Rural dentistry.

Abstract

Of all health professionals, dentists have the most opportunity to provide services in a rural location independently of other health care services. The dental workforce is not as diverse as those of other health professions, and thus it can be relatively more available in rural locations. In this chapter, we review dental needs, including problems amenable to collaboration with behavioral health such as dental fear, as well as dental disease and special populations, such as patients infected with the human immunodeficiency virus (HIV). This chapter also addresses the availability of dental services in rural areas, considers sociodemographic and access issues, and reviews the crossover literature. The chapter concludes with recommendations for training and collaboration between dentistry and mental health.Dentistry and mental or behavioral health have points of potential interaction. These points are diverse and range from addressing dental fears and phobias to helping dental professionals deal with personal crises of stress and isolation. Between those extremes lie multiple areas of interaction. Examples of areas of interaction include designing appropriate and effective patient compliance measures, tobacco cessation counseling, dealing with traumatic stress disorders, and helping patients cope with the chronic pain response seen in temporomandibular disorders (TMD). Dentists can also benefit from additional skills in recognizing the role that depressive disorders can play in dental care behaviors and in employing effective education and communication techniques for working with both dental staff and patients. An increasing area of interaction involves assessment of patient competence. Patient competence is a necessary aspect of understanding dental procedures and of providing informed consent.Nearly all of these areas of potential interaction between the behavioral and dental sciences are present and, in some cases, magnified in rural areas. In all locations, particularly rural locations, the potential interaction between dental personnel and mental health professionals is rarely more than a dormant potential. There is room for significant development of professional interactions in the training of both types of professionals and in fostering practical interactions in the practice of their respective fields.One of the most germane areas of latent interaction involves dental fears. Nearly all people experience some degree of reluctance with regard to dental

Technologies for Expanding the Reach of Evidence-Based Interventions: Preliminary Results for Promoting Social-Emotional Development in Early Childhood

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Expanding the Reach of Preventive Interventions

“…Barriers to service delivery and utilization, particularly in rural areas, often result in low-income parents having limited access to preventive mental health services in general and parenting interventions in particular (e.g., Connell et al; Elder & Conger; Franke-Ogg & Pritchard, 1989; Friedrichsen & Stamm, 2003; Gale & Deprez, 2003; Nordal, Copans & Stamm, 2003; Olds, 2003; Sanders, 1997, 1999; Sheeber, Biglan, Metzler, & Taylor, 2002). Major obstacles to accessing services include the lack of medical coverage, absence of public (or reliable private) transportation, lack of child care, and limited flexibility in work schedules (Connell et al; DeLeon, Wakefield, & Hagglund, 2003; Nordal et al, 2003; Organista, Muñoz, & Gonzalez, 1994; Stamm, 2003).…”