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“ You are not healthy ……… unless you have good oral health” C. Everett Koop

East Carolina University School of Dental Medicine JACKSON COUNTY ROTARY MEETING THURSDAY 7 February, 2013. “ You are not healthy ……… unless you have good oral health” C. Everett Koop Former U.S. Surgeon . The Challenge.

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“ You are not healthy ……… unless you have good oral health” C. Everett Koop

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  1. East Carolina UniversitySchool of Dental MedicineJACKSON COUNTY ROTARY MEETINGTHURSDAY 7 February, 2013

  2. “ You are not healthy ……… unless you have good oral health” C. Everett Koop Former U.S. Surgeon

  3. The Challenge • Dental caries remains the most common chronic disease of childhood • Almost 40% of children in NC have already had decay in primary teeth when they start school • Individuals with lower income and fewer years of education are more likely to have had teeth removed because of tooth decay or gum disease

  4. NC Demographics • NC is the 10th largest state (about 9.5M) • NC is the 5th fastest growing state • NC will be the 7th largest state by 2030 • - Population will be 12.4M – a growth rate of 52% • Population: 50/50 Rural-Urban split

  5. RURAL AND URBAN COUNTIESNorth Carolina North Carolina Rural Economic Development Center, Inc. ArcGIS 9 ESRI Data & Maps

  6. Dental Workforce *Source: North Carolina Health Professions Data System, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, with data derived from the respective licensing board, 2010.(Includes those who are licensed and active within the profession as well as those with unknown activity status; inactive are excluded.) • In 2010 there were 4,178 dentists • NC ranks 47th in the number of dentists to 10K population • 28 Counties where 2 or fewer dentists serve as many as 10,000 population…….. including 4 counties, all in eastern NC, that have no dentist • About 1/3 of the dentists practicing today are 55 years of age and older • Does not reflect the diversity of the State

  7. Dental Demographics Dentists per 10,000 Population US Average6.0 NC Average4.4 4.9 Metropolitan 3.1 Non-Metropolitan

  8. Counties with NO dentists (4) Counties with 1 or less dentists/10K (3) Counties with 2 or less dentists/10K (21) NC Counties with < 2 Dentists/10K Population, 2010 CAM- DEN ALLE- GHANY CURRITUCK ASHE GATES NORTH- AMPTON WARREN SURRY HERT- FORD STOKES GRAN- VILLE ROCKING- HAM PASQUO- TANK CASWELL VANCE PER- QUIMANS PERSON HALIFAX WATAUGA WILKES CHO- WAN YADKIN ORANGE BERTIE FORSYTH MITCHELL GUILFORD FRANKLIN AVERY ALA- MANCE CALDWELL YAN- CEY ALEX- ANDER EDGE- COMBE DURHAM NASH DAVIE WASH- INGTON MADISON DAVID- SON MARTIN DARE IREDELL TYRRELL WAKE BURKE WILSON BUN- COMBE RANDOLPH HAY- WOOD CATAWBA MCDOWELL CHATHAM PITT BEAU- FORT ROWAN SWAIN HYDE JOHNSTON RUTHER- FORD LINCOLN GREENE HENDER- SON LEE GRAHAM CABARRUS JACK- SON WAYNE CLEVE- LAND GASTON MONT- GOMERY HARNETT TRAN- SYLVANIA MOORE LENOIR STANLY POLK MACON CHEROKEE CRAVEN PAM- LICO MECKLEN- BURG CLAY CUMBER- LAND JONES SAMPSON RICH- MOND HOKE UNION ANSON DUPLIN SCOT- LAND CARTERET ONSLOW ROBESON BLADEN PENDER NEW HANOVER COLUMBUS BRUNSWICK Source: UNC Sheps Center; 2010

  9. Dental Workforceis “Graying” • Over 42% of NC dentists are 50 or older • 31% are 55 or older • The average age of all NC dentists is 47.4 years. • Average age in metropolitan counties is 46.7 years • Average age in non-metropolitan counties is 49.9 years • Female dentists in NC (22%) are 10.5 years younger than male dentists, on average. The Dentist Workforce in North Carolina; UNC The Cecil G. Sheps Center for Health Service Research; January 2009

  10. North Carolina’s Dental Workforce Bottom Line: Shortage and Maldistribution

  11. “The ECU Model” • Primary Care • Increasing Access: educating/providing care • Traditional Values: education/service/research • Facilities: • Greenville • Approximately 188K sq. ft. - three floors initially outfitted (fourth floor – shelled-in space) • Community Service Learning Centers (10) • Across the state in rural/underserved communities • Curriculum/Use of technology • All students from NC

  12. Community Service Learning Centers:“The ECU Model” Community-based, economically sustainable dental practices of the School of Dental Medicine where students will advance their skills and knowledge under the supervision of dental faculty while living in rural areas across North Carolina. Education  Access  Sustainable

  13. Community Service Learning Centers(Education  Access Sustainable) • 4th Floor Concept • Traditional vs. Medical Education • Partnership/Collaboration • Regional Approach • Safety Net Provider

  14. Community Service Learning Centers(10 Sites Across North Carolina) • Faculty • 1.5 FTE (practicing general dentist) • Community dentists • Residents • 2 AEGD residents • Students • 4-5 per site, each student rotates to three sites • Staff • Business manager and staff • Dental assistants • Hygienists • Patient coordinator/dental social worker

  15. Resource to State Support Practitioners Economic Impact Increase Healthcare Infrastructure Referral Resource Tele-dentistry Selection Patient Care Experience University Presence Work with Auxiliaries Create Jobs Support Return to Rural Area Continuing Education More Clinical Relate directly with Rural Patient Needs Mentoring More Diagnostic Observe County Board of Health CSLCs.. The Hypothesis Hands on Practice Management Interprofessional with Primary Care Partners Community Outreach Community Experiences Live in Rural Areas Actual Practice Experience See Faculty Actually Practice Medicaid Pipeline Development Business Office Safety Net Assist Faculty Dental Student Patients Remove Part of 4th Year Expense Multiple Locations Comprehensive Care Faculty Produce Income Access to Care Cost of Dental Education

  16. East Carolina University School of Dental Medicine Community Service Learning Center (CSLC) Locations and Counties Served Alleghany Currituck Granville Northampton Camden Ashe Gates Surry Stokes Rockingham Warren Person Caswell Vance Hertford Halifax Pasquotank Watauga Wilkes Perquimans Orange Yadkin Forsyth Guilford Bertie Mitchell Chowan Franklin Avery Nash Alamance Durham Caldwell Alexander Davie Yancey Edgecombe Wake Madison Tyrrell Iredell Martin Washington Davidson Dare Wilson Chatham Randolph Burke Catawba McDowell Rowan Buncombe Haywood Johnston Hyde Swain Lee Lincoln Greene Beaufort Pitt Cabarrus Rutherford Montgomery Wayne Henderson Harnett Graham Jackson Moore Gaston Polk Stanly Cleveland Lenoir Craven Mecklenburg Transylvania Macon Pamlico Cherokee Cumberland Clay Union Richmond Hoke Jones Anson Sampson Duplin Scotland Carteret Onslow Bladen Robeson CSLC Location Pender Ahoskie ECU SoDM Columbus New Hanover Elizabeth City Lillington Brunswick Sylva Spruce Pine Davidson County

  17. Impact on the Oral Health Workforce • Educational opportunities – student selection • Educating more primary care dentists (pre-doctoral and post-doctoral programs) • Educational experiences in rural/underserved areas • Delivering primary care in rural/underserved areas • Recruit applicants to return to areas of need

  18. Ahoskie Community Service Learning Center June 2012

  19. www.ecu.edu/dentistry

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