Since elementary age, Rafael Urrutia Camargo remembers going to medical appointments with his parents and trying his best to translate providers’ communications from English to Spanish for his family.

“That was the main motivation [in my career] — sometimes things get lost [in] translation and it’s just better to have somebody that can connect at a more personal level with their patients,” he says.

When Urrutia Camargo came across the Regional Initiatives in Dental Education (RIDE) program offered at the University of Washington School of Dentistry (UWSOD), he knew it was the right fit. Currently in his first year, he plans on practicing dentistry somewhere near the orchard town of Monitor, Washington, his hometown, which is close to Wenatchee, in the rural north-central area of the state.

“I do see myself coming back to my community and working at a community clinic to help fill that void of a lack of Hispanic dentists that are competent with the culture [and] with speaking and writing the language,” he says.

Supporting Regional Populations
Individuals in rural communities face a number of barriers in accessing oral care, including financial concerns, lack of insurance coverage, shortage of providers, and difficulty accessing transportation services, according to the 2023 report “Still Searching: Meeting Oral Health Needs in Rural Settings” by CareQuest Institute for Oral Health, a nonprofit organization.

The study reveals that 67% of rural areas are designated as having a shortage of dental health professionals. Additionally, 40% of adults in these communities have not received professional dental care in over a year and 34% rate their oral health as fair or poor, which is 9% higher than people living in urban and suburban areas.

To address this, the RIDE program is creating a pipeline of providers dedicated to working in rural and underserved communities. Inspired by the University of Washington School of Medicine’s successful regional medical education program operating in what is known as the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) area, RIDE is designed to train dental students across this region.

“People coming from rural areas and going into the cities to get trained as dentists, or physicians, or nurses, or pharmacists, and then staying in [that city] is a problem around the world,” says Frank Roberts, DDS, PhD, associate professor, RIDE director, and associate dean for regional affairs at UWSOD. “[We’re working on] how to actually get people to return [to rural communities]. So far, we’ve been really, really successful.”

State funding was first designated for the program in 2007, and the first cohort of RIDE students graduated in 2012. Since then, nearly 70% of RIDE alumni are practicing in non-urban WWAMI areas and over 80% are in rural or underserved communities.

Due to high demand, leaders received $2.5 million in additional funding this year to double the number of participants and expand clinical options across western Washington. RIDE will enroll 64 students annually.

Many RIDE participants are from Hispanic, Latino, and Native American populations and come from farmworking communities, says Roberts. There are a myriad of benefits to having providers reflect patient populations. However, he says, the greatest one is that individuals are more likely to seek dental care when they feel understood by their provider.

“A ton of what we do as dentists is drill and fill, or take teeth out that are causing problems, but it’s much better to prevent [complications],” he says. “[This requires] good communication with patients and trust, [which] gives them [the] support to take care of themselves.”

Advancing Skills
RIDE students commence the program with an orientation and an introductory course. During their first year, they travel to the Eastern Washington University (EWU) Spokane campus, where they participate in coursework with EWU faculty and stay connected via virtual learning at UWSOD.

The summer after their first year, students complete a four-week rotation at an affiliated community health center in central or eastern Washington. They return for their second and third years at UWSOD in Seattle and partake in clerkship and comprehensive care clinical training models. In their fourth year, they return to a community health center, building on their growing clinical and professional skills.

RIDE is advancing a number of goals, one of which is to ensure that participants are equipped with leadership expertise so they can improve health care in their practice. This includes becoming involved in local, state, and national policy.

In addition, students should be comfortable treating patients from all different backgrounds, says Roberts. One initiative advancing this goal at UWSOD is known as the Dental Education in the Care of Persons with Disabilities (DECOD) program, established in 1974. The program provides clinical services to patients in Seattle and has recently expanded to include training at regional health centers focused on treating adults and children with disabilities.

Projects like DECOD and RIDE can serve as models for higher education institutions, governments, and agencies across the world. In addition to working with the American Dental Education Association to assist in the development of rural service rotation models throughout the country, UWSOD leaders have spoken with international groups about how to address provider shortages in their own communities, says Roberts.

“We’re [addressing] the issue from a lot of different angles and [finding] best practices in all areas to support students and dentists to practice in rural areas as a lifetime career,” he says.

Jared Ortiz, currently in his fourth year of the program, says his RIDE journey has been indispensable. Although he has lived in the Seattle area his whole life, he was inspired to join after learning about it as an undergraduate, wanting to put his dedication to community outreach and bilingual skills to use in a Spanish-speaking location.

Throughout the program, not only has he felt supported by faculty, but also by two provider mentors. He urges students pursuing health care careers to embrace the opportunity to explore rural practice.●