UW rural dentistry program helping to fill vital need across Washington

WALLA WALLA — When Patty Martin was 13, she already knew she was interested in science and people.

She made a list of potential occupations in alphabetical order, pausing to consider becoming a chiropractor. She never made it past the letter “D.”

While having her teeth cleaned, she asked her dentist about his job. He invited the teenager to shadow him, an experience that placed her on a trajectory to her career.

Martin grew up in the Seattle suburbs and attended Washington State University. After graduating, she got a job as a flight attendant for Alaska Airlines to help pay off student loans. On a layover in Sitka, Alaska, she received the phone call from the University of Washington School of Dentistry.

Martin was accepted to what was then the inaugural class of the Regional Initiatives in Dental Education, known by its acronym RIDE, a special cohort trained to practice dentistry in rural communities.

She felt at home in Eastern Washington, drawn to the sunshine, the rugged landscapes, and small enough communities where she could see the impact of better oral health care on her patients and their families.

A dozen years later, Dr. Martin has built herself a thriving dental practice in Walla Walla, the remote, compact city about an hour east of the Tri-Cities.

“If you can change someone’s life or leave a little piece of you along the way, I think that’s fulfilling,” she said. “What’s great about dentistry is you do get the chance to have those interactions.”

Good oral health is about much more than fighting cavities and encouraging flossing. Dentists can spot the signs of a number of other health conditions such as diabetes, cancers and high blood pressure, to name a few.

Dentists are in high demand nationwide, but especially in rural areas like Eastern and Central Washington. That is why the UW School of Dentistry created RIDE. Its mission is to offer practical experience in rural community clinics, preparing graduates for the challenges of practicing in remote locations.

In addition to workforce development, RIDE also has built a professional network throughout the Pacific Northwest, offering expertise via new technologies and creating mentorship opportunities among generations of dentists.

RIDE’s origins modeled after WWAMI

About 15 years ago, School of Dentistry officials wanted to develop a program modeled after the success of UW School of Medicine’s WWAMI, the medical education program for the five-state region of Washington, Wyoming, Alaska, Montana and Idaho.

WWAMI helps doctors train in far-flung, rural areas as well as cutting-edge trauma centers in Seattle.
RIDE, first funded by the Washington Legislature in 2007, is similar to WWAMI in the connections and network the School of Dentistry has helped foster throughout the Pacific Northwest. By providing world-class training in small communities, the UW is creating gateways.

“We’re trying to improve access to care, particularly in rural sites in Washington and in the five-state region,” said Dr. Frank Roberts, the RIDE Director and associate dean for Regional Affairs in the School of Dentistry. “It’s the rural areas that have a lot of challenges.”

The demand is so high that the UW this year asked the Washington Legislature for and received $2.5 million to expand RIDE from 32 to 64 students, doubling the number of graduates and expanding into clinics in rural, Western Washington.

The program also is using federal money from the U.S. Department of Agriculture to pay for technology to connect community clinics to UW dental specialists and to enhance the classroom experience for first-year RIDE students, who are based in a high-tech classroom on Eastern Washington University’s Spokane campus.

“We still get the same education,” said Grace Martin, 23, a first-year RIDE student from Spokane. She’s pursuing dentistry after seeing the impact good dental care had on her grandmother. “We take the same tests and everything.”

Some classes are held over Zoom with professors in Seattle; other classes are taught by faculty in Spokane. The students have access to dental labs, in shared space with Eastern’s dental hygiene program. At the end of the first year of classes, RIDE students complete a four-week rotation in a community clinic in Eastern or Central Washington.

Second- and third-year RIDE students take classes on the Seattle campus, although officials are looking to use the newest funding to allow second-year students to remain in Spokane.

RIDE students spend their final year in extended placements at one of the rural dental clinics, where they hone their clinical and professional skills under the supervision of UW affiliate faculty.

There’s no extra cost for students who are accepted to the RIDE track. The four-year degree costs about $420,000 for in-state students and about $552,000 for those from out of state, including fees and living expenses. State and federal programs provide some scholarships and loan repayment plans. While compensation varies depending on location and patient population, a dentist could expect to earn enough to pay off their education in about three to five years, according to data compiled by the U.S. Bureau of Labor Statistics.

Caring for complex communities

During her junior year at Washington State University, Dr. Mariany Morales attended a presentation about RIDE. She heard from RIDE students about working in small, isolated communities in Eastern Washington.

The daughter of Spanish-speaking farmworkers, Dr. Morales grew up in Yakima, not far from the community clinics where RIDE students are placed to gain real-world experience.

“I was just, I was blown away. And it was very heartwarming,” she said. “And I was like, ‘This sounds like exactly what I want to do for my career.’”

After earning her doctor of dental surgery degree in 2021, Dr. Morales took a job about an hour north of her hometown at the Quincy Community Health Center.

She was drawn by the demands of caring for a population that can have complex needs. Specialty care — which can be easily accessed in big cities like Seattle — can be out of reach for some patients in remote parts of the state. The cost, distance, language barrier and lost wages alone can present insurmountable barriers.

Plus, working in Quincy has other benefits to being in a big city. Dr. Morales often cares for multiple generations of the same family, patients she’s likely to bump into while grocery shopping. She lives minutes away from the clinic, and the town can feel like an extended family.

The trust she builds with patients, often Spanish speaking, translates to better outcomes. Patients can require complex dental care, but if they’re not onboard, they’re not likely to make an appointment.

“If they don’t feel that comfort, I mean, some people just won’t return and won’t get that treatment,” Dr. Morales said.

Playing an important role in communities

About 10 years ago, when Cyndy Knight and her family were looking for a new dentist, her husband heard Dr. Martin speak at a Rotary Club of Walla Walla event.

He was impressed by Martin’s UW credentials and her commitment to patient care.

The family of five, including a daughter with special needs, have been with Dr. Martin since.

“I used to really dread going to the dentist because I knew I had delayed maintenance,” she said. “So I knew whenever I would go that I was probably looking at a couple fillings.”

And Knight was self-conscious of her smile, embarrassed by her crooked alignment — a barrier to her non-profit advocacy work, which often involves public speaking.

Dr. Martin helped Knight develop better oral health, filling by filling, and then improve her smile using orthodontics.

“That’s what Patty does so well is that she’s in there and she’s talking to you about, ‘Let’s address what we’re currently seeing, let’s get this cleaned up and good. And then let’s start talking about where you want to move from here,’” Knight said.

Roberts, the RIDE director, said that 80% of graduates go on to develop practices in rural and underserved areas, a trend that far surpasses the national averages.

Most RIDE graduates, including Dr. Martin, do very well, he said.

“They get a chance to be really important and matter in that community, have a big role in leadership of the community, leadership with the young people in the community towards education, and towards considering professional careers,” Dr. Roberts said.

The UW now is working to improve telehealth options in the community clinics, opening access to experts who can help assess if a case can be managed locally or requires specialty care in a larger city.

“It just saves everybody a lot of time and money, really. And it saves the health care system money, too,” Dr. Roberts said.

Making a difference

Rafael Urrutia-Camargo grew up helping his parents pick cherries in Monitor, a small town near Wenatchee. He also would accompany them to medical appointments, translating between the doctors, who spoke English, and his parent’s native Spanish. Urrutia-Camargo was able to see firsthand the barriers that underserved families often experience in rural communities.

His decision to enroll in RIDE this year was fueled by his passion to return to his hometown and help provide quality care to underserved populations, with the empathy of someone who grew up on the receiving end of community clinics.

“I feel like it’s my duty, because the University of Washington, they’re doing all of this training,” the 25-year-old said. “For me, it’s really important to be able to go back and utilize all those skill sets that we’re going to gain in the next four years.”

For Dr. Morales, the dentist in Quincy, it’s about the good feeling she gets knowing she helps patients improve their health. She said she enjoys meeting and learning from the diverse people who fill her practice. She’s also looking forward to one day helping to train the next generation of dentists like Urrutia-Camargo, who are just beginning their careers.

“I love the RIDE program and everything that it stands for,” Dr. Morales said. “It is doing great things and preparing people to be able to come back to these rural communities and make a difference in other people’s lives.”

A related story was published by KXLY.