As rural hospitals struggle with declining reimbursements and deepening workforce shortages, Tennessee has been hit especially hard. A recent report by the Physicians Advocacy Institute found that between 2019 and 2024, rural Tennessee lost 42% of its independent physicians and 44% of its independent medical practices.
Amid the growing strain on rural health services, Meharry Medical College is stepping in to address gaps in dental care. The private, historically Black medical school affiliated with the United Methodist Church operates mobile dental units that deliver affordable services to underserved communities.
Dr. Julie Gray, associate dean of community affairs and a 1999 graduate of Meharry’s School of Dentistry, leads the initiative. The mobile units are currently serving Bedford County, a largely rural area where many residents live below the poverty line and lack insurance coverage.
“The state of health and dental in Tennessee has very much been affected by the decline,” Gray said in a February interview with U.S. News. “Many people are uninsured and lack access to care. They often wait until they have urgent or emergent needs because their dental issues go untreated.”
The mobile clinics focus on prevention. Services include cleanings and fillings designed to stop minor problems from escalating into costly procedures such as root canals or extractions.
“We try to take care of patients before they have a problem,” Gray said. “If we can address issues early, we help them avoid emergency room visits, which are far more expensive.”
Accessibility is central to the program’s mission. The units travel to churches, schools and community centers, reaching residents who may lack transportation or struggle to schedule appointments during standard business hours.
Meharry first launched the mobile dental program in 2018. It was paused during the COVID-19 pandemic and resumed in 2021. Since then, the school has expanded outreach across rural parts of the state, including West Tennessee, where access to dental services is limited.
Gray described strong community response. At some evening events, patients have waited in line after hours for cleanings because daytime appointments are not feasible for working families.
“It’s been overwhelmingly positive,” she said.
Gray believes the units are increasingly vital as rural hospitals face mounting financial pressure. Preventive dental care, she noted, can help avert broader health complications. Tooth loss, for example, can lead to difficulty chewing and digestion problems, potentially contributing to other systemic conditions.
“Our goal is to help patients sustain what they already have and provide education so problems don’t become emergencies,” she said.
Gray said partnerships are essential to the program’s success. By collaborating with churches and local organizations, Meharry builds trust and ensures sustainability.
“Aligning with community partners who share our mission helps patients feel comfortable and ensures we can continue meeting their needs,” she said.
As rural health systems continue to contract, Meharry’s mobile model offers one approach to preserving access to dental care in Tennessee’s most vulnerable communities.