By Anne Blythe

As North Carolina struggles to meet the oral health care needs of many of its residents, especially in rural areas, three philanthropic organizations have come together with a promise of millions of dollars over the next five years to help expand access.

The Duke Endowment and the Blue Cross and Blue Shield of North Carolina Foundation and its foundation in South Carolina announced recently that they plan to invest $35 million in initiatives and projects in the bordering states.

Health care workers have been pushing in recent years to stop the segregation of oral and overall physical health. Manifestations of autoimmune disorders, cancer, diabetes, heart disease and gastrointestinal problems often show up in the oral cavity.

A movement to “bring the mouth back into the body,” as oral health care advocates say, is important so dentistry does not stand as a separate and unequal auxiliary service that fails to reach many patients who need it.

In announcing the five-year commitment to North Carolina and South Carolina, the grant providers noted that more than 4.1 million people in the two states live in regions where access to oral health care services is inadequate.

dentists are lacking in two far eastern counties of the state, but really, dentists are concentrated where the people are: Wake, Durham, Orange and Mecklenburg counties, affecting oral health access in the state.
98 of North Carolina’s counties have dentists, but still, the statewide rate of dentists to the population is still around 5 per 10,000 people. Map, data courtesy: Sheps Center for Health Policy Research, UNC Chapel Hill

According to data from the American Dental Association, both North Carolina and South Carolina are in the bottom third of the country when it comes to the number of dentists per resident.

“Oral disease is highly preventable, yet millions living in North and South Carolina still suffer from it, affecting chronic conditions such as diabetes, cardiovascular disease, and stroke, as well as school and work attendance, health care costs, and overall quality of life,” Stacy Warren, the Duke Endowment’s program officer for health care, said in a prepared statement. “As philanthropists committed to improving health in our region, we recognize that oral health is closely tied to all aspects of well-being and an area of health where the opportunity to affect change is ripe.”

Among the programs and initiatives to be funded are:

  • The launch of school-based oral health programs in rural and underserved areas, where the children can get their teeth cleaned, get sealants painted on them to help prevent decay, and even have silver diamine fluoride applied in some cases of decay to fight further deterioration. The grant providers say that tooth decay is the most chronic disease among children and that in low-income communities many school absences correlate with children’s dental problems as they cope with pain and complications from not having had oral health care access.
  • The North Carolina Oral Health Collaborative’s effort to bring together a “diverse coalition” to explore and promote new policies and practices, grounded in research and “evidence-based solutions” to improve oral health care. 
  •  Projects and partnerships that integrate dental and medical care. The providers maintain that this ultimately could lead to the lowering of all health care costs as disease and infection are either prevented or caught and treated earlier.

Zachary Brian, director of the North Carolina Oral Health Collaborative, applauded the philanthropic effort.

“This is really a very comprehensive approach,” Brian said. “It’s definitely a huge investment that’s going to do really good things. What they’re saying is: ‘This is kind of seed money.’”

While the financial investment might make many across North and South Carolina smile, Brian and Katie Eyes, vice president for program and strategy at the Blue Cross Blue Shield Foundation of North Carolina, cautioned that other funders, providers and policymakers will have to supplement their efforts.

“Sustainable improvement in oral health will ultimately depend on changes at the policy and systems level that support more widespread impact,” Eyes said. She noted recent attempts by dentists, hygienists, researchers and others to work together to create new programs. “When health care providers, government, philanthropy, schools, consumers and others work together, we can better prevent oral disease and ensure more access to much needed oral health care.”

Disclosure: Both the Duke Endowment and the Blue Cross and Blue Shield of North Carolina Foundation provide grant funding to NC Health News. 

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Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.