State Grants Could Create County’s First Dental Clinic

SNOW HILL – Two-thirds of children from low-income families in Worcester County do not receive any dental care, but that may change with state funding for a new dental clinic through the local health department.

The Maryland General Assembly voted to offer grant money for dental clinics this spring, in response to the death of a Prince George’s County boy on medical assistance from an untreated dental infection.

Worcester County is one of five counties in Maryland without a dental clinic and has been targeted for the money by the state.

According to Worcester County Health Officer Debbie Goeller, the lack of dental care for low-income children has been a concern for the 15-plus years she has held the post.

“We are a recognized dental professional shortage area,” Goeller said.

Only one dentist and one oral surgeon in Worcester County take medical assistance and low-income dental patients.

Without funding for a dental clinic, the health department has focused on prevention and screening, from fluoride rinses for first and second graders to fluoride varnish offered through Head Start and the Judy Center.

One-third of the children in those two programs need dental care, and one-third of those children have immediate dental problems, which should be seen within a few days of detection. Less than 20 percent of schoolchildren live in communities with fluoridated water, Snow Hill and Pocomoke City.

“In Worcester County, only 32 percent of our Medicaid children received dental services in 2006. Two-thirds of our medical assistance children did not get any dental care,” Goeller told the County Commissioners at their meeting Tuesday.

In the past, state money has been available for operating, but not creating, a dental clinic. This year, the State of Maryland is offering two grants, one for capital costs and one for operating costs. The capital grant does not need a match in fiscal year 2009, but will require a 25-percent match in fiscal year 2010. An operations grant is available for the first three years.

“It’s a lot to build a facility, to put in dental chairs and suction and water,” Goeller said.

The health department has looked at several options, such as building more space at the new health department building, renovating an existing building, buying a dental practice or adding it on to the Berlin Health Center.

The need for children’s dental services is spread throughout the county, split evenly between the north and south ends.

“Our recommendation is to put it in Snow Hill,” Goeller said. “It’s about 50-50, so Snow Hill seemed like a good location for us.”

Commissioner Linda Busick pushed to have the dental clinic placed in the north end.

“Everything that has been built is in [the Snow Hill] area,” Busick said.

The clinic needs to be available to everyone, Commissioner Louise Gulyas said.

The Berlin Health Center site has no room for expansion.

Leasing space would be more expensive in the long run, Goeller reported, with not only the renovation to pay for, but rental costs as well, and there appear to be no existing offices for sale.

Goeller presented two options to the County Commissioners: building new space at the health department or taking over the unused Purnell House in Snow Hill, formerly the senior center.

New space would cost, overall, $855,000, with $500,000 of that from grant money. That would pay for 3,000 square feet, including room for expansion.

To begin, the clinic would have three dental chairs, using 1,800 square feet, to handle the flow of patients and pay for the operation.

The commissioners questioned the need for so much space, several saying their own dentists made do with much less for three or four chairs.

Private dentists will not serve the numbers of clients the clinic will, Commissioner Bobby Cowger said.

Betty Shockley, health department nursing director, explained that the size was generated through a formula recommended by the State of Maryland.

The health department expects to add another three chairs in the future and would already have space for those chairs with 3,000 square feet.

“I think it’s going to cost way more down the road,” Goeller said.

The Purnell building would require twice the funding, between $1.5 million to $1.8 million, as it is in need of extensive renovation before the dental office work begins.

Worcester County would pay the balance of the costs.

“It’s really the best time for us to apply because they’ve got both types of money available,” said Goeller, acknowledging that now is not a good time to ask the county to consider taking on new construction.

The commissioners voted to support the new space at the health department and authorized submission of the application, unanimously.