Our Opinion: A reason to smile

Robert Ruhl, the dentist for Windham County Dental Center.

Don't miss the big stories. Like us on Facebook.  

BRATTLEBORO — For nearly a decade, the United Way of Windham County has held an annual Adult Dental Care Day during which Windham County residents who have no way of paying for care could get it at no cost.

This year, the United Way will not be offering that same service.

That's actually good news, because on May 21 or thereabouts, the United Way and Brattleboro Memorial Hospital will be opening the Windham County Dental Center on the corner of Belmont Road and Canal Street in Brattleboro. The dental center will offer care for those who are uninsured or on Medicaid.

"I will be in Brattleboro two days a week," said Dr. Robert Ruhl, of Deerfield Valley Dental Care

in Wilmington.

Ruhl, who was an active participant in the United Way's annual free dental care day, said while he will be in the office only two days each week, the office will be staffed five days a week, from 8 a.m. to 5 p.m. with a practice manager, a hygienist, an expanded function assistant and a dental assistant.

"We have, unfortunately, a group of folks who can't find dental care, either because of their income levels of because they are Medicaid recipients and can't find anybody who will accept new Medicaid recipients," he said.

Ruhl, who is also a BMH employee and a member of the hospital's medical staff, said Medicaid only pays 50 cents on the dollar for most procedures, with a limit of $510 per year for each patient.

"That's below the cost of care," he said. "Every time somebody is in your chair who is a Medicaid recipient, you're not just making no profit, you're not covering costs. While many dentists get a bad name for not accepting Medicaid recipients, the truth is, they simply can't afford to accept them."

Carmen Derby, the executive director of United Way of Windham County, said the free dental care day got started after she met with Ruhl who mentioned he had been doing free care once a year in his office in Wilmington.

By 2018, the last year of the program, about 100 people received free dental care from 10 local offices.

"And that was great," said Derby, "but we always knew and the data told us that there is much more to be done and the need was huge."

Brattleboro Memorial Hospital also recognized there was a need that wasn't being properly attended to, said Eilidh Pederson, BMH's vice president of Medical Group Management and Population Health.

"We have been hearing from our primary care clinicians that they couldn't find 'dental homes' for their patients dependent on Medicaid and those who don't have dental insurance," said Pederson.

According to a recent community health needs assessment conducted by the hospital, she said, there are about 5,000 adults in Windham County who don't have a regular dental care provider.

"Patients go the emergency room to get access to dental care," said Pederson. "We all know going to the ER is not the right place to get dental care. It doesn't get to the root of the problem. The ER is not able to provide comprehensive dental care to these patients."

Pederson said partnering with the United Way to offer dental care was a natural evolution of the services United Way offered during its free dental health care day.

Support our journalism. Subscribe today. →

BMH owns the building, which formerly housed the urology practice of Dr. Craig Rinder.

"We are getting this facility in-kind from BMH," said Derby. "We are not paying any rent and that is huge in being able to get this started."

Pederson said that in addition to having a location free of rent, United Way and BMH needed to scout for grants and solicit donations to make the dental care facility a reality.

"We need partnerships, grant funding and private donations from our generous community because of the challenging reimbursement model," she said.

Windham County Dental Center received a $450,000 grant from the Thomas Thompson Trust to help pay for operations over the next three years, but that's still not enough, said Derby. Other donations for the first year total about $100,000, but United Way and BMH also received in-kind work and equipment from local companies to get the building ready for patients.

"We will be forever grateful to GPI Construction, A.L. Tyler and Sons, Alliance Mechanical, Southern Vermont Telephone, the Brattleboro Rotary Club, Horizon Dental and Derby Building and Woodwork for their generous support," said Derby, noting Derby Building and Woodwork is owned and operated by her husband. "In reality, we can have all the in-kind donations we can get, but we need cash to make this work."

Derby said the efforts of Debbie Cloutier, the practice manager for Windham County Dental Center, are the reason United Way and BMH were able to advance the opening date from 2020 to this May.

"She is the hub of the operation," said Derby.

"She does everything short of drilling teeth," Ruhl said with a laugh. "I work for her."

"I was absolutely attracted by the challenge of making this work," said Cloutier. "I have experience working with underprivileged children in pediatric dentistry. To find a center that was going to serve the community was where I wanted to be."

The dental clinic will also host dental students from the University of New England, said Pederson.

"It will give them an opportunity to see Windham County and how awesome Brattleboro is," she said.

The reimbursement dentists receive from Medicaid might be increased if legislation working its way through the Vermont State House is approved and signed into law by the governor.

"We have a desperate need around dental care in Vermont, especially in more rural areas of the state," said Senate Majority Leader Becca Balint who represents Windham County. "There's a real problem in regard to access to dental services and that access is reduced further by poor Medicaid reimbursements. Senate bill 94 is designed to address the very low reimbursement rates for Medicaid participating dental providers. In the same way that we are rightly expanding our ideas about how mental health services are a critical component of health care, we must remember that dental care is critical for Vermonters' health and well-being. We know that too many Vermonters suffer needlessly because they are not able to see a dentist. This needs to change."

Windham County Dental Center will accept patients with no insurance, commercial insurance or Medicaid. To learn more or to donate, find the Windham County Dental Center on Facebook.

Bob Audette can be contacted at 802-254-2311, ext. 151, or raudette@reformer.com.