The three-week free dental care clinic that has been up and running since April 4 of this year at the First Baptist Church Parish House in Vineyard Haven will finish up its work for this year on Friday, April 22. The clinic has seen a steady flow of around 16 adult patients a day during its three weeks on the Island.
Vineyard Smiles, which initially kicked off in 2005, aims to increase access to oral health care for Island residents, and through support from the Martha’s Vineyard Community Foundation and the Island Boards of Health, has been able to provide free dental hygiene services to those with limited access.
Originally conceptualized to offer dental care to children, Vineyard Smiles quickly morphed into a wider-range program, encompassing residents of all ages.
Through comprehensive analysis and fieldwork of healthcare on the Vineyard, the Health Care Access Program, in collaboration with Dukes County, concluded that one of the most pressing issues was the lack of access to adequate and affordable dental care, Sarah Kuh, director of the Vineyard Care Access Program/Vineyard Smiles, said.
In considering how to cater to this vital “unmet need,” the county applied for grants to help secure funding, and eventually partnered with providers Commonwealth Mobile Oral Health Services (CMOHS) and Polished Teeth, LLC., in addition to the United Nurses Association (UNA).
Attempts have been made on the Island in the past to establish monthly dental hygiene clinics, but the efforts lost steam, partly due to administrative issues.
The COVID-19 pandemic has exacerbated the already-scarce availability of dental care for many Island residents. Especially for low-income patients, securing affordable oral health care is a challenge, with many insurance plans leaving receivers lacking the much-needed coverage. The Martha’s Vineyard Hospital Dental Center, which provided care to an estimated 1,500 Islanders annually, permanently closed in December 2020, further widening the gap between patients and affordable dental care.
According to the CDC, in 2020, 63% of Americans over the age of 18 claimed to have had a dental visit that year. Between 2019 and 2020, the percentage of children under the age of 18 who had received dental examinations decreased, with children from lower income families being most affected. Various social determinants of health, such as the environment in which a person lives and works, greatly impact the accessibility to dental care, which in turn, makes the disparities in access an ongoing socioeconomic issue, according to the CDC.
Since its inception, Vineyard Smiles has provided annual clinics which are held at local senior centers and mobile services for public school students in addition to its three-week clinic at the First Baptist Church Parish House in 2021, where through support from the MV Community Foundation, the Boards of Health, and various donations, about 240 residents received dental services.
Precipitated by the pandemic, many older, established dental practices that took MassHealth coverage have closed their offices, and in doing so, have left a dire need for affordable oral health care. In Massachusetts, the community health centers are being inundated with calls for dental appointments, said dental hygienist Ellen Gould. “I’ve had patients tell me they are waiting eight or nine months just for a cleaning.”
On Martha’s Vineyard particularly, said Gould, “there are a lot of barriers,” that contribute to the challenges of obtaining dental care. Cost of first exams, x-rays, cleanings, transportation fees, ability to take time off work─with many patients having to go off island for appointments, the trip is often dependent upon the Steamship Authority─are only some factors in the accessibility, or lack thereof.
The program tries to mitigate a lot of those barriers, said Gould, adding that one of the office assistants, Lydia, took it upon herself to pick up an elderly patient for their appointment that day, who was unable to drive themselves to the clinic.
Additionally, explaining that the program serves kind of as a first line of defense, “It’s a lot of directing [patients] to where they need to go and helping them navigate that,” said dental hygienist Heather Reid. Because Vineyard Smiles’ clinicians do not perform any invasive dental work, a lot of the job is helping people get the needed referrals for them to manage how to move forward in cases where a patient might need oral surgery or show signs of an abscess or a form of cancer.
“There are only two reasons people may not have great teeth,” said Reid. “Fear and money.”
The biggest thing, she said, is being able to inform patients on how to take care of their teeth, hopefully to avoid more serious issues.
A lot of this year’s patients have returned from the prior year, said Gould, adding that when many came last year, they had told the team they hadn’t been to a dental checkup or teeth cleaning for a decade or longer.
In addition to the clinic at First Baptist Church, which has served as a kind of a homebase, Gould and Reid, mobilize portable clinics to serve residents from various organizations, including Martha’s Vineyard Community Services building, Island Wide Youth Collaborative, in which kids starting at age 3 ─ and sometimes their parents ─ are provided free check-ups.
“To have a portable program like ours, is really a blessing,” said Gould. Not just for Island residents, but for the dental team as well. Gould and Reid ─ both of whom are Polished Teeth LLC. workers ─ are mainland residents who often spend weekends and late nights at the MV-based clinics. On supplying a very much needed demand for services on the Island, Gould said, “We love coming here…everyone is so appreciative.”
Kuh said the clinicians are “absolutely committed,” emphasizing that the team “gives up their lives for three weeks” at a time, in order to provide this service.
Vineyard Smiles’ current model has been successful, but is like a “Band-aid for a whole lot of unmet needs,” said Kuh, adding that the program “just scratches the surface” and sheds light on a much deep-rooted problem in the healthcare system, which is access to reliable and affordable healthcare.