, Kerns says “just plain old regular adults” can at least get a foot in the door with most dentists – and can often find financial assistance from organizations like Father Fred or Salvation Army, should affordability be a barrier.

“A lot of people don’t understand that your bodily health is directly related to your mouth health,” Kerns says. “There are so many things that mouth bacteria causes with your heart, with stroke, with premature birth. Mouth bacteria can actually stimulate labor, and then pregnant women go into labor early. There are just so many things that happen from your mouth and people don't understand.”

In Sorber’s view, the best way to avoid the negative health outcomes of deferred dental care is to address the economic factors that cause patients to defer care in the first place. Those economic factors are commonplace in Leelanau County, where nearly half of all households are considered ALICE – or “Asset Limited, Income Constrained, Employed.”

“When I lived and worked in Denver, Colorado, there was a program a lot of the dentists were a part of,” Sorber recalls. “And this organization actually found patients that needed help with a significant amount of dental care, and then reached out to dentists to see if they would do the work for free. And maybe it was one of the benefits of being in a bigger city, in that there was more of a means to set something like that up and make it work. But that was a really good program, both from the patient side and from the dental care side, and I’d love to see something similar here.”

For Hallstedt, the process of raising funds for McCulloch has offered a closer look at local inequities and their impacts. Even as the fundraising process nears its conclusion – of the $41,000, about $28,000 has been raised so far – Hallstedt doesn’t want to lose the urgency of the cause. He’s hoping McCulloch’s story can ignite a conversation about dental care access and affordability throughout northern Michigan.

“To me, this is an extension to the conversation our community has been having around affordable housing,” Hallstedt concludes. “In order to have a workforce here, we have to come to terms with the fact that they're going to need more than just a home. They're going to need healthcare; they're going to need dental care; they're going to need other supportive services. To think about these issues in a broader way is an important thing. And I think it’s on each of us, if it's on our hearts, to try to find a way to help.”

Pictured: Phil Hallstedt, Dick McCulloch, and Sarah Hallstedt