was in private practice in Mobile before he came to the Alabama Department of Public Health a year ago. Johnson said Alabama provides coverage for children’s dental care, but adults, especially if they are low-income and live in rural areas, have challenges finding and paying for dental care. Transportation can be a problem. Alabama does not pay for dental care for adults on Medicaid, so adults with income well below the poverty level often end up having problem teeth pulled as a result. But Alabama Medicaid Director Danny Rush said the program does have some non-emergency transportation funding to help patients get to a doctor’s office. Alabama rural health advocate Dale Quinney is a retired director of the Alabama Rural Health Association. Quinney questions whether dental hygienists could clean and check teeth for problems in rural areas and use telehealth to connect with a dentist who could check for problems. Johnson said the public health department already uses telehealth, and designs and builds programs to communicate with public health clinics around the state. “I would like very much to be able to incorporate tele-dentistry in public health at some point, but the Alabama Dental Practice Act requires direct supervision of dental treatment by a dentist,” Johnson says. The dental association’s Studstill said current Alabama law requires that a dentist be in the same location as a hygienist or other dental professional doing cleaning or other preventive or diagnostic treatment. Studstill said the requirement is a patient safety issue in case a patient has problems with bleeding or other medical issue needing quick response of a dentist. The law is one that he said the dental association and the Board of Dental Examiners support. But along with the telehealth tools that the Department of Public Health has, Studstill said the dental school is developing telehealth capabilities to help dentists practicing in small towns consult with specialists who are usually in larger city settings. Bradley W. Edmonds, executive director of the Alabama Board of Dental Examiners, says the board is aware that there are concerns about access to dental care in rural areas. He said the board earlier this year voted to allow dental hygienists with additional training to administer local anesthesia by injection, something he said is a step toward better access to care. Alabama Living
MAY 2019 21