Earlier this year, researchers at Albany’s Center for Health Workforce Studies shared a shocking report on the availability of dental care in rural Kentucky. “In 24 of the 120 counties, mostly in eastern and western Kentucky, there were fewer than 1.7 dentists per 10,000 population. There was no dentist in four counties, only one dentist in 13 counties and only two dentists in 12 counties.” Sadly, many rural states across America share statistics like these. Rural towns in Arizona, Kentucky, and Wisconsin have been in the spotlight for dental programs that bring dentists to Americans who have lacked proper care for decades. For these people, regularly seeing a dentist is a luxury that they cannot afford or have no access to. What is being done to improve dental care in rural America?

 

Rural Wisconsin Dental Clinics

NPR shared Jessica Stefanik’s story with the world this month. Jessica is a young mom of 3 living in Mosinee, Wisconsin. She’s lived with the pain of decaying teeth for years and as such has lost most of her upper teeth. Jessica is not alone in this, so many other Americans lack proper dental care. “A study by the Federal Reserve found that a quarter of Americans went without dental care they needed in 2014 because they couldn’t afford it.” Even though Wisconsin’s comprehensive dental benefit through Medicaid is considered one of the best in America, most dentists deny Medicaid patients of care. Low reimbursement rates for the care they provide displeases rural dentists. When the few dentists per capita refuse Medicaid patients like Jessica, those people have nowhere to go. As a result,  Jessica’s teeth deteriorated to a point where she was unable to brush them or eat solid foods. That was until she visited Marshfield Clinic, a place that offers dental care to anyone, regardless of how much they, or their insurance, can pay. Dentists at Marshfield Clinic fitted Jessica for upper dentures. They restored her smile, and she no longer suffered from the pain of rotting teeth.

 

Greg Nycz opened the clinic 12 years ago. “He saw people in pain with broken and missing teeth all the time. And he got calls from desperate people looking for help. One from a young mother haunts him to this day.” Greg is one of many pioneers of dental clinics that have sprung up in rural areas across the country. His 10 clinics in Wisconsin employs 45 dentists, 3 oral surgeons, and 41 hygienists. They are able to serve 60,000 patients a year.

 

Rural Wisconsin Dental Clinics

 

 

School-Wide Tooth Sealant Programs in Kentucky

Just as in rural Wisconsin, rural dwellers in Kentucky are often left behind when it comes to dental care. Dentists are hard to come by and when they are available, many people cannot afford the costs of care. “In 2014, only half of Kentucky’s 22 federally qualified health centers provided dental services directly to patients, with most dental services provided by private practice dentists. And while the report found that about 40 percent of general dentists in the state provided at least one oral health service to a Medicaid patient, most of them do not participate in a ‘meaningful’ way.” The state of Kentucky has been working to increase the number of citizens who has reasonable access to dental care. Medicaid expanded to include dental benefits, programs were initiated to encourage dentists to practice in rural areas, and fluoride was introduced to community water sources to control cavities.  Additionally, The Healthy People 2010 Sealant goal seeks to bring tooth-sealant programs to Kentucky schools. “School based sealant programs are proven to reduce cavities by 60 percent over five years.” These statewide initiatives, paired with local initiatives, are improving the quality of life for many Kentuckians.

 

 

School-Wide Tooth Sealant Programs in Kentucky

Mobile Dental Programs in Arizona

Children in Pima County, Arizona aren’t taken out of class for dental appointments across town. Instead, they leave class and walk to the mobile dental clinic parked outside the building. This mobile dental program outfits RVs as traveling dental offices. The RV remodel includes a full dentist’s office, 2 exam rooms, an x-ray room, and a patient waiting area. Fully funded by local grants, dental staff members see children with and without dental insurance. “‘These children simply have no other way to get dental treatment done,’ [the dental director for United Community Health Center] said. “We all think that dental treatment isn’t as important as some other kinds of health care, but what we know now is that the infection in the mouth can (spread to the) rest of the body … If that becomes a load of bacteria in the bloodstream, it can be fatal and has been.”

 

To prevent infection and tooth decay, these children return as many times as required for complete treatment. They are also educated on proper dental habits and routines. “At the end of the visit, kids get a goodie bag with a toothbrush, toothpaste, floss and a timer to help kids ensure they spend enough time brushing their teeth.”

 

People all across the country are beginning to receive the standard level of dental care many of us have become accustomed to. Though Texas ranks low in overall dentists per capita, access to board-certified dentists in the greater Houston area is superb. We are lucky to be served by many dental professionals who care for us and our children. As we read about dental advances in rural America, let us not forget to schedule appointments to take care of our pearly whites!