Tooth decay is the most common chronic childhood disease, according to the U.S. Centers for Disease Control and Prevention. Accessing high-quality dental care is already difficult for low-income families. But in rural communities, the need is even greater, where limited public transportation and a shortage of dental providers make care even more challenging to find.
Liberty-based dental hygiene nonprofit PRASAD saw a 40 percent increase in children patients from 2023 to 2024 after they expanded their mobile clinics in Sullivan County, says PRASAD’s Executive Director Dr. Cecilia Escarra. Still, she’s worried that a stigma around dental care and limited available providers serving low-income patients continues to stagnate access.
“Families lack awareness about the importance of preventative care, that you don’t come to the dentist only when you are in pain or when you have cavities,” said Escarra. She says she sees rural residents carry a greater stigma around seeking dental care compared to urban residents. “Unfortunately, we see many children who are very young and it’s sad to see that they come with many, many cavities.”
A 2024 report from the Center for Health Workforce Studies found that Sullivan County is one of 31 areas in New York with the highest needs for oral hygiene services. The report cites population-to-dentist ratios, disability, and poverty levels as major barriers to access.
Other rural regions in the state including the Southern Tier, North Country, and Mohawk Valley also face a high need for dental care, according to the report.
Established in 1998, PRASAD serves children six months to 18 years old in Sullivan County. The nonprofit serves more than 3,500 low-income children each year by delivering services directly to schools to minimize challenges posed by limited public transportation and the county’s rural terrain. Participating schools include Liberty Elementary School, Tri-Valley Elementary School, and Roscoe Central School District.
While PRASAD does not serve adults, Escarra says her team frequently receives calls asking for adult care that accepts Medicaid or low-cost insurance with nowhere PRASAD feels they can refer them to.
Escarra says that navigating the oral healthcare landscape also hits providers.
“It’s very expensive to run a dental clinic,” she said, noting that dentist salaries, supply costs, and varying reimbursement rates can quickly add up.
You can reach out to PRASAD about insurance eligibility or to make an appointment by phone at 845-434-0376. You can also find dental clinics in New York State that accept Medicaid on the state’s Department of Health website.
Image: Exterior of one of PRASAD’s mobile clinics (Photo Credit: PRASAD)