Collaboration Sought to Address Rural Disparities in Oral Healthcare

Dentistry Today


As residents of rural communities continue to face challenges in accessing oral healthcare, the nonprofit DentaQuest Institute has issued a white paper outlining the findings of its multi-year Medical Oral Expanded Care (MORE Care) Initiative, which establishes interprofessional oral health networks (IPOHNs) to integrate and coordinate person-centered oral healthcare in these communities. MORE Care seeks to address oral and overall health disparities through cross-collaboration and coordination between primary care and dental teams. 

“Not only are there fewer dentists in rural communities, but both children and adults often disproportionately experience poor dental health or unmet needs in these regions,” said Sean Boynes, DMD, co-author and director of interprofessional practice at the DentaQuest Institute. “By sharing this learning collaborative’s best practices, challenges, and innovative ideas, we hope to show other rural health clinics, state offices of rural health, and rural healthcare systems that they can effectively bring together previously siloed sectors of care.” 

MORE Care was launched in South Carolina in 2015 through a partnership with the South Carolina Office of Rural Health and the Medical University of South Carolina. In the initiative, primary care teams learn strategies and skills to integrate oral health services such as evaluations, risk screenings, pediatric fluoride applications, and self-management goal development into their practices as well as to implement quality improvement efforts and measure their impact. 

At the same time, the initiative develops relationships and formalizes referral networks with dental care providers. To bolster ongoing, effective partnerships, primary and dental care teams also perform cooperative tasks, such as implementing a bi-directional referral system for managing systemic diseases, improving communication, and identifying areas of clinical and operational overlap.

 “As we strive to improve coordination across healthcare, we recognize that rural health providers and organizations are making these efforts in environments with unique sets of challenges and experiences,” said Alan Morgan, MPA, CEO of the National Rural Health Association and MORE Care advisory council member.

“MORE Care is an important example of a rural health-specific approach to achieving the Quadruple Aim (improving population health, increasing patient satisfaction, reducing per-capital healthcare spending, and addressing clinician and staff satisfaction), and it allows rural health leaders to work together and share insights that can ultimately better the health of their communities,” Morgan said.  

MORE Care is now in phase 2 with additional partnerships with the Colorado Rural Health Center and the Pennsylvania Office of Rural Health. Across 3 states, 21 primary care team sites and 15 dental care partners participate in the initiative. The white paper gives an overview of oral health’s connection to and impact on systemic well-being; details on the MORE Care project; key factors, challenges, and opportunities for rural oral health interprofessional care as identified by MORE Care participants; and innovative ideas from each state, among other topics.

“With oral and overall health intrinsically linked, truly improving a person’s and community’s well-being requires us to structure healthcare delivery to promote preventive care, improve disease management, and connect providers together so patients are at the center,” said Teryl Eisinger, MA, executive director of the National Organization of State Offices of Rural Health and MORE Care advisory council member. “Rural health organizations, providers, and stakeholders have the chance to lead in creating viable IPOHNs, and the information in the MORE Care white paper is a critical step in that direction.”

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