The number of uninsured Americans has steadily climbed since the COVID-19 pandemic began driving job loss — and thus employer-sponsored insurance — for many people. And a shortage of health professionals is compounding the problem in Virginia. As executive director of the Virginia Health Care Foundation (VHCF), Deborah D. Oswalt leads the organization’s mission to help uninsured Virginians and those who live in underserved communities obtain medical, dental and mental health care. A public-private partnership, the VHCF supports free clinics and community health centers, and other similar health and dental safety net practices. It also supports statewide programs like Smiles For Children and ToothTalk that are dedicated to providing and expanding oral health access to those who need it most.

VHCF originally focused on primary care and affordable medications. What prompted the inclusion of oral health?

Our realization that we needed to look beyond medical care happened about four years into the life of our foundation, which launched in 1992, when we got a proposal from a school system on the Eastern Shore of Virginia asking for money to build a dental clinic for children outside one of the elementary schools. They had just done an assessment of all the fifth graders in their county and learned that 75% had never been to a dentist. It was shocking! That major “aha!’” moment led to our involvement in building a dental safety net in Virginia. Since then we’ve invested $16 million to create and expand those dental clinics.

How would you describe the influence VHCF has had on communities in Virginia?

If I died tomorrow, I’d be happy with the way I spent my life — helping people get the health care they need. When it comes to dental, all you have to do is see the contrast between people who haven't had access to dental services and those who have. Someone who hasn’t will equate teeth with pain — they just want their teeth taken out. So just making regular dental care available to them means changing their lives. People who never smiled are now smiling because they're not ashamed of their appearance. We have one guy out in Southwest Virginia who, after he got his dentures, got a new job and a girlfriend! He was a changed person. You see that over and over again. 

On the children's side: Can you imagine being a kid at school and having a throbbing toothache and not being able to concentrate or get it fixed? Those days are gone in Virginia. That same place on the Eastern Shore, where 75% of the kids had never been in a dentist’s chair, now has dental access everywhere, and kids have a place to go. That’s because of our work.

What are other ways VHCF supports those providers who offer care to the underserved?

ToothTalk is a community comprising dental safety net personnel, as well as others interested in dentistry, from academics to board members of organizations. Twice a year we have a roundtable where we bring everybody together to talk about cutting-edge policy issues and topics within the practice of dentistry that everyone is facing. We also have a ToothTalk listserv, which has been incredible during COVID. We have several dentists who have made a point to research and post the latest guidelines from the state, the ADA and the CDC. There are a lot of how-tos: “OK you have to close down your dental practice except for emergencies. Well, how do you define an emergency?” “What’s teledentistry and how do you do it?” It’s a fabulous venue for people to share their questions, concerns and ideas. And it’s not exclusive — anyone can participate in it!