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Individuals' utilization of dental services depends upon an array of factors, including access to care, financial restrictions, attitudes toward dental care, and dental fear. These factors, in turn, may vary across geographic locations and demographic groups. The goals of this study were to assess the use of dental services in both rural and urban areas of Kentucky and to examine challenges facing practitioners in rural areas. Individuals sampled from a rural population and patients in rural and urban dental clinics completed questionnaires about use of dental services, self-rated dental health, and dental fear. While these variables were strongly interrelated, differences emerged across locations. Patients in the urban area reported having more dental insurance but not better dental health. Patients in more rural areas reported seeking more emergency dental treatment but not more dental fear. While these factors are important considerations across locations, dental practitioners in rural areas in particular should be aware of barriers to dental care facing individuals in these areas. They have unique opportunities to provide education to their patients regarding the importance of dental care and the role of oral health in overall physical health.

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The Surgeon General's report on oral health called for improved education about oral health, a renewed understanding of relationships between oral and overall health, and an interdisciplinary approach to oral health involving primary care providers. This study examined the following: 1) family medicine residency directors' knowledge of preventive dental care, 2) status of an oral heath curriculum in family medicine residencies, and 3) the likelihood of initiating an oral health curriculum. We conducted a fifty-item survey of family medicine program directors emphasizing pediatric oral health assessed demographics, knowledge of preventive procedures, existing oral health curriculum, composition, and time commitment for an oral health curriculum. Directors returned 208 (45 percent) surveys. Approximately 95 percent agreed that oral health knowledge should be a component of residency training. Most programs are teaching anticipatory guidance. The mean time program directors felt should be given to an oral health curriculum was four hours. Program directors lack knowledge of preventive dental procedures and oral health care recommendations. Oral health care knowledge is felt to be an important component of residency training. Program directors need faculty development for a successful delivery of an oral health curriculum.

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