Cross Cutting

Oral Health remains a cross cutting area of concern for the USVI.  Many families cannot afford the cost of much needed oral health services. Due to the lack of adequate oral health care, common concerns include tooth decay, tooth loss and bone loss. Limited access to care has created waitlists of upwards of one year through our FQHC’s.  Some private providers accept insurance while many remain out of network due to the reimbursement and application wait times under insurance providers and/or the Medical Assistance Program (MAP). 

While a significant portion of the population are Medicaid eligible, there are not enough providers and not enough facilities participating in the territory’s Medicaid program, commonly referred to as Medical Assistance Program, or MAP. “A recent report by University of the Virgin Islands researchers, the Community Needs Assessment, said there is a waiting list for Medicaid-backed dental care on St. Croix that is 4,000 people long” (VI Source, 2019). MAP is set up so that a patient on Medicaid must use a public center for general dental care. If the center can’t provide what is needed, the patient can be referred to a private dentist, but only after being assessed at the public center.

In 2012, Dental services that were available at clinics administered by the Department of Health were suspended and have not resumed. The Federally Qualified Health Centers (FQHCs) in both districts are the only current public entities providing oral health services. Those services include providing examinations, fluoride applications, fillings and extractions to the children and families who have Medicaid and who are underinsured and uninsured.

At Frederiksted Health Care, Inc. it is estimated that there is a need to cover about 200,000 visits per year. If the centers operate at full capacity every day, the most they can handle is about 18,000 visits (VI Source, 2019).  With expansion of the St. Thomas East End Medical Center’s dental services facility in 2016, the waiting time for a regular appointment is about five weeks; emergency cases are handled on a same-day basis (VI Source, 2019).

The Charles Harwood Complex on St. Croix was closed after extensive damage resulting from Hurricanes Irma and Maria.  Plans to conduct an oral health assessment in partnership with Title V and MCHB were suspended. While the new modular units do not include a dental suite, the Department of Health is in discussions with local partners to determine how best to move forward in meeting the wide range of unmet oral health needs in our population.