Abstract
Historically, county health departments have not been responsible for providing dental care to needy citizens. However, as the need for dental care among indigent and low-income citizens has grown health departments are being called on to provide these necessary services. This article describes one local board of health's effort to establish a dental program within a large rural county. The board of health directed the local county health department to purchase and operate a mobile dental clinic, build a permanent dental facility, recruit a dental staff, and most important, provide the financial resources to pay for the program.
The Surgeon General has reported that tooth decay is five times more common than asthma and seven times more common than hay fever among America's children. 1 In fact, tooth decay is the most common chronic childhood disease. 1 The Surgeon General also reports that most adults in the United States have symptoms of periodontal or gingival diseases and that almost 25 percent of adults 65 to 70 years old have severe periodontal disease. 1 At least 108 million Americans are without dental insurance. 2 Unmet dental health needs are recognized as a growing problem among the poor, the indigent and the elderly. 3-8 We know that children from low-income families are much more likely to have dental problems and much less likely to receive dental care compared with children from moderate to high-income levels. 9-12 Untreated tooth decay occurs more often among Hispanics (24%) and Blacks (22%) when compared with Whites (11%). 13 The General Accounting Office has reported that only 21 percent of children 2 to 5 years, and 37 percent of children 6 to 18 years of age receiving Medicaid made a dental visit in 1995. 13