MARYLAND

The Eastern Shore

Dental disease and lack of access to oral health care is one of the most critical health care issues on Maryland’s Eastern Shore. Children living in the region have more dental disease than in any other area of the state. In 2005, a coalition of health organizations formed the Eastern Shore Children’s Regional Oral Health Consortium to address oral health access issues in the mid- and lower counties on the Shore, all designated Dental Health Professional Shortage Areas. Historically, most local dentists have not participated in the Medicaid program. Children who are pre-cooperative, have special health care needs, or have extensive dental disease requiring sedation, have to travel to Baltimore for dental care. An estimated one in five children attends school each day with dental pain. There are considerable oral health disparities in this area, especially among the low-income and pediatric populations.

Since 1980, the Choptank Community Health System (CCHS), a JCAHO-approved community health center, has provided primary health care services in the mid-counties of Caroline, Dorchester, and Talbot on the Eastern Shore. The center has had over a 50 percent growth in its patient base over the past five years; among the patients, 52 percent are below 200 percent of the poverty level and 29 percent are uninsured. The system has seven primary care locations offering family practice, pediatrics, women’s health, and behavioral health care. The system also has four school-based wellness centers and offers outreach services through its Migrant Health Program. The Federalsburg Dental Center is a five-operatory dental facility providing comprehensive oral health services since December 2001. Since its inception, the demand for services at the dental center has far exceeded the capacity of the facility and staff. In order to cope with the demand, the center requires that patients must reside in the mid-counties. There is a focus on children who are uninsured or eligible for Medicaid. Adult care targets pregnant women, those with emergencies, or those referred by medical providers for chronic illness such as HIV or diabetes. Another interim two-chair dental facility will open in Cambridge in October 2006 and move into a new medical professional building with three additional chairs in late 2007.

The highly productive staff includes two general practitioners, four dental hygienists, and four dental assistants. Two part-time pediatric fellows from the University of Maryland provide services at Dorchester General Hospital, thereby relieving some families of the burden of traveling to Baltimore for care for their children. Approximately two to five children a month require hospitalized oral health services. In addition to the Federalsburg and Cambridge facilities, the center is seeking funding to open a third dental clinic in Goldsboro in Caroline County, and it sponsors school-based and migrant dental health programs.

CCHS is also cooperating in the enhancement of training for dental hygienists for the region. In 2004, two slots at Allegany Community College in western Maryland were allocated for Eastern Shore students who must return and work for two years in a Federally-qualified health center. The University of Maryland Dental School is establishing an affiliation between the two community colleges on the Eastern Shore and the University’s Dental Hygiene Bachelor of Science Program.

”...a fruitful and delightsome land.” -John Smith

In 1634, Leonard Calvert and 140 others arrived at the mouth of the Potomac River, where the river meets the Chesapeake Bay, seeking a refuge for Catholic settlers and a source of potential income. He acquired a 30-mile stretch of land from the chief of the Piscataway Indians and founded St. Mary’s. Calvert declared religious freedom for Catholics and Protestants, but not Jews. He envisioned establishing a system of manors owned by English gentleman and worked by tenant farmers with labor by indentured servants and slaves. The region was bountiful-fish, oysters, crabs, ducks, deer, and forests filled with a variety of wood. Within several decades the peaceful Piscataway, who had hoped for protection by the English, were decimated by disease and raids from the rival Susquehannock. The majority of settlers were indentured servants who established their own small farms and the most important crop became tobacco. Eventually, Protestants outnumbered Catholics and they carried off a political and religious coup when William and Mary overthrew King James in England. The colony was placed in the hands of a royal governor, the capital moved to Annapolis, and Catholics lost the right to vote until after the American Revolution.

Tobacco brought prosperity to the region and produced wealth not only for the gentry but generations of shopkeepers, craftsmen, and artisans; for many except the tenant farmers and slaves. The “Tobacco Coast” thrived until surpassed in the 19th century by Baltimore and western cities in the state.

Only a hundred miles from Washington, DC and Baltimore, today, this exquisite region hosts picturesque towns, spectacular waterways, and is highly desirable as an idyllic residential and vacation region. The justly-famous bounty of the Chesapeake Bay, oysters and blue crabs, inspire crab festivals and oyster roasts throughout the region.

Maryland *Scott Wolpin, DMD AEGD Assistant Program Director 410.754.7723 swolpin@choptankhealth.org

© 2006 Lutheran Medical Center Department of Dental Medicine Photo provided by Maryland Office of Tourism