FULFILLING A PROMISE
Innovation, community partnerships help ECU bring dental care to underserved Hyde County
Once a month, the post office building on Main Street in Swan Quarter also serves as the area’s only oral health care location for miles around.
East Carolina University’s School of Dental Medicine’s Hyde County Outreach Clinic, which occupies a few rooms in the rear of the small brick building, provides much-needed dental care to residents from Hyde and surrounding rural counties.
Created through outreach and partnerships born of necessity, the Hyde County Outreach Clinic has made the most of high-tech dental education and smalltown ingenuity since opening its doors in April 2022. Students and faculty have provided care for close to 75 unique patients from seven counties.
“We’re relatively new here in Hyde County, so we’re still establishing our relationship with the county, getting to know the people,” said Rob Tempel, the school’s associate dean for extramural clinical practices, “but our books are full every day from start to finish, and our students are getting tremendous experience.”
Hyde County, which connects to Beaufort County to the west and reaches into a pocket of the Atlantic Ocean cradled by the Barrier Islands, joins Tyrrell and Camden counties as the only three of North Carolina 100 counties with no practicing dentists.
ECU’s partnerships with local health and government agencies work to creating solutions to the lack of access and dental professional shortages. The program’s partners — which include the Hyde County Health Department, Hyde County government and the county commissioners, Ocracoke Health Center and Engelhard Medical Center, among others — have pledged to make a difference for those in remote, forgotten communities. The dental school’s part of that promise is to make sure patients receive quality care through strong provider-patient experiences that establish trust between the community and dental school.
“We want the citizens of Hyde County and nearby areas to know who we are and why we are there, and we want them to trust us to provide them with quality care,” said Greg Chadwick, dean of the ECU School of Dental Medicine. “It is our hope that they will consider us a part of their community.”
Set up with a check-in area at the front door and private, partitioned treatment spaces, the Hyde County Outreach Clinic can provide care for 16 patients per monthly visit, on average. Patients are screened and scheduled appointments during which students, faculty and residents complete restorative care.
The system is working, thanks to partners keeping the moving parts running — but also thanks to funding that represents a vote of confidence in the dental school’s efforts..
HEARST FOUNDATIONS BACK HYDE COUNTY CLINIC
The East Carolina University School of Dental Medicine’s transformational care for the dental needs of rural and underserved populations is growing with funding and accolades from the Hearst Foundations.
The $100,000 grant, awarded in December, is the first time ECU has earned support from Hearst Foundations, which identify and fund outstanding nonprofits to ensure that people of all backgrounds in the United States can build healthy, productive and satisfying lives. The funds will boost efforts by ECU to provide dental care to uninsured and low-income rural patients in Hyde County and other SoDM clinics in North Carolina.
“I believe — through these amazing clinics — ECU is the only institution doing such exceptionally comprehensive work,” said Ligia Cravo, senior program officer with Hearst Foundations. “The focus was incredibly rich. They are united by an unconditional mission of service to underserved communities.”
The funding supports what Cravo described as high quality, state-of-the-art level care provided by the SoDM and by the passionate commitment of its faculty and students to serving the neediest, irrespective of patients’ ability to pay or the complexity of procedures required.
The SoDM will use the Hearst Foundations grant to purchase additional portable dental equipment and provide Patient Care Funds, which enable the SoDM to support individuals who need assistance paying for dental care, beginning in Hyde County.
“It is my hope that the SoDM’s exceptional and proven model of patient-centered care will inspire replication nationwide,” Cravo said.
— Patricia Earnhardt Tyndall,
In 2019, the Anonymous Trust — a philanthropic group that aims to support rural and underserved communities — provided the School of Dental Medicine a grant award of $144,000 for portable dental equipment and personnel to launch the Hyde County Outreach Clinic
In December 2022, the Hearst Foundations — national philanthropic resources for organizations working in the fields of culture, education, health and social services — approved funding in the amount of $100,000 for the school to provide dental care to underserved, uninsured and low-income rural patients. Portable dental equipment and special patient care funds will allow the school to provide high-quality dental care to low-income, rural populations and veterans in North Carolina’s most medically underserved communities, beginning with the Hyde County Outreach Clinic.
The county’s access to dental care has been spotty over the years at best — a practicing dentist left years ago, and a mobile dentist from Raleigh became overwhelmed with the demand and had to halt visits to the county.
No hard feelings, according to Luana Gibbs, Hyde County’s Health director, who says the absence of a dentist for years makes ECU’s presence even more meaningful.
“When there was an opportunity for us to make this happen, I was ready to jump on it,” said Gibbs, who held conversations about the project with Chadwick and Tempel even before the pandemic began.
Gibbs said the clinic space was rented to the county from a local business owner who supported efforts to bring dental care back to Hyde County.
“We said, ‘Let’s take advantage of this so we have a space,’” she said. “Naturally, it fills me with pride to know this has happened. It’s a partnership, truly. I hope that we can grow this even further, because I definitely know the need is here.”
The clinic, like the dental school’s facilities on campus and across the state, accept Medicaid, another obstacle that keeps many patients from receiving care. Some people hear about the clinic by word of mouth and come by to see what it’s all about, while others get referrals from the health department, the nearby federally qualified health center (FQHC) and other medical offices. Emma Williams, a nurse practitioner at the Hyde County Health Department, helps assess patients and make referrals.
“The closest dentist is 30 miles away, and after that the closest one is 60 miles away,” Williams said.
To help ease the distance between offices, the School of Dental Medicine has also equipped the health departments with cameras so that students and faculty in Greenville can help diagnose oral health problems in spite of the distance.
“We might only be here one day a month,” said Tempel, who also chairs the dental school’s community service and outreach committee, “but the health department and FQHC have cameras that we donated to them so that we can have live, synchronous conversations and help them diagnose the problem and see how urgent it is.”
ECU undergraduate student Wrenn Whitfield has an ideal vantage point to the clinic’s success so far. Whitfield, who is studying biochemistry, business administration and entrepreneurship, serves as the Hyde County project coordinator and virtually runs the clinic by scheduling patient appointments, ordering supplies and coordinating with the local health care agencies. A Kinston native, Whitfield has found the project particularly meaningful because she’s seen smalltown residents go without medical care — and she’s determined to be part of the solution.
“It’s been a really special experience for me as an undergraduate student,” said Whitfield, who is applying to dental school. “Dentistry seemed to click for me. I have always played violin, I danced, I did well in school, and I felt my time was kind of split between academics and finding an outlet.
“When I shadowed dentistry, I got to see how academics and service and creativity all came together through that, and I fell in love.”
A scenic setting
In Hyde County — whose claims to fame include Okracoke Island, Farm Days festivities and not one stop light in the entire county — the air is always alive with birds. Two-lane roads snake through the wetlands, and signs announce the Historic Albemarle Highway and streets like Seed Tick Neck Road. A thin stretch of dirt road leads to the Bell Island Pier, while U.S. 264 skirts Lake Mattamuskeet, North Carolina’s largest natural lake.
Life in this rural scenic area is slow, but that’s part of its appeal, according to residents.
“It’s very rural, the people are super-friendly and it’s very laidback,” said Hyde County Clinic patient Jan Moore, of Swan Quarter. “We’re about 15 or 20 years behind everyone else, and that’s not a bad thing. But people forget us because of where we’re located, and there’s nothing to draw people. That’s why we don’t have a lot of doctors or dentists or lawyers or anything else.”
The flash of purple of an ECU sign on the clinic building is enough to instill confidence in residents that they haven’t entirely been forgotten.
“It’s meant a great deal to our county to have a service like this be readily available right here,” said Lee Brimmage, 4H extension agent in Hyde County Cooperative Extension and president of the Hyde County Chamber of Commerce. “I’ve heard nothing but great things, and to have this here kind of revitalizes our community and gives us another service to be able to offer our citizens and constituents.”
ECU’s dental students are also taking in the experiences the clinic offers. Fourth-year students spend nine weeks in three of the school’s community service learning centers (CSLCs) across the state, for 27 weeks of rigorous clinical experience.
Students can volunteer to travel to the Hyde County Outreach Clinic when they are assigned to rotations in the service learning center in Ross Hall on campus. It has proven a popular, off-the-beaten-path option for students.
“Before we even had the details worked out on exactly where the Hyde County clinic would be located, we had students, faculty and residents who were eager to be a part of the team,” Chadwick said.
Fourth-year student Sung Baek, from Indian Trail, said caring for patients in Hyde County is like looking out for family.
“This means everything to me,” Baek said. “I kind of grew up in a similar situation in a rural county, and my parents were going through a lot of similar situations that I’ve seen in patients here. For me, it’s just about giving back and just imagining that’s my mom or my dad — and I would want the same thing for them, to have access to dental care.”
Moore said the students who have provided her dental care have been top-notch skilled professionals.
“If you hadn’t told me that it was a student, I wouldn’t have known,” she said.
Moore said the clinic offers a resource that goes beyond restoring smiles; it also makes life easier for people with challenges like transportation.
“For a lot of people here, going to the next county is a big issue,” she said. “Having this right down the street is really nice. The more the community supports this, the more likely you are to keep coming back to us. This is desperately needed. Desperately needed.”
Charting new ground
Part of the Hyde County clinic’s success comes from the unique model of the ECU School of Dental Medicine itself.
The eight CSLCs located across the state give students unprecedented clinical experiences that prepare them not only to practice dentistry but to understand and create solutions to the challenges of practicing in rural and underserved communities.
“It’s an extremely innovative school; it’s the only school with a model that has eight clinics throughout the states that are owned by ECU, manned by ECU and that teach to the same standards,” Tempel said. “Having a clinic like this shows the innovation that is promoted throughout the university to have us reach out to rural communities and provide innovative solutions to very challenging problems.”
The school’s model of education and patient care — and projects like the Hyde County Clinic and school-based preventive care programs in Bertie and Jones counties — are catching attention on a grand scale.
“Providers across the nation, schools across the nation are looking at what we’re doing and seeing the innovative ways we can help people in rural America,” Tempel said.
It’s also caught the eye of Hyde County native Melony Hodges, who is also a freshman in ECU’s Honors College. Hodges is a prospective dentist with sights set on returning to her home county to practice.
“I’m hoping that if I am able to come back and be a dentist here that I can also help inspire the youth here to go off and pursue those kinds of careers and hopefully come back and help this county as well,” she said. “I want to help make this county as good as I can, and I feel like this is one of the first steps toward that goal.”
Second-year ECU dental student Markus Mosley is also inspired to return to Hyde County to participate in the clinic when the time arrives. Mosley assisted in Swan Quarter last fall during an oral health screening event at Hyde County Farm Days; the experience gave him a more profound perspective on his future career and the importance of service.
“To be able to see the more intangible things like hope and joy, I really got a great opportunity to be there and help other people out,” Mosley said. “Each and every person we come in contact with has a story, has an identity outside of what they’re presenting with today.
“The person-centered care is the mission of our school. It’s really important, and a blessing in my opinion, to be in my second year and still have the opportunity to do that all the way in Hyde County.”