Proposed change to N.C. rule could pave way to better access to dental care

CHARLOTTE, N.C. (WBTV) - The North Carolina Division of Public Health recommends you see a dentist twice a year, and yet the agency also reports about 14.3 percent of kindergartners in the state have untreated tooth decay.

Local groups in North Carolina are providing dental care to areas who lack dental providers or do not have insurance to cover visits. However, they say a rule is preventing them from helping even more people in need of oral healthcare.

Dr. William Donigan is the Dental Director for Gaston Family Health Services. He says they provide dental care to about 35,000 people per year. Some of the care is provided on the Mobile Dental Unit which is like a dental office on wheels.

“It’s a 3-chair dental office on a Chassis freight-liner built right here in Gaston County,” Dr. Donigan said.

The bus travels to school sin Gaston, Lincoln, Catawba, and Iredell counties where dentists and dental hygienists provide dental care to children free of charge.

The Mobile Dental Unit has served nearly 2,700 children since September of this year.

“One of the things we find, especially with kids and especially in the low-income populations is that parents can’t get off work,” Dr. Donigan said. “They have multiple kids and they can’t bring those kids in.”

Dr. Donigan says they could serve even more people in need of dental care but what is known as the “prior exam rule” is inhibiting their efforts.

The prior exam rule requires patients who are seeking dental care from public health programs like the Gaston Family Health Services school program to have had a prior examination by a dentist within 120 days. Without the prior exam, then a dentist must be present on the bus to supervise dental hygienists who perform the cleanings, fluoride treatments, x-rays, and other hygiene treatments.

Dr. Donigan says staffing a dentist on each bus is not always an easy requirement to meet.

“We have some counties in the state that don’t even have a dentist,” Dr. Donigan said. “That’s why some of the new changes in the rules are so vital.”

Under the proposed changes to the prior exam rule, a dentist would not have to be present to supervise a dental hygienist who is providing care to a patient who has not met the prior exam requirement. The rule only requires that the doctor give the hygienist written order to carry out specific procedures.

Dr. Donigan says this would keep dentists in the clinics serving patients, while more dental hygienists could serve in the community like on their Mobile Dental Units.

“We could reach a lot more people,” Dr. Donigan said.

The North Carolina Board of Dental Examiners approved the proposed changes at its board meeting on Friday, December 13. According to Board CEO Bobby White, the proposal is expected to be addressed by the Rules Review Commission at its meeting in January. If the commission approves the proposal and there is not significant public objection, the rule could officially go into effect as early as February 2020.

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