Dental consortium to boost rural access to oral health care

by Vicky Cerino, UNMC public affairs | January 30, 2004

The UNMC College of Dentistry has partnered with state dental associations in Nebraska, Wyoming, Kansas, and South Dakota to form a consortium to address oral health access problems of underserved populations in rural areas. The consortium's strong interest in the oral health of their citizens prompted them to form a partnership called Target Access: Great Plains Oral Health.

Funding for the consortium was made possible by an appropriation in the 2004 Omnibus Appropriation Bill recently approved by the U.S. Congress. President George W. Bush signed the bill on Jan. 23. Congressional delegation members in Nebraska and Wyoming secured the funds, with Nebraska receiving $250,000 and Wyoming $360,000. Additional funding will be sought by Kansas and South Dakota for consortium support in their states.

Reducing disparities in oral health

The consortium will use the funds to reduce disparities in oral health care in rural areas. The goal will be to attract more students from rural areas into the field of dentistry, by beginning recruitment in high school, ultimately exposing dental students to a rural practice during their schooling, providing incentives for choosing to practice in a rural area after graduation, and retaining dentists once they're practicing in rural communities.

Consortium officials say the plan is vital in order to educate and train more oral health providers who will address the current and future needs of the underserved in rural areas of the Great Plains. The UNMC College of Dentistry is a regional resource for the three Midwestern states that have no dental school.

Partnership yields health, economic benefits

"We are grateful to our congressional delegation members for working on our behalf to secure this critical funding that will have significant health and economic benefits," said Harold M. Maurer, M.D., chancellor of UNMC. "This partnership will address health disparities in rural areas and build a foundation to ensure good oral health. It also has the potential to serve as a national model."

John Reinhardt, D.D.S., dean of the UNMC College of Dentistry, said the partnership calls on the talent and resourcefulness of each state to address the looming shortage of dentists in the Great Plains/upper Midwest.

"State dental associations in this region predict more dentists will retire in this decade and in the next, than will enter the dental workforce," Dr. Reinhardt said. "This workforce crisis is already resulting in problems with access to dental care, especially among rural populations. The disparities caused by increasing patient need and declining dental workforce is predicted to worsen. The Great Plains states have an interest in solving this problem together.

"This partnership is a great opportunity between the state dental associations and the university. It's a public/private solution to this problem. Our partnership will develop a pipeline of outstanding students who understand the challenges and opportunities of a career in dentistry and will learn the importance of giving back to the community and those less fortunate," Dr Reinhardt said.

"The regional network will allow local and state organizations to monitor the program's success in each state. It also will enhance coordination among the states to ensure the program's efficiency and success," he said.

Dental shortage areas

In Nebraska, 46 of 93 counties are considered dental shortage areas, and 16 counties are without a dentist, Dr. Reinhardt said. The dentist to population ratio is one dentist per 1,720 people -- close to the national average. However, the problem is distribution. Most dentists practice in Lincoln and Omaha.

Dr. Reinhardt said because of access problems in Nebraska, and in the three other states, many underserved populations go without oral health care or have to drive a great distance to get care. "That's not good for anyone, especially if they have to take off work and take a child out of school for the day, or have to drive more than 100 miles to take care of a dental emergency," he said.

Dentists not only play an important role in oral health care, they make significant contributions to the economic health of their states.

Partnership is "a model"

Nick Bouzis, D.D.S., president of the Wyoming Dental Association, said the consortium partnership is a model for how the country can recruit dentists to serve rural America.

"The partnership provides us with access to a world class dental education program for our students and future dentists," Dr. Bouzis said. "It holds potential for us to educate an adequate number of dentists to provide care to the citizens living in the rural and underserved areas of our state."

Of 23 large counties in Wyoming, one doesn't have a dentist and several other counties are in need of more dentists, Dr. Bouzis said.

Educating more students

The partnership also would increase the capacity to educate more students from consortium states. The UNMC College of Dentistry, which began more than 100 years ago, provides doctor of dental surgery programs for many states that don't have dental schools, including Wyoming, Kansas and South Dakota. Currently, about two-thirds of dental students at UNMC are Nebraskans and most of the remaining students hail from states with no dental schools, Dr. Reinhardt said. About 82 percent of the dentists in rural Nebraska are graduates of the college.

COD's reputation for excellence

The college has a long-standing reputation for excellence. For the past seven of 10 years, the UNMC class of incoming freshman had the highest grade point average among the 55 dental schools in the nation. For six consecutive years, UNMC dental students have scored among the top 10 schools in the nation on national board examinations that test their clinical knowledge and skills.