Hal Pickett remembers his first patient, and the last one who walked out the door. The others are a bit fuzzy. You cant really blame him, though. Hes been seeing patients since the 1950s.
At age 86, Pickett is one of the oldest health care professionals in the state. He also is one of six prosthodontists working in Idaho. A prosthodontist is a dentist who specializes in fixing and replacing teeth and the structures around them.
Hes weathered major changes in the health care industry and in his specialty, but he doesnt plan to quit.
Retire sounds too much like expire, he said. I enjoy the work, and Ive got to have something to do.
Pickett didnt start out planning to work on teeth. The soft-spoken father of five and grandfather of three jokes that he used to be a professional student.
After high school in Oakley (class of 1944), Pickett signed up for the U.S. Army, where he bounced through training courses at the University of Idaho, the U.S. Military Academy and Cornell University. He spent the end of World War II in the Philippines as a commissioned second lieutenant.
His appetite for higher learning whetted, Pickett headed to U of I and got bachelors and masters degrees in zoology. He attended the University of Oregon for a doctorate in medical dentistry and followed that up with a masters degree in his current specialty at the University of Iowa.
He did all of this, and started a practice in Boise, by age 30.
The world was different then for dentists like Pickett. He entered the workforce with no student debt the G.I. Bill helped with that so it wasnt as difficult to start a practice from scratch. He also didnt have competition from denturists, who have education and technical training to make dentures, without the medical dentistry background. In the 1980s, Idaho became one of a few states to grant denturists the ability to practice without a dentists supervision, and there are about 20 with current Idaho licenses.
Just as with primary-care medicine and psychiatry, the rural parts of Idaho are underserved by dentists, Pickett said. Many of his patients come from the far reaches of the Treasure Valley.
Some of his longtime patients have moved out of town but make it a point to get a checkup when they arrive from Seattle, Missouri or New York. Pickett also wants Idahos low-income children and seniors to have access, so he helped create programs decades ago to give them dental care.
Pickett started out in general dentistry. There was a time when his prosthetic work included glass eyes and replacing missing parts of a patients head and face, including ears. But he did so few of those that he didnt feel proficient, so he stopped several years ago. Now he works with dentures.
Im not setting the world on fire now, he said. Im probably enjoying it more than I did 40 or 50 years ago, because money isnt my main objective anymore.
One set of shelves in his lab is packed with plaster of Paris-esque impressions taken from the jaws of various patients. Some have just two or three teeth remaining, and Pickett makes them whole again.
I think its a tough business to be in, because (dentures) are so far from satisfactory. ... Expectations are in many cases way too high, he said.
You really have to keep on your toes to read each patients comfort level, he said. Some people, you tell them, Youve got a cavity in a certain spot, and they consider that a major disaster. (Others) say, Take out the whole thing, get rid of it.
Some of his current patients swear by the work he does in his spartan office. Pickett still works five days a week and does most of the denture work by hand, in the office, while the patient is there. He sends the denture material to a lab for curing, the final step.
Hes not very talkative but hes very precise, said Judith Little, an 88-year-old former nurse who first saw Pickett in the mid-1970s on the referral of an orthodontist. She travels from Mountain Home for her appointments.
Little said she appreciates that Pickett doesnt pad his office with fancy decorations or furniture. It has just what he needs to do the job, she said.
Little also likes Picketts very pleasant office manager, a woman whos spent much of her adult life working for him.
And she likes that Pickett charges more than reasonable prices. His dentures usually cost $900 to $1,100, depending on the patients needs and the materials used. He doesnt take Medicaid or Medicare, which usually wont cover dentures, but takes other insurance plans and tries to give discounts for some out-of-pocket customers.
Im at the point where I dont trust anybody else, and I dont know what Ill do when he retires, Little said. Go without teeth, I guess.
Audrey Dutton: 377-6448, Twitter: @IDS_Audrey