ASHLAND — A small dental practice in Ashland opened during the COVID-19 pandemic, not only facing the routine challenges that any new business must overcome but also complications from ongoing health concerns.
Yet, the practice’s structure turned out to fit the very needs that arose because of the pandemic.
As unemployment rates rose, people lost their employer-sponsored dental insurance, resulting in increased reliance on Medicaid. 9th Street Dental caters to uninsured and low-income clients by offering sliding fee scales, as well as accepting Medicaid and most insurances.
“What I’ve heard the most in the last year is, ‘Hey, my dentist doesn’t take my insurance anymore, and I know you guys do,’” said chief dental officer David Hoag about the patients 9th Street has acquired.
9th Street Dental opened a year ago in October 2020, and the practice is able to offer these flexible fees because it is a Federally Qualified Health Center, meaning it qualifies for specific reimbursement systems under Medicare and Medicaid.
FQHCs provide services regardless of patients’ ability to pay, and qualify for federal Section 330 grants under the Public Health Service Act. These centers range from oral care, general health care, and mental health and substance abuse services.
9th Street’s parent company, Third Street Family Health Services, has other FQHC services in the north central Ohio region, including various community clinics and OBGYNs in nearby Mansfield and Ontario, as do several other areas in the state.
Nearby Knox County, for example, offers services through FQHCs at Knox County General Health District and Lower Lights Christian Health Center. Marion County has Center Street Community Clinics, and Wayne County has Alliance Family Health Centers and Ohio Northeast Health Systems, among others.
FQHCs are not pandemic-era additions to the healthcare safety net.
The centers as they are known now were established in the 1990s, but the concept dates back to 1964 when neighborhood health centers were part of President Lyndon B. Johnson’s “War on Poverty.”
A key aspect of FQHCs is preventative care, and many centers focused on prevention during the pandemic by serving as vaccination sites, including Third Street Family Health Services.
FQHCs also continue to respond to health issues that have arisen due to the coronavirus pandemic. Overall, the number of patients FQHCs serve has tripled since 2000. They currently serve nearly 30 million patients.
Price flexibility at 9th Street has helped patients get affordable emergency care at a time when emergency rooms were often full or much busier than before.
Hoag said each of Third Street’s locations (Ashland, Mansfield and Shelby) have had spikes in dental emergencies since the onset of the pandemic.
“We probably see about anywhere from 14 to 20 (emergencies) a day between the three locations,” Hoag said, adding that before the pandemic, 10 per day would have been considered high. “That’s 100 people a week.”
Dental problems that could have been saved by a quick trip to the dentist last year have turned into emergencies because of skipped check-ins, Hoag said.
Before the pandemic, dental care was one of the greatest unmet children’s health needs in the United States, especially in low-income, minority, and rural communities. Dental care has also been one of the main health care services that even people with insurance skip because of cost.
Dental access was further stymied due to closures and health concerns amid the pandemic. Many dentists also saw increases in stress-related conditions among patients (teeth grinding, jaw pain) as well as increased cavities and gum disease, which are believed to be due to changes in people’s diets and hygiene.
While the Third Street practices have long seen their fair share of emergencies, Hoag said he had never before seen such a high number of emergency cases in his 11 years with the company.
The challenge now is getting patients in for regular check-ups, said Peggy Anderson, chief executive officer for Third Street Family Health Services.
“We’re trying to shift back to getting folks to just schedule regular appointments, have regular care, be taken care of and have a dental home,” Anderson said. “We hear a lot about medical homes, but we don’t hear a lot about dental homes, and those are just as important.”
In the remaining months of 2020 after the practice opened, 9th Street had 339 visits, and so far in 2021 through August the practice had 1,611 visits, which includes both emergency and routine visits, Anderson said.
“Opening up a new practice in the smaller community, I mean, that’s always a hurdle,” Anderson said. “How do you find people? How do they find you?”
Attracting and retaining a consistent patient base is still a work-in-progress for the year-old practice, Anderson said.
“It’s been a slower build for us, but still a build,” Anderson said. “And we’ve consistently been increasing in numbers.”
As routine services pick back up, 9th Street Dental has one dentist, one hygienist, two dental assistants and front desk staff to keep up with demand.
The sole dentist at 9th Street, Shelby Rohr, grew up in the Ashland area. She said she was eager to switch from her previous position at the Shelby practice to serve her hometown.
“It has been a whirlwind, not only opening a new practice but during the pandemic and trying to get all of the patients that utilized 9th Street previously back in,” Rhor said. “So we’ve been very busy, but we’re finally rolling.
“We’re busy every day.”
