By Dr. Mike Shirtcliff

As one of the experts in your Oct. 13 story “Medicaid patients struggle with dental access,” I agree it’s critical that we acknowledge and address shortcomings in access to health care in Central Oregon, particularly for Medicaid patients.

However, it’s also important that we take a moment to consider how far we’ve come and what we can do next.

When the Oregon Health Plan underwent its expansion under the Affordable Care Act a few years ago, our community worked hard to meet this capacity challenge, embrace new patients and address their unmet need for dental and health care. This was no small undertaking.

As an example, my organization, Advantage Dental, saw the number of enrollees in the expanded Oregon Health Plan increase at a significantly higher rate than expected. Many health care providers, including those at Advantage Dental, were overwhelmed.

But we rose to the challenge. In addition to opening or expanding our clinics in Bend, La Pine, Sisters, Madras and Prineville, we also recruited new contracted health care providers and worked with a variety of partners to bring a pediatric dentist to the Sisters School-Based Dental Clinic, create dental access for Federally Qualified Health Centers and even reduce emergency room visits for oral health issues. As we’ve learned, it has and will continue to take a variety of tactics and approaches to meet the health needs of our community.

There have been and will continue to be bumps along the road to true health care innovation. But, if we work together to overcome the challenges, we will continue to establish the Oregon health system as a national leader in increasing access to care for those who need it.

Everyone deserves the opportunity to live a healthy life, and this is a vital part of our commitment as community members in Central Oregon. As health care providers and leaders, we know that change of this magnitude takes time to evolve as we open new clinics, decrease wait times, train practitioners and expand access.

While we focus on these improvements, here are some other ways we will work to expand access:

• As health care providers, it’s important that we not only continue to open new clinics, hire new practitioners, employ creative ways to grow our provider base (like financial assistance with education or training more hygienists), but also push for local policies that enable these changes, incentivize whole-person care and ultimately yield better health outcomes for Oregonians.

• Over the long term, we must also focus on preventive care to manage, treat and ultimately avoid cavities, infections and other oral health issues. Preventive care not only is better for oral health, but is also significantly less expensive over the long term. By decreasing cavities and enhancing our patients’ health, we will reduce the demand — and costs — on the system.

• Unfortunately, undeserved and vulnerable patients, such as those served by Medicaid, are grappling with a complex web of factors that impact their ability to get regular care. Pressing daily challenges — which could include a lack of financial stability or coping with mental or behavioral health issues — are oftentimes a barrier to optimal preventive dental (and health) care. We must provide culturally competent care to patients through enhanced outreach — educating them on the health care options available and the importance of oral health, particularly in connection to overall health.

• Possibly most importantly, we must meet patients where they are. This needs to become core to our efforts — whether conducting outreach over the phone, dispatching hygienists to local schools or simply understanding these other burdens — we can improve health. The trail ahead is steep — we have many current (and unforeseen) challenges in our health care system. But providers, patients, community leaders and health experts across the state are working hard together to improve access to care, decrease long-term costs and — most importantly — make our community healthier.

— Dr. Mike Shirtcliff is the president and founder of Advantage Dental and lives in Redmond.

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