Aug 8 2011
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Fourth in a Series: A Call to Action on Oral Health Care, Bringing Dentistry to Children Who Need It

On July 13, the Institute of Medicine released reports calling for expanded access to oral health care. In this post, Kris Volcheck, D.D.S., M.B.A., a 2010 Robert Wood Johnson Foundation Community Health Leader, discusses community-specific solutions to oral health care disparities. Volcheck is director of the CASS Dental Clinic for the homeless and the Murphy Kids Dental Clinic in Phoenix, Arizona. See all the posts in this series.

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Just down the street from the CASS Dental Clinic for the Homeless in Phoenix are four elementary schools, in the very impoverished Murphy school district. Although this is the urban core, it might as well be rural America. The families in these neighborhoods live on minimal incomes and don’t have transportation, making everything a long distance hike – grocery stores with fresh produce, medical centers and, not surprisingly, dentists. When basic health care is secondary to just surviving, oral health care falls by the wayside.

Last year we decided to open a dental clinic for impoverished children, as an extension of the homeless clinic we’ve had in place for more than 10 years, and in collaboration with a community funded health center already in the works. But the tough economic times meant the Murphy elementary schools we had planned to serve were unable to pay for transportation and chaperones to bring students to our clinic. And because the schools’ funding is closely tied to student performance, they were hesitant to disrupt the school day to bring children to our site.

So we refocused, and decided to bring the dental clinic straight to the children.

We now operate a portable, school-based dental clinic in the elementary schools twice a year. The Murphy Kids Dental Clinic brings oral health professionals, supplies and technology into the elementary schools to provide comprehensive dental care to children who would otherwise go without it.

The care available to underserved and vulnerable populations –in rural settings and in the middle of a city alike – lags behind those available in middle- and high-income communities. There’s a high density of dentists in high-dollar areas, but we’re scarce in the urban core.

We are fortunate that the Arizona School of Dentistry and Oral Health has a public health component in its curriculum. Its students rotate through both our homeless clinic and our children’s clinic. The exposure students get to public health in their dental school years has a huge impact on what they do once they go into practice – whether it’s pursuing a public health career, or volunteering at a clinic like ours as a private practitioner.

The Institute of Medicine’s recent report, “Improving Access to Oral Health Care for Vulnerable and Underserved Populations” drives home the important points that oral health cannot be disconnected from overall patient health, and that we have hard work ahead of us to ensure that all Americans have access to the oral health care they need.

To reach that goal, we’ll need to change our mindset. We need to hold oral health care in high esteem and educate our communities, legislators and parents so they’ll understand why oral health is important to overall health. Of course, there’s no one-size-fits-all-communities model or approach that will fix the need in every part of the country. Broad solutions won’t be found without work at the ground level. That’s why community leaders everywhere have to be fully behind the cause to find a solution that’s right for them.

Tags: Arizona (AZ) M, Dental, Early intervention, Health & Health Care Policy, Human Capital, IOM Oral Health Care Report, Medical, Nursing & Dental Workforce, Oral health, Publications, Research & Analysis, Underserved Populations, Underserved populations, Voices from the Field