Solving crisis of oral health in rural S.C.

The DentaQuest Institute is part of an initiative to improve oral health in rural South Carolina. (Photo provided)

By Sean Boynes, Amy Martin

and Melinda A. Merrell

Five times more common than asthma, tooth decay is the most common chronic disease for children and is almost completely preventable.

In a world where we are faced with a growing number of health care conditions and rising costs, we cannot afford to ignore the simple, preventive measures we could take to improve the lives of approximately one in five children who have untreated tooth decay. And, recent studies are showing — more and more — the link between oral health and overall health.

Here in South Carolina — like many other states across the country — both children’s and adults’ overall health is further complicated by lack of access to regular dental care. This disparity is especially present for those who live in rural areas, which accounts for about 34 percent of our state’s population.

In the United States, there are more than 24.5 million people who live in dental health professional shortage areas, where there is only one dentist for every 5,000 people.

In South Carolina, there are nearly 80 of these areas, which often are in rural communities.

This disparity is making a measured impact on our state’s oral health across all ages, but particularly with children. As an example, while the 2013 South Carolina Oral Health Needs Assessment demonstrated improvements across baseline measures like untreated decay and treatment urgency needs, disparities between rural and urban communities remained pronounced.

Unfortunately, this issue doesn’t have an easy fix — we cannot simply place dental residents in rural communities.

So we formed a coalition of 10 state partners and vowed to address this issue head on.

Thanks to the tireless work of this coalition, we were able to develop and pilot a crucial addition to our rural health care system — the MORE Care (Medical Oral Expanded Care) Collaborative — over the past year.

Contributing to our efforts was the award of an oral heath workforce grant to the Medical University of South Carolina’s College of Dental Medicine from the Health Resources and Services Administration for Rural Oral Health Advancements in Delivery Systems.

Using the existing backbone of the health care system in rural communities, this program helps empower primary care doctors to identify, screen, monitor and find access to treatment for many dental conditions.

Because we know primary care doctors are already overextended, we worked hard to find ways to seamlessly integrate oral health best practices into primary care doctors’ daily routines with patients.

MORE Care also helps connect people living in rural South Carolina with a “dental home.”

In an often-fragmented health system, a dental home is critical as both a source of care, and to educate parents and kids about the importance of oral health.

At the same time, the program provides doctors with best practices and management improvements, allowing us to strengthen their positions as leaders in communities across our state.

The partnerships we established are helping to build a program that meets the needs of each community, and reflects the experience of living and providing care in rural South Carolina.

As we mark the end of our first year, MORE Care is slated to impact approximately 10,000 children across the state through oral health care.

In just one year, preliminary data look very promising and show a direct effect on the rural communities involved in the initiative.

And we recently launched a second pilot program in Colorado, bringing dental services to those who need it most.

Americans’ health should not suffer because they live in rural areas. While the debate over how to address health disparities continues, perhaps one of our strongest tactics is sharing our collective knowledge as health care professionals and our passion for our local communities to empower the front lines and make rural care the new health care model, not the last frontier.

Dr. Sean Boynes is director of Interprofessional Practice at the DentaQuest Institute. Dr. Amy Martin is director and associate professor at the James B. Edwards College of Dental Medicine at MUSC. Melinda A. Merrell is senior program director at the S.C. Office of Rural Health.