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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 Pathway
Updated/reviewed August 2019
  • 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.

Promising Examples

funded by the Federal Office of Rural Health Policy Healthy Smiles: Early Childhood Dental Outreach
Updated/reviewed October 2019
  • 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 School-Based Health Center Dental Outreach
Updated/reviewed July 2019
  • Need: To improve the oral health status of children ages 3 to 17 living in underserved rural areas of Louisiana.
  • Intervention: School-based nurse practitioners perform oral health assessments, apply fluoride varnishes when indicated, and make dental referrals, with completion rates of the latter tracked by dental case managers.
  • Results: Significant numbers of school children are receiving oral health examinations, fluoride varnish applications, and receiving care coordination to improve numbers of completed dental appointments.
funded by the Federal Office of Rural Health Policy Northern Dental Access Center Patient Support and Outreach Program
Updated/reviewed January 2019
  • 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

Smiles for Life
Updated/reviewed November 2019
  • 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 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 Oral Health Outreach Program
Updated/reviewed October 2019
  • 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 35,000 children have received oral health education through presentations in schools since 2006.
funded by the Health Resources Services Administration MORE Care
Updated/reviewed July 2019
  • 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: MORE Care has led to increases in fluoride varnish administration, improvement in interprofessional communication, and patients' improved self-management of their daily oral health.
funded by the Federal Office of Rural Health Policy Something to Smile About: Preventive Dental Care for Garrett County
Updated/reviewed July 2019
  • 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 Federal Office of Rural Health Policy Delta Dental/Head Start Early Childhood Caries Prevention Project
Added May 2019
  • Need: To provide dental care to Head Start children on South Dakota reservations.
  • Intervention: The Early Childhood Caries (ECC) Prevention Project brings dental hygienists to tribal Head Start programs to provide dental care to children and oral health education to parents.
  • Results: In three years, 1,133 children and their parents completed an ECC visit. An additional 2,780 children received preventive care.
Disabled Adults Oral Health Initiative
Updated/reviewed April 2019
  • Need: To help rural Maryland adults with disabilities learn more about oral health and access care.
  • Intervention: Health Right community health workers gave 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.
Delta Dental Mobile Program
Updated/reviewed February 2019
  • 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 $26 million in dental care to more than 52,000 South Dakota children.
funded by the Federal Office of Rural Health Policy Northern Dental Access Center Medical-Legal Partnership
Updated/reviewed January 2019
  • 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.
Capitol Dental Care's Virtual Dental Homes
Updated/reviewed November 2018
  • 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.
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: CF3 has trained over 5,000 medical and dental 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.
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
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.

Last Updated: 11/1/2019