Rice Regional Dental Clinic in Willmar, Minn., fills need for oral health services
WILLMAR -- As the Rice Regional Dental Clinic approaches its five-year anniversary next month, officials say it is living up to its promise of improving rural access to dental care and training a future generation of dental professionals.
The program, a partnership between Rice Memorial Hospital and the University of Minnesota School of Dentistry, may be "the most successful example" of statewide outreach efforts by the School of Dentistry, said Dr. Leon Assael, dean of the dentistry school.
"We're committed to this program," he said. "This is an essential part of who we are and what we do."
But officials say long-term sustainable funding will be among the most critical challenges for the future.
Since first opening its doors in December 2007, the dental clinic, housed on the third floor of Rice Memorial Hospital, has provided affordable dental care to thousands of underserved rural residents while also serving as a hands-on training site for dentistry and dental hygiene students at the University of Minnesota.
One of the most critical unmet health needs in the U.S. is for oral health, Assael said. An estimated 48.6 million Americans lack health insurance but the number of those without dental insurance is more than three times as large -- some 170 million, he said.
For these individuals, the cost of dental care comes entirely out of pocket, he said. "That is a big problem for working poor."
Many may receive dental checkups either infrequently or not at all. The largest burden is borne by elementary-age children, a population that is the most underserved and for whom dental decay is one of the most prevalent health problems, Assael said.
Added to this is an overall shortage of dental professionals, especially in rural and inner-city neighborhoods, he said. "Having dental insurance does not equal access of care."
It's these two issues -- underserved populations and the dental workforce -- that the university is addressing with its outreach and rural training.
The Rice Regional Dental Clinic is believed to be the first such program in the U.S. that is hospital-based.
Local and university officials say patient volume has been far beyond what anyone anticipated. In the first few months after the clinic opened, demand was so high that appointments for new patients were temporarily suspended while the staff caught up.
"Frankly the volume has outpaced our expectations," said Mike Schramm, chief executive of Rice Hospital.
Of all the School of Dentistry's outreach programs, the clinic at Rice covers the largest area, said Jeff Ogden, the school's chief administrative officer.
Patients come from 17 counties in southwestern and west central Minnesota, he said. "In fact the geographic reach has surprised us."
Long-term data will help assess the extent to which the program is changing oral health outcomes in the region, university officials said.
They're also starting to collect data on how rural training at the Rice Regional Dental Clinic and other School of Dentistry rural sites are influencing where dentistry graduates choose to practice.
Multiple studies have demonstrated that when students in the health professions are exposed to rural practice during their training, they're more likely to end up in a rural community after graduation.
Schramm said feedback from the dental students who train in Willmar has been consistently positive. "There's been a lot of success," he said.
The largest challenge ahead may lie in sustaining the Rice Regional Dental Clinic as a viable business model. Although the clinic receives a steady stream of revenue for services provided to patients, it also relies on state and nonprofit foundation support, plus a subsidy from Rice Memorial Hospital which owns the facility.
It's currently running close to capacity and the staff has worked hard at efficiency measures such as holding down the rate of no-show patients, Schramm said.
But some form of grant support will likely always be necessary, he said. "Long-term sustainability and diversification of funding sources is going to be important. We can't afford to continue to subsidize this."
Assael thinks the nonprofit support will be there. "The first piece of it is we have to have a good story to tell," he said.