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Oral Health in Rural Communities Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

Effective Examples

funded by the Federal Office of Rural Health Policy Regional Oral Health Pathways
Updated/reviewed September 2017
  • Need: To address the oral health needs of low-income uninsured and underinsured residents in rural Appalachia.
  • Intervention: An oral health education program was implemented in Appalachian Maryland, Pennsylvania, and West Virginia.
  • Results: This program has increased oral health visits in the area and has provided residents with valuable information on oral health resources and services.
Calhoun County Community Dental Access Initiative
Updated/reviewed August 2016
  • Need: Poor and uninsured residents of Calhoun County, Michigan were in need of dental services but lacked the funds to pay on their own.
  • Intervention: The Community Dental Access Initiative created a "pay it forward" dental program where patients volunteered in their community in exchange for dental services and oral health education.
  • Results: Treatment worth nearly $1,100,000 has been provided to residents, the community has seen a decrease in dental-related emergency room visits, and over 98,000 volunteer community service hours have been provided by patients.

Promising Examples

funded by the Federal Office of Rural Health Policy School-Based Health Center Dental Outreach
Updated/reviewed January 2018
  • Need: To improve the oral health of children ages 3 to 13 living in underserved rural areas of Louisiana.
  • Intervention: Students enrolled in school-based health centers receive oral health assessments, fluoride varnishes, and dental referrals as part of a comprehensive physical exam by nurse practitioners.
  • Results: Results from the two most recent grant periods (2015-2016 and 2016-2017) included: 4,000 oral health exams, over 3,000 fluoride varnish applications, and 1500 dental referrals; the last great year seeing 68% of referrals completed, an 11% increase over the prior year.
funded by the Federal Office of Rural Health Policy Healthy Smiles: Early Childhood Dental Outreach
Updated/reviewed October 2017
  • Need: To decrease the number of children entering kindergarten with untreated tooth decay in the rural Appalachian counties of Rutherford, Polk, and McDowell in western North Carolina.
  • Intervention: A program to give children a dental home that included screenings, targeted outreach, and restorative services.
  • Results: An overall decrease within the service area of children entering kindergarten with sub-par oral health.
funded by the Federal Office of Rural Health Policy Northern Dental Access Center Patient Support and Outreach Program
Updated/reviewed October 2017
  • Need: To connect low-income people in rural northwest Minnesota to dental care and support services in order to address barriers to care.
  • Intervention: Partners work together to provide patient transportation, care coordination, and insurance navigation and enrollment.
  • Results: Patients accessing support services are more likely to complete dental treatment. Over 1,000 people a year have been assisted with Medicaid enrollment, and reported use of the emergency department for dental pain has been reduced.

Other Project Examples

funded by the Federal Office of Rural Health Policy Something to Smile About: Preventive Dental Care for Garrett County
Updated/reviewed July 2018
  • Need: In rural Garrett County, Maryland, a 1998 community survey found that 41% of kindergarten students had untreated dental decay, and many dentists in the area were not willing to see patients with medical assistance or state health insurance plans.
  • Intervention: In 1999, the Garrett County Health Department started the Something to Smile About program to improve access to dental care and help dentists negotiate higher reimbursement rates from managed care organizations.
  • Results: The program established a community dental clinic, provided care to thousands of individuals, and negotiated 30% higher rates for dental service reimbursement.
funded by the Health Resources Services Administration Cavity Free at Three
Updated/reviewed June 2018
  • Need: Nearly 40% of Colorado children have experienced dental decay by the time they reach kindergarten. With several frontier and rural counties in Colorado considered dental deserts, options for oral healthcare are limited.
  • Intervention: Cavity Free at Three (CF3) works to improve access to preventive oral health for pregnant women and young children. While CF3 is a statewide effort, 87% of the program's target counties are considered rural or frontier.
  • Results: Since its start in 2007, CF3 has trained 4,938 professionals in performing preventive dental health. The percentage of children who received dental care before their first birthday rose from 3.1% in 2010 to 9.5% in 2017.
Smiles of HOPE
Updated/reviewed June 2018
  • Need: To provide affordable exams and tooth extractions to adults unable to afford traditional dental care.
  • Intervention: Smiles of HOPE, a faith-based charity clinic inside Lighthouse Church in Dexter, Missouri, provides reduced-cost tooth extractions for residents in need.
  • Results: Over 3,000 patients in the region have had over 9,000 painful or infected teeth pulled, collectively saving them over $3 million in dental care costs.
Disabled Adults Oral Health Initiative
Added March 2018
  • Need: To help rural Maryland adults with disabilities learn more about oral health and access care.
  • Intervention: Health Right community health workers give educational presentations at agencies serving those with disabilities.
  • Results: From March 2014 to February 2016, educational presentations reached 1,084 adults with disabilities and 344 staff and caregivers, and 256 people received dental treatment.
funded by the Federal Office of Rural Health Policy Floyd County Dental Clinic
Updated/reviewed March 2018
  • Need: Lack of dental healthcare access for rural northwest Georgians with lower incomes/no insurance.
  • Intervention: A dental clinic accepting Medicaid, PeachCare (Georgia's low income child health insurance program), and private pay started through collaboration of a local medical center, dental college, and county health department.
  • Results: From 2015 through current June 2017 totals, the Floyd Dental Clinic provided quality oral healthcare to nearly 6000 low-income patients.
Delta Dental Mobile Program
Updated/reviewed January 2018
  • Need: Lack of access to oral healthcare for children from limited-income families in the rural and urban areas of South Dakota.
  • Intervention: Delta Dental of South Dakota launched the Delta Dental Mobile Program in 2004 to expand access to oral healthcare services to children throughout the rural state.
  • Results: The Delta Dental Mobile Program has provided over $19.4 million in dental care to more than 48,000 South Dakota children.
funded by the Federal Office of Rural Health Policy Miles for Smiles Mobile Dental Unit
Updated/reviewed December 2017
  • Need: Dental care access for children in low-income families living in a 7-county region of southwest Missouri.
  • Intervention: A mobile dental unit was created to expand dental care access.
  • Results: The Miles for Smiles mobile dental clinic provides comprehensive dental care to children throughout the 7-county region
Capitol Dental Care's Virtual Dental Homes
Added November 2017
  • Need: Dentists in Polk County, Oregon who accepted Oregon Health Plan were booked out for months, causing patients with dental needs to have to wait for an appointment or travel to an adjoining county for dental care.
  • Intervention: Capitol Dental Care began a Virtual Dental Home teledentistry model to bring preventive dental care to 3 elementary schools and several Head Start programs.
  • Results: Through this program, over 700 students have received dental care in their schools.
Smiles for Life
Updated/reviewed November 2017
  • Need: Oral healthcare for low-income adults and children unable to obtain dental care in the Mid-Ohio Valley of West Virginia.
  • Intervention: Public health dental hygienists act as gatekeepers, screening low-income clients and placing them with area dental providers who volunteer, from their private practices, to provide most-needed dental treatment.
  • Results: Reduces the number of emergency department visits for dental pain and infections and provides a safety net for those unable to afford dental treatment.
funded by the Federal Office of Rural Health Policy Northern Dental Access Center Medical-Legal Partnership
Updated/reviewed October 2017
  • Need: To help low-income patients in rural Minnesota overcome legal barriers to oral healthcare and self-sufficiency.
  • Intervention: The medical-legal partnership of Northern Dental Access Center and Legal Services of Northwest Minnesota provides free consultations and support services.
  • Results: The innovative and collaborative approach has been recognized regionally and nationally, and over 9,000 new patients have been screened for legal issues.
funded by the Health Resources Services Administration Regional Initiatives in Dental Education (RIDE)
Updated/reviewed August 2017
  • Need: Address oral health disparities in Washington’s rural and underserved communities.
  • Intervention: The University of Washington School of Dentistry developed the Regional Initiatives in Dental Education (RIDE) program preparing dentists for practice in rural and underserved areas.
  • Results: Since the first graduating cohort in 2012, more than 70% of RIDE graduates are practicing in rural and underserved areas.
funded by the Federal Office of Rural Health Policy Oral Health Outreach Program
Updated/reviewed July 2017
  • Need: Tooth decay is the most common chronic disease among children in the United States.
  • Intervention: The Eastern Shore Area Health Education Center provides Oral Health education through the “Tooth Fairy's Helper” to elementary-aged children along the Eastern Shore of Maryland.
  • Results: Over 27,000 children have received oral health education through presentations in schools since 2006.
funded by the Health Resources Services Administration MORE Care
Added June 2017
  • Need: To improve rural residents' oral healthcare.
  • Intervention: MORE Care creates interprofessional oral health networks to 1) better integrate oral health into primary healthcare and 2) coordinate oral health between primary and dental healthcare.
  • Results: Operating in 3 states, MORE Care has led to increases in fluoride varnish administration, improvement in interprofessional communication, and patients' improved self-management of their daily oral health.
Sanford Canby Dental Clinic
Updated/reviewed February 2017
  • Need: To replace a dental practice in rural Minnesota for local and regional residents.
  • Intervention: The Sanford Canby Medical Center started a new dental practice when the private dental practice closed.
  • Results: Quality dental care is available for Canby residents, keeping business dollars local and reducing absenteeism at work due to long commutes for dental care.
funded by the Federal Office of Rural Health Policy West Central Dental Clinic
Updated/reviewed July 2016
  • Need: The West Central District Health Department discovered unmet dental care needs for low-income residents.
  • Intervention: A dental clinic was formed to serve low-income residents in the rural areas of Lincoln, Logan, and McPherson counties in Nebraska.
  • Results: The permanent clinic opened in 2006 and has served 24,000 patients as of 2016.

Last Updated: 7/6/2018