Blog | July 13, 2018
Oral health care access issues persist in rural areas

Patients living in less populated communities frequently have too few oral health care options close to home, according to a special report in the Washington Post. The article, entitled Cavity Country, described how patients living in rural areas face limited access to oral health care:

“About 43 percent of rural Americans lack access to dental care, according to the National Rural Health Association…”

Rural residents are more likely to live in dental health professional shortage areas, which are defined as underserved communities where there aren’t enough dentists to meet population needs. In Washington, 36 of the state’s 39 counties are designated as dental shortage areas. The result is a broad swath of residents have to travel outside their community to get care, or in many cases, go without.

“The glaring need in Washington’s rural areas is the distance in which you have to travel to receive care which can be attributed to a lack of dental providers,” said Andrew Lau, an Oral Health Fellow at Arcora Foundation, founded and funded by Delta Dental of Washington. “Having Medicaid coverage isn’t enough when there simply are not enough providers.”

Limited or no access to oral health care can lead to a host of problems. Untreated decay and oral disease can develop into painful cavities, tooth loss, expensive hospital emergency department visits, declining quality of life and even more severe illnesses.

In Jefferson County, health advocates and providers are looking at new approaches to expand access in rural areas and reduce geographic disparities. Jefferson Healthcare has leveraged $1 million in funding from the state’s capital budget to add comprehensive dental services to its Rural Health Clinic (RHC). Arcora Foundation granted Jefferson Health an additional $250,000 to establish a six-chair dental clinic at the RHC aimed at treating many of Jefferson County’s 9,000 Medicaid-eligible residents.

“For too long, low-income patients in Jefferson County have struggled to find a dentist,” said Mike Glenn, Jefferson Healthcare CEO. “Funding from the state’s capital budget and Arcora Foundation will enable us to provide essential dental care for our community and reduce the number of people seeking costly emergency room care for painful dental problems.”

The $250,000 for the Jefferson Health RHC dental clinic is part of Arcora Foundation’s mission to increase oral health equity and reduce health disparities. Since 2013, Arcora has invested more than $1.2 million in the Olympic Peninsula to expand dental care access for lower-income residents.

In addition to increasing access to much-needed dental care, rural health providers and advocates also are incorporating oral health care into medical care. Though the ultimate goal is to find a dental home for all patients, said Madlen Caplow of Arcora Foundation, medical providers are integrating oral health assessments in routine checkups and are trained to perform preventive services like applying fluoride varnish and talking to patients about healthy food choices and the importance of oral hygiene.

“Oral health is tied to overall health and oral disease can be prevented,” Caplow said. “It makes sense to work with primary care medical teams, especially in underserved communities, to incorporate oral exams and basic oral health information into routine checkups.”

The Jefferson Health RHC will provide medical, dental and behavioral health care. Its dental clinic is scheduled to open early next year and is expected to serve 3,000 children and adults a year. The RHC dental clinic will focus on prevention, education, emergency care and basic restorative services.