Oral Health

The Kate B. Reynolds Charitable Trust's Poor & Needy Division is dedicated to improving the lives of Forsyth County’s most financially disadvantaged. Limited access to quality oral health care is a priority among the needs of these families and individuals.

Forsyth County is home to two low- or no-cost dental clinics, but even so, thousands of local residents cannot afford basic oral health care, including routine dental cleanings and checkups, which can result in costly visits to hospital emergency departments due to severe pain and untreated infections.

While lack of health insurance is a problem in Forsyth County (approximately 56,000 adults and children are uninsured in the community according to the North Carolina Institute of Medicine), lack of dental insurance is even more profound. As a result, financially disadvantaged adults often go without dental insurance, forgoing regular cleanings and checkups, and only seeking dental care for emergencies at a high cost.

The disparities among the dental health of children are significant. According to the 2011 North Carolina Annual Report,slightly more than half of children enrolled in Medicaid did not have a dental visit that year and 21 percent had untreated dental disease. Kindergarteners in Forsyth County have a significantly higher percentage of untreated dental disease than children in the state as a whole.

When oral health status of Forsyth County residents is evaluated based on ethnicity, regardless of insurance coverage, minority children are twice as likely as white children to show incidences of prior dental disease and untreated decay.

Lack of regular oral health care has serious consequences, including increased risk of respiratory disease, cardiovascular disease and diabetes, as well as inappropriate and expensive use of hospital emergency departments for preventable dental diseases.

"Poor oral health has an impact on people’s overall well-being. One of the symptoms is pain. We know in children that dental pain is one of the primary reasons they miss school. Adults with pain miss work and can’t care for their families, diminishing their quality of life,” said Sara Quandt, Ph.D., Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine and volunteer coordinator for the November 2014 free dental clinic.

To address this pressing health challenge, the Kate B. Reynolds Charitable Trust is supporting both short- and long-term efforts to increase access to oral health care. Investments have included support for a massive, two-day free dental clinic, which served 850 patients, as well as support for a low- or no-cost dental clinic. These investments to date total more than $1 million.

"Finding dental care can change your life, make you more productive. It’s hard to not feel confident because of your smile. But healthy teeth don’t just make you feel better about yourself. Healthy teeth mean you are better, from a medical point of view,” said Joe Crocker, director of the Trust’s Poor & Needy Division.

Last year, the Trust served as the principle funder of Forsyth County’s first-ever North Carolina Missions of Mercy (MOM) free dental clinic on November 14 and 15 in Winston-Salem. The dental clinic involved hundreds of volunteers, dozens of local nonprofit organizations and businesses, and more than 300 dentists, dental assistants and hygienists. Nearly 1,000 people arrived to see a dentist, and more than 850 clinic attendees received treatments ranging from simple cleanings to much-needed extractions.

The MOM portable free dental program is an outreach program of the North Carolina Dental Society and is sponsored by the North Carolina Dental Health Fund, which organizes more than a dozen clinics statewide each year.

Leticia Moctezuma, 37, and her husband Paulino Hernandez, 39, were among those who braved long lines to receive free dental care. While Paulino had visited a dentist many years ago, the clinic marked Leticia’s first time in a dentist’s chair.

"I read about the free clinic in the local newspaper and decided then and there that we would go,” said Leticia Moctezuma. “I’ve never even had a cleaning before. It’s so expensive. At the clinic I received an X-ray and a cleaning and the dentists found some problems with my teeth. The people there referred me to the free clinic and I’ll be going there soon to have more work done. I’m so grateful we had the opportunity to see a dentist. Already I feel more confident when I meet people and speak with them.”

"Our teeth are part of our bodies and we need to take care of them,” added Paulino Hernandez. “But for us visiting a dentist isn’t a simple choice. Of course I’d like to go once a year, but we simply cannot afford it.”

Additional MOM clinic funders included the Reynolds American Foundation, Winston-Salem Foundation, NC 2nd District Dental Society, and Forsyth County Dental Society. The City of Winston-Salem provided use of the Education Building at a reduced fee. A number of local restaurants and organizations donated food and beverages for attendees and volunteers.

"As a dentist, I know that a two-day free dental clinic won’t solve the issue of people’s lack of access to dental care, but we’re making a difference. The dentists who work at each MOM clinic are committed to helping people,” said Dr. Tony Porter, NC MOM clinic lead organizer. “The clinic helps people in need, but it also highlights the problem so state leaders and policymakers, as well as the media, understand that the lack of access to dental care is a serious and significant health problem that must be addressed.”

Planning is underway for a second Forsyth County MOM clinic later this year.

While the two-day MOM clinic addressed many of the most urgent oral health needs of Forsyth County’s financially disadvantaged, local leaders working in the community, as well as the Trust, recognize the ongoing need to improve access to oral health care services.

"During an average week, Crisis Control Ministry receives at least one call from someone in terrible pain due to neglected oral health. But we’re not a clinic. We operate a low- and no-cost pharmacy, so I refer people to places where they can access care. However, the need is great and Forsyth County must find a more sustainable way to address this serious health challenge,” said Margaret Elliott, executive director of Crisis Control Ministry.

Over the last 18 months, the Trust bolstered a locally led effort, the Forsyth County Dental Collaborative, which includes nonprofit organizations, oral health providers, hospitals, churches, and local leaders committed to systemically addressing the dearth of access to dental care for low-income families and individuals. The Collaborative, which held monthly meetings, introduced the idea of a local low- and no-cost dental clinic with regular hours and salaried staff.

Operated by the Forsyth County Department of Public Health, the Cleveland Avenue Dental Clinic generates more than 5,000 visits annually but was at risk of closing last year because of budget shortfalls. With support from the Dental Collaborative and a new two-year grant from the Trust, the clinic has hired a new dental director, stabilized operations and began seeing more patients.

The clinic is open to anyone, but its target population is those with income at or below 200 percent of the federal poverty level. The clinic sees patients of all ages, but most are adults. Clinic leaders hope to introduce a portable clinic program next year to reach more children.

The clinic also recently partnered with Forsyth Technical Community College, allowing second-year dental hygiene students to assist at the clinic.

"When it comes to critical issues such as the lack of access to oral health care, Kate B. Reynolds isn’t afraid to collaborate to come up with the best way to address it,” said Joe Crocker. “We support community-driven initiatives and help provide funding and leadership to bring the right people together to have a conversation and make things happen.”

Although the conversation is in its early stages, with input from Forsyth County leaders and dental professionals, the Kate B. Reynolds Charitable Trust is confident that by working as a team, the community will find ways to address the most pressing dental health needs of County residents today and in the future.