Dr. Darby Lefler Returns to Tribal Health to Expand Pediatric Dental Care | News

POLSON — Dr. Darby Lefler of Arlee has taken a path back to the Flathead Reservation. Before becoming a dentist, he worked in construction, the trucking and logistics industry, coached wrestling, and worked on cell towers.

“I feel useful when I’m doing something useful,” he said. “If I am the short guy that can crawl under something, I feel useful if I can do it,” Lefler added with a laugh.

He said dentistry began as a feeling more than a plan, “not feeling a whole lot of purpose, or feeling I needed to make some different kind of impact.” In the early 2000s, he worked as a dental assistant in Missoula before returning to school, not sure exactly what he wanted to do but knowing it would be in the medical field. He studied pre-med with a declared microbiology major at the University of Montana.

He also always planned to return home to the Flathead Indian Reservation.

“I’m not a city boy,” he said. Present-day Polson is “even too big” for him, and Arlee is “getting too big as well.” He said people often talk about the past, “the belly aching and dreaming of the old time when there were half as many people here.”

“But this place is like a magnet, it sucks you back in,” he said of the reservation.

While working on cell towers, Lefler attended a meeting at the KwaTaqNuk Resort for the National Society of American Indian Dentists. There he met Dr. George Blue Spruce, who recently passed away and was the first Native American dentist.

“He’s the root of so many, so many Indian kids getting into dental school and influencing so many people,” Lefler said. “He kind of solidified my decision to get serious about applying to dental school.”

Lefler began dental school in Arizona in 2005 and later completed a pediatric residency at the Alaska Native Medical Center in Anchorage.

He returned to Montana and worked in private practice. Around 2012, he said, conversations began with colleagues about developing a pediatric dental program for the Confederated Salish and Kootenai Tribes.

He worked with Tribal Health for a few years, then left to purchase a practice in Missoula, where he operated a children’s dentistry clinic. By January of last year, he said he was “tired of the business.”

He returned to Tribal Health in June 2025.

“There’s a big need, and there’s a big need to change the way people perceive oral health,” he said.

As of early fall, adults needing routine dental care faced long waiting times, with St. Ignatius reporting waits of about six months and Polson up to a year. Emergency cases could be seen sooner, but Lefler said children are prioritized and do not have to wait as long.

Lefler said many rural areas have this kind of retroactive response to oral health needs, like people wait till they hurt right before they go to a dentist. He said that in pediatric care, shifting families toward early prevention and early education makes a major difference.

When planning first began for a Tribal Health pediatric program around 2012, he said those ideas were always in mind, “trying to align with the altruism thing.” He said balancing idealism with the volume of need is difficult.

He said that over time the program grew with support from colleagues and Tribal Health leaders like Dr. Gary Pitts and Joe Durglo . Dave Burke, the other pediatric dentist, also joined the program in 2021 to help meet demand. As patient needs increased in the southern part of the valley, Lefler began working in St. Ignatius.

“Me being in Mission is based on the fact that the program has had growth that way, and that is because of that education piece that’s getting the word out, that’s getting people adhering to these principles, regular routine care, getting through the clinic more often and not waiting till your kid’s teeth are hurting,” he said.

He said many families still do not realize how early children need dental care.

“A year, if you haven’t seen a dentist by age one, you need to,” he said.

He said prevention remains the focus, and while progress has been made, more education is needed.

Lefler said part of pediatric dentistry is shaping habits early, before bad habits form around age when permanent teeth arrive.

“You know, presently, I think in the general dental side, we are still dealing with a vast number of patients who have extreme needs,” he said. He emphasized that children should not be waiting six months to a year for care.

“It’s not that easy to have dietary control over your kid and most of it’s just sticking with it and being very routine,” he said.

He said some factors are outside a parent’s control. “You send your kid with a lunch bag with carrots and bananas in it, and the kid across the table from them is eating Twinkies and Bug Juice, you know? Those influencers that you have to fight at home.”

“This is not easy,” he said. “We may be overly pragmatic about it when we talk about it, just do this and you do this and then it works out fine. And that’s true. But putting this and this and this in play when you’re a single working mom, or on the rez we see a grandma doing a lot of it. It’s hard for them.”

Lefler said the program is working on ways to better educate and prepare parents and grandparents “so they aren’t catching information late and instead of feeling something has been done to them but feel something has been done for them.”

He also noted that today’s children can be technologically advanced but still struggle with basic skills.

“Yeah? But probably 90 percent of first grade kids cannot tie their shoes. Right? You think they’re dexterous enough to articulately brush their teeth. They can’t look at a shoe and visibly tie it. They can’t brush their teeth properly, which means you as a parent has to do it for them,” he said. “But at the same time he can sit down and program a computer. Why can’t they take care of themselves? They can’t, you know, they don’t think about that stuff.”

Lefler said the pediatric dental program is seeing slow but steady growth.

“I have a motivation, not just for this program but just in general,” he said. “I am very intimate with the community, and I feel very affectionate of where I come from, and I don’t take it lightly.”

“There’s that cultural component that brings me back here, but there’s also that altruistic component that makes me feel like if I know how to do something and know how to do it well, that I should be doing it for my people.”

He said community impact is not limited to healthcare.

“It doesn’t have to be health care, I can stand on a soap box and feel all proud that I earned a doctorate and treating patients, and I’ve treated thousands of patients, tens of thousands,” he said. He said his work will touch a fraction of the people compared to, for example, filmmakers whose videos reach millions.

“I think all of us are motivated to make money, everybody wants to kind of earn a decent living, yeah? But I think it’s the giving part that matters,” he said.

Lefler also praised the dedication of the pediatric dental team. He described how Mary Driscoll, who works in public relations and outreach for the program, came in on her own unpaid personal time to pick up a patient who lacked transportation.

“That’s big stuff, that’s big time,” he said. “People just don’t do that. You might have a family member that does that, but it is really uncommon to have a stranger make that kind of sacrifice these days.”

He said the program succeeds because of people who care deeply about serving the community.

“It is selectively saying I’m going to completely give myself to serve this other person when it doesn’t do anything, it doesn’t have a benefit for me except to say I feel good about doing it,” he said.

“I subscribed to the idea that you had to be doing something really meaningful, like health care, to help people, and I think that is completely false. That’s not the pedestal that I stand on today. I feel my work is important, and I feel I’ve done well with it, and I’ve helped people but I don’t think it’s a calling that devalues everything else. Like Mary Driscoll… there are many ways you can help people,” he said.