By Rachel Baldauf
On any given day throughout the school year, you’re likely to see a blue and white recreation vehicle parked outside a public school in Columbus County. It’s the Toothmobile, a mobile dental clinic that serves more than 1,000 students each year.
Students can visit the Toothmobile during the school hours for cleanings, fillings and other critical dental procedures. Those without dental insurance are charged a reduced rate, and most students go back to class at the end of their appointments.
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Creative solutions like the Toothmobile are essential to providing accessible dental care in rural Columbus County where dentists are hard to come by, said County Health Director Kim Smith.
“There’s just not enough dentists,” she said, adding that there are only five private dentists in the county of about 50,000 people.
It’s not a new problem in rural southeastern North Carolina. Bladen, Columbus, Robeson and Scotland counties are considered Dental Health Professional Shortage Areas by the U.S. Department of Health and Human Services.
Across the country, 40% of adults living in rural environments said they have not visited the dentist in over a year, and over 65% of rural areas nationwide have dentist shortages, according to a 2023 report by the nonprofit CareQuest Institute for Oral Health.
Rural areas struggle to attract and keep medical professionals, including dentists, who are often lured to urban and suburban areas by higher salaries.
“They want to be in a Raleigh or a Charlotte or a Greenville where there’s more people,” Smith said. “There’s a lot of people who just don’t want to live in a rural area.”
The shortage means that many people have to drive to Wilmington or Fayetteville to get the dental care they need. For children, this can mean skipping school.
That’s where the Toothmobile comes in. The service has been available in Columbus County since the early 2000s.
“We get great feedback,” Smith said. “Sometimes it’s easier to get in with us than it is to get in with a private dentist.”
Last year, the Toothmobile provided dental care to as many as 1,200 students, Smith said. The vehicle, which was upgraded in 2020, is run by a dentist, two dental assistants and an office assistant. With permission from their parents, students under the age of 19 can get cleanings, fillings and other minor procedures. Major procedures like tooth extractions are done at the health department’s on-site dental clinic.
The N.C. Department of Health and Human Services released a dental health improvement plan in 2021 that aims to solve dental health issues across the state. The plan identified so-called “safety net dental providers” that serve low-income families in each county. The Border Belt region has four such facilities: CommWell Health in Dublin, the Columbus County Health Department clinic in Whiteville, the ECU Community Service Learning Center in Lumberton and the Scotland County Health Department in Laurinburg.
“Improving North Carolina’s oral health outcomes requires dedicated providers, resources and strategic planning to apply evidence-based practices,” Dr. Sarah Tomlinson, the state dental director, said in a statement. “Our focus for 2020-2025 is strengthening regional partnerships as we work together to address disparities and improve oral health for our most vulnerable citizens.”
Poor dental health can affect the whole body, not just the mouth, Smith said. Neglecting dental hygiene can lead to tooth decay and gum disease, and bacteria in the mouth can spread to other areas, causing pneumonia and even heart disease.
“If you have bad teeth and you can’t chew your food, then you don’t get the necessary nutrients that you need from your food,” Smith said. “There is a big relationship there between oral health and physical health, and I just feel that a lot of people don’t understand that.”
Building good oral hygiene habits early on sets children up for healthy lifestyles in adulthood. “Whatever we teach them,” Smith said, “hopefully the kids will pass it on to their parents, and then we can get the whole population.”
