The Lyon College dental school plan is a source of smiles, an inspiration to persevere in the face of access challenges

As a Lyon College alumnus, I was surprised at the college’s recent announcement of its intention to establish a dental school in Little Rock as part of a new Lyon College Institute of Health Sciences.

Do not mistake yourself. I am in no way skeptical of the courage and persistence of the institution that miraculously honed some of my very rough edges, not to mention those of my classmates. Additionally, Lyon College has been the undergraduate teaching base for many dentists in Arkansas, one of whom is my boys’ pediatric dentist.

It’s just that it was such a bold move for the college that has held a place in my memory as a quaint, residential liberal arts college nestled on a bluff at the foot of the Ozarks. I shouldn’t have been as surprised as I was, as Lyon College has adapted in response to educational needs and environmental challenges in the more than two decades since my opening ceremony.

This bold leap into post-graduate dental professional education will be no different. Arkansas has had persistent problems with access to dental care, especially in rural areas. A report released this month by the Arkansas Center for Health Improvement (ACHI) found that there were 11 counties in Arkansas that had more than 5,000 residents per active dentist in 2019. An area with a ratio of 5,000 or more residents per dentist ranks as a dental provider shortage area, according to the Federal Health Services and Resources Administration. ACHI found that two counties – Cleveland and Lafayette – had no active dentists.

A contributing factor to these access challenges has been the lack of an in-state dental school option, with students in Arkansas getting their professional dental training from out-of-state schools and then seeking out opportunities. careers elsewhere once they leave the state. An in-state dental school could mean progress on labor supply, but there are other contributing factors at play.

Cost is the biggest barrier to accessing dental care for Arkansans. According to the American Dental Association, of those who have not visited the dentist in the past 12 months, 72% of Arkansans cited cost as the reason they did not visit the dentist more frequently. This is despite the fact that 96% of Arkansans said they value oral health and 85% said they feel the need to visit the dentist twice a year.

Arkansas has successfully closed the medical insurance coverage gap over the past decade, with the percentage of the population without coverage dropping by half to about 9%. However, far fewer people have dental coverage. In fact, the ACHI report found that only 54% of Arkansans had dental insurance in 2019.

Even among those with dental insurance, only about 30% of adults and 51% of children used dental services in 2019. Routine dental care can help patients avoid dental problems that require emergency care, but 92% of patients with dental insurance who sought dental care in an emergency department had not received preventive dental care in the past 12 months.

In the face of these challenges, there are emerging opportunities to break down the artificial divide between dentistry and other fields of medicine to foster more comprehensive, high-quality care. In 2011, Dr Atul Gawande wrote about an impending transformation in medicine that would force doctors to operate less like cowboys and more like supply teams, with “diverse people actually working[ing] together to direct their specialized capabilities towards common patient goals. Some see a similar transformation of dentistry on the horizon, with the shift from disease-centered to holistic patient-centered approaches, the growth of interprofessional education and practice, and the acceleration of payment alternatives focused on accountability for health outcomes.

Medical-dental integration promises to improve patient experience and outcomes through better screening and coordination of care and the potential to reduce avoidable costs through prevention and early treatment. Collocation of medical and dental services is common at federally licensed health centers, including some in Arkansas. Many states have launched formal medical-dental integration efforts, and the Centers for Disease Control and Prevention launched a partnership in 2020 to develop a national framework for medical-dental integration.

Having a dental school in Arkansas won’t solve all of our problems, but it certainly gives us something to smile about. It should also serve as a call to redouble our efforts to address the challenges of access to dental care that we face as a state and to ensure that oral health is more commonly seen as an essential part of our overall health.

Editor’s note: Craig Wilson, JD, MPA, is the director of health policy at the Arkansas Center for Health Improvement, an independent, nonpartisan health policy center in Little Rock. The opinions expressed are those of the author.

Comments are closed.