Common Implementation Challenges

Rural oral health projects may experience implementation challenges or require mid-course corrections. Some of the challenges that existing rural oral health projects have encountered are described below.

Recruiting Dental Staff
Rural programs implementing a dental clinic model have faced barriers to recruiting a dentist. Some programs work with volunteer or retired dentists, dental students, or other allied health professionals.

Hard-to-Reach Populations
In rural communities, the priority population served by an oral health program may be highly mobile, traveling to new locations throughout the year. Or, they may live in remote geographic areas that are difficult to reach. These populations may be best served by a school-based model or mobile dental services model.

Providing Services in Mobile Units
In the mobile dental services model, rural oral health programs use mobile dental vans to provide oral health services. Dental vans are limited in the types of services they can provide — for example, they often cannot provide root canals or, surgeries. Programs that employ mobile dental units often partner with dental clinics to refer patients who need more extensive dental care.

Start-Up Costs
Rural oral health programs may have start-up costs that exceed the revenue the program can generate. Programs should develop financial and sustainability plans early.

Language
Several existing rural oral health programs provide services to communities with a large Hispanic or immigrant population. Such programs need to ensure that their staff understands the importance of providing services or public health education in a culturally appropriate manner. In addition, programs may need to either employ staff proficient in Spanish or other languages.

Culture
Rural oral health programs face cultural challenges related to stigma. Individuals may not want to access services from a free dental clinic because of the stigma associated with receiving “charity” care. To address this challenge, some programs provide services at hospitals or medical offices.

Additional information regarding challenges is available in the Rural Community Health Toolkit (see Common Implementation Challenges).