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HELPFUL INFORMATION RESOURCES:
What is Local Start Dental?
Where is the clinic located and what does it look like?
Our 5,000 sq. ft., state-of-the-art dental clinic is located on the ground floor of the new Willard Street Apartments, a Self-Help Credit Union affordable housing project next to Durham’s downtown bus station and regional transportation hub. The clinic has 10 operatories, design and denture labs, a classroom, X-ray room, and several consultation offices. Click here for a floorplan, for photos and architect’s renderings
Who provides treatment in a service-training model?
We pair advanced dental education with oral health services for adults who are edentulous (have no teeth) or are missing key teeth and have no affordable access to tooth replacement care.
- The UNC Adams School of Dentistry (ASOD) will operate a faculty-supervised 3rd and 4th year student denture and oral-surgery practicum at the clinic each weekday alongside our clinical directors, UNC ASOD residents in graduate prosthodontic and periodontics specialty programs, and area dentists who are willing to volunteer their services.
- Throughout the year, we will also host professional continuing education courses for licensed dentists locally and across the country focused on efficiently incorporating dental implant techniques to improve denture care outcomes.
- As part of the educational experience, Local Start will continually introduce practitioners to state-of-the-art dental technology, such as digital design and 3D printing of dentures, and the newest dental materials and diagnostic techniques.
- Dentists: Please click here to learn more about volunteer service.
How does Local Start Dental know these services are needed?
Durham and the Triangle region are similar to the rest of North Carolina in terms of oral-health needs among underserved populations. The NC Oral Health Collaborative found in 2017 that the limited capacity of safety net clinics is a recognized barrier to care in North Carolina. Even in the best of times large segments of the Triangle’s communities lack access to anything but the most basic dental services. In addition to the health risks of untreated dental distress, adults with even a few missing teeth often encounter difficulties finding jobs commensurate with their abilities and are relegated to low-paying positions or unemployment. Just a few statistics include:
- Up to 30% of all North Carolinians over age 65 have no natural teeth
- NC has more than twice the national rate of costly emergency room dental visits where patients receive treatment only for pain, not for the underlying causes of dental distress
- Untreated oral infections and decay promote a multi-year deterioration process, often leading to infection in other areas of the body and to larger health issues such as diabetes and stroke
- Despite the large public health implications of oral disease, only 27% of dentists statewide accept Medicaid (as opposed to 42% nationally), and Medicare does not cover dental services
- NC’s poverty rate of 16.1% puts 1.65 million people at risk for oral health problems. In Durham, 47,000 people live below the poverty level
How did local start dental decide on the types of patients to serve?
There is a huge gap in service options for disadvantaged adults who are missing some or all of their teeth, and we are working in collaboration with others in the community to fill that gap:
- Seniors disproportionately experience periodontal disease and tooth loss, which can lead to malnutrition and more serious health problems as their ability to eat diminishes.
- Durham’s VA Hospital Dental Clinic must send 4,000 or more patients back to the community for care each year when it reaches capacity. For many of these patients, particularly those in need of extensive dental restoration, it can be difficult to find local dentists who will accept VA benefits. Additionally, not all veterans covered by the VA Health Plan are eligible for dental care, and 54% of veterans are not enrolled in the VA Health Plan at all. In North Carolina, 42% of veterans are older than 65 and 40% have a household income below $50,000, making major dental care a significant expense.
- Four other non-profit dental clinics in Durham are able to treat about 4,000 low-income patients annually, however are unable to treat those needing dentures and other tooth replacement services, which they do not offer. Durham Health Department dentists serve only children and pregnant women.
- Social service organizations throughout the Triangle serve thousands of clients each year who are dealing with substance abuse recovery, homelessness, disability and lack of employment. Many of these clients require significant dental care. While Local Start cannot eliminate poverty or reduce opioid abuse in our region, we can over time help thousands of people who need advanced dental care to improve their health and increase their chances of successful employment and self-sufficiency.
What geographic area does Local Start dental serve?
What about patients who lack transportation, especially from outside of Durham?
The clinic’s downtown location adjacent to Durham’s regional bus transit station and near several social service agencies, combined with a UNC fund that will provide transportation assistance for elderly patients will help address barriers to access. (Also see note about teledentistry above.) In the future, Local Start Dental hopes to provide an transportation option to elderly patients.
What qualifies a patient for treatment at Local Start Dental?
How do patients apply for treatment?
Patients can be referred by health and dental agencies and nonprofits that pre-screen patients for financial need, in addition to contacting the clinic directly. Patients may also be referred by private dentists, primary care clinics, ERs, the Durham VA dental clinic, and nonprofits working with uninsured veterans, among others.
Local Start currently is collaborating with a group of local health agencies including Project Access, Lincoln Health Center, Samaritan Health Center, Duke Division of Community Health, Wake Smiles, Piedmont Health Center and social service agencies including Urban Ministries, Durham Rescue Mission and TROSA. As our capacity grows, we will continue to expand our outreach for patient referrals and to ensure that duplication of services with other agencies is avoided.
Who manages the clinic’s day-to-day operations?
Is there a Board of Directors?
Local Start Dental is guided by an 11-member Board of Directors and an Advisory Council composed of local dentists. Local nonprofit dental, healthcare and social service organizations further advise on the clinic’s operational structure and provide patient referrals (See “How do Patients Apply for Treatment” above). Learn more about our Team here >>
How is Local Start Dental funded?
We rely on a mix of financial and in-kind contributions and earned income to meet an annual operating budget of approximately $1.6 million. This mix includes
- reimbursements from Medicaid and the VA;
- sliding-scale fees for patients who qualify for treatment under Federal poverty guidelines, yet can afford payments at some level;
- tuition from continuing education courses throughout the year;
- in-kind contributions of equipment, dental materials and supplies that are necessary to treat patients;
- the value of contributed services from UNC dental students and residents, and volunteers; and
- philanthropic contributions from individuals, businesses, foundations, service organizations and others.
Your financial support will enable Local Start Dental to provide more free and low-cost services. Please donate today at www.localstartdental.org, or contact Karla Santiago, Executive Director, or Lisa D’Amico, Interim Development Director, for more information, including naming opportunities within the clinic.
Are there opportunities for civic or professional organizations to be involved?
Rotary Clubs in Durham provided important financial support during the clinic’s start-up phase and will conduct one or more volunteer days at our site in the near future to assist patients with oral-health education and other services. We welcome volunteer assistance, and plan to continue to reach out to more civic and professional organizations, communities of faith and service clubs in the future. Please send an email to firstname.lastname@example.org if your organization would like to learn more.
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