When Erik Johnson first practiced dentistry, he found inspiration working with kids. Now he's opened Presque Isle's second dental office dedicated to children.

County Roots Children's Dentistry opened in mid-October. So far, 200 kids have become patients there.

Aroostook County has struggled with a shortage of dental practitioners, especially since the pandemic. There are nearly twice as many people per dentist in northern Maine than statewide, according to the 2024 Maine Shared Community Health Needs Assessment. Some groups are trying to help by bringing oral care into schools. Johnson wants to tackle the problem by reaching kids early and making them less afraid to go to the dentist.

"I feel like when you're working with adults, sometimes the damage to the teeth is already done," he said. "Kids, a lot of times, you can teach them so they can take care of their teeth for their whole lifetime."

Johnson was Aroostook County's first pediatric dentist when he came north in 2013. A graduate of the University of Connecticut School of Dental Medicine, he served at community health centers, including the Katahdin Valley Health center in Houlton, and at St. Apollonia Dental Clinic in Presque Isle.

But his longtime goal was to set up his own practice just for kids, because he saw the need.

Aroostook and most of Maine are considered dental care shortage areas, according to the U.S. Department of Health and Human Service's Rural Health Information Hub.

The pandemic sparked some of those shortages, increased wait lists and caused families to delay care, according to the health needs assessment. The number of Aroostook kids who attended at least one preventive visit fell from 65 percent in 2019 to 50 percent in 2022, even as the number of kids with dental insurance increased to about 70 percent.

Johnson found his niche with pediatric dentistry around 2013, while working his residency at Penobscot Community Health Center in Bangor. A pediatric dentist had come on board and Johnson started seeing a lot of young patients, including those with special needs. That inspired him to expand his education.

"I was seeing a lot of children with autism and I felt like I needed additional training," he said. "I found that I could really connect with kids. Even the nonverbal ones, I felt like I could somehow communicate with them and guide them."

The biggest roadblock is fear: some kids are just scared to come to the dentist, he said. In fact, a dentist visit can be so traumatic that a trip to a hospital operating room is necessary so dental work can be completed under anesthesia.

Distraction and humor are some of his main tools, he said, sitting in his office with a Spiderman shirt visible under his scrubs. For instance, if he's trying to get a sense of a child's overall teeth, he challenges them to a smiling contest. He and the staff sing with them. For those afraid of the big dentist's chair, he gets down on the floor with them.

The clinic serves all patients, with or without insurance or MaineCare, and not just from The County. Already the clinic has welcomed patients from all over Maine, office manager Mary Michaud said. Some drive six or more hours from areas like York, Saco and Waterville for their children's appointments.

"It's like a gold mine to a lot of parents, really, because they haven't been able to get their kids in for certain things, especially kids that can only be seen in the [operating room]," Michaud said.

So many kids need care that Johnson believes County Roots will mesh well with existing resources, like St. Apollonia, the Aroostook County Action Program and other health centers that help bring dental care to kids, whether in the clinical setting or in schools.

County residents have multiple oral health challenges, Johnson said. It's often hard for parents to find a dentist who can see their kids right away. Nutrition, including sugar intake, can be a problem. And drinking water plays a big role.

Not everyone drinks fluoridated water. Many local residents have wells, while others opt for bottled water. While fluoridation has been in the news and some oppose its use in public drinking water, in the right amounts fluoride is really useful in proper tooth development, Johnson said.

He described himself as a big kid and has three kids of his own -- 8, 10 and 12. Outside of the practice, he's a firefighter with the Presque Isle Fire Department.

County Roots' staff includes Michaud, front-desk receptionists Tim Tarr, Hannah Doody and Ashley Clark, dental assistant Amber Nemer and certified dental assistants Hannah Brown and Grace Tarr.

For Johnson, it's all about creating a welcoming space.

"It's a happy place instead of a scary place for the kids," he said. "Every day, there's some sort of cool thing we do to help somebody else. It's a good feeling."