Vermont
Vermont lacks dental providers, efficient treatments, new report finds – VTDigger
Many Vermonters have insufficient or nonexistent access to dental care, and the state is losing dental providers, according to a new report released Thursday.
The Vermont Oral Health Equity Landscape Report, published by the nonprofit Voices for Vermont’s Children, found that, over roughly the past half-decade, Vermont has lost dentists at a faster rate than almost every other state and seen a decline in its children’s dental health.
The state has also been slow to roll out new dental procedures — non-invasive methods that could easily and cheaply improve oral health for many Vermonters, according to the report.
“It’s very clear that oral health is a key component of overall systemic well being,” Michelle Fay, the executive director of Voices for Vermont’s Children, said in an interview. “And the system that we have set up isn’t working.”
According to national data from the American Dental Association cited in the report, Vermont had nearly 60 dentists per 100,000 residents in 2019, roughly the national rate.
The state reached that figure “after many years of robust recruitment and policy incentives meant to bolster the dental workforce,” the report reads. But the Covid-19 pandemic erased those gains: As of 2023, Vermont had only 53 dentists per 100,000 residents, the second-steepest decline in the country, per the report.
From 2015 to 2021, the number of dental hygienists practicing in the state also declined by about 4%, according to data cited by the report. The number of public health dental hygienists — hygienists employed by the Vermont Department of Health — dropped from five prior to Covid-19 to one currently, the report reads.
The state has also struggled to add dental therapists, professionals who perform routine dental care, to the ranks of practitioners. Last year, the Vermont state auditor found that Vermont State University had failed to stand up a dental therapy program, even after seven years and a $2.6 million investment of public funds.
One bright spot noted in the report is Vermont Medicaid’s coverage of dental care. As a whole, Vermont dentists see more Medicaid patients than any other state, although its Medicaid reimbursement rates for dental care were mixed: adult reimbursement rates were relatively high, while rates for children’s dental care were in the middle of the pack nationally.
Still, Fay said, accessing dental care as a Medicaid patient is not easy. Some dentists may think, “in theory, I’ll take a Medicaid patient,” Fay said, “but only if I haven’t filled all my slots with either private pay or insurance with a higher reimbursement.”
The report also notes that Vermont providers have been slow to adopt new, inexpensive and minimally invasive dental procedures. The report names two specifically: silver diamine fluoride and silver modified atraumatic restorative technique, methods in which protective materials are applied to the outside of teeth.
Those procedures could have a significant impact on Vermonters’ dental health at low cost, the report says.
Voices for Vermont’s Children recommends that the state invest in low-cost dental facilities and procedures across the state, including the integration of dental facilities with primary care facilities. The state’s health department should also consider a public education campaign focused on oral health, the report says.
“The top line is really just the need to think differently about integrating oral health into overall health,” Fay said, “and using all available treatment models to meet the needs of these communities.”
Via Community News Service, a University of Vermont journalism internship, in partnership with Vermont Public
🎧 This story was produced for the ear. We highly recommend listening to the audio. We’ve also provided a print version of the story below.
On solar farms, the ground beneath the solar panels is often planted with turf grass and left alone. But some Vermonters are experimenting with productive ways to use that land: grazing livestock, growing crops, and creating habitat for threatened pollinators and birds.
Solar makes up about 16% of the energy Vermont generates, and that number has been growing for over a decade. As solar grows, so does Vermont’s capacity for agrivoltaics — the dual use of land on solar farms for agriculture.
Lewis Fox is a sheep farmer in Leicester, Vermont. With his wife, Niko Kochendoerfer, he runs a business called Agrivoltaic Solutions. They are hired by solar companies to manage the vegetation on solar farms. “We’re in charge of keeping the vegetation within certain limits, and the sheep are the tools that we use to do it,” Fox said.
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Community News Service
Fox said that sheep are ready-made for solar farms. “They’re pretty short stature, so they can really fit into nooks and crannies,” he said. “They’re also not really interested in chewing on wires or jumping on panels.” The panels also provide sheep with protection from the elements and shade, which means that the sheep don’t need to drink as much water on hot days.
Fox and Kochendoerfer work with farmers from Buffalo, New York to Bangor, Maine, helping them learn the ropes of solar grazing. Fox is also a founding member of the American Solar Grazing Association, an organization that promotes solar grazing and provides educational materials for farmers who want to get into it.
In the winter, when there is no grazing to be done, Fox and Kochendoerfer breed the sheep and sell grass-fed lamb. Fox said that the additional revenue they earn from agrivoltaics is a huge help financially. “For us as livestock producers, being able to use the animals in another way is very significant in terms of farm viability,” he said.
Solar grazing has exploded in recent years. There are currently about 130,000 acres of solar arrays in the United States grazed by sheep. “We think it’s got a bright future,” Fox said.
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Community News Service
Sheep aren’t the only animals that can find food on a solar farm.
The Weybridge-based nonprofit Bee the Change is turning solar fields into habitat for bees and other pollinators. Since 2015, they’ve created habitat on 30 solar sites.
Mike Kiernan is a co-founder of Bee the Change. He said one of the organization’s main goals is to support Vermont’s native bees, many of which are threatened by loss of habitat, disease or pesticides.
Kiernan said that although some invasive plant species can be helpful to pollinators, the team at Bee the Change tries to plant native species at these sites. “Our goal is to get the highest percentage possible of native plants, because they have the longest relationship with these species,” Kiernan said.
And their efforts are working.
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Community News Service
Through careful monitoring, the leaders at Bee the Change have seen pollinator populations on their sites increase dramatically in both number and diversity.
Supporting pollinators also helps support the plants they pollinate, which helps people, too. “We’re all actually connected, and our survival is connected,” said Kiernan. “And when people see a habitat that is enriched with pollinators, they are appreciative.”
Encore Renewable Energy, a Vermont-based B Corp, has hired both Kiernan and Fox to manage the vegetation on its solar sites. The company specializes in community-scale solar projects.
Chad Farrell is the co-CEO of Encore Renewable Energy. He said the company prioritizes using agrivoltaics because it’s good for local economies and good for the environment.
Solar grazing is often cheaper than mowing, and it cuts down on emissions because mowers, which run on fossil fuels, are not needed as often.
Planting native plants to build pollinator habitat can increase the soil’s potential to store carbon by 65%. It’s also good for the soil’s overall health — potentially paving the way for future agriculture on the land. “At the end of the useful life of the project, we’re actually able to return that land in a better condition than what we found,” Farrell said.
Maeve Fairfax
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Community News Service
Some Vermonters don’t like to see agricultural land repurposed for energy production, but agrivoltaics can help alleviate this tension. “Everybody loves driving by one of our projects and seeing a bunch of sheep out there doing their thing,” Farrell said.
Lewis Fox, the sheep farmer, agrees.
“It’s often difficult for people to see solar being built on ag land, for various reasons, and I think you could argue the merits either way,” he said. “But we can help bridge the gap in that. What we’re able to do is have solar production coexist with agriculture. And it’s not just window dressing. It’s real agriculture.”
This week, a bill that would make changes to Vermont’s Act 181 is receiving testimony in the House Committee on Environment. Certain provisions in Act 181 could trigger a permitting process through Vermont’s land use protection law, Act 250. A rule related to road building and some lands identified as “critical natural resource areas” by the state’s land use review board are expected to take effect this year. Last month, legislation passed the Senate and is currently in the House to push those deadlines back by a few years. For Corinth resident Neil Ryan, that not enough. “The group of people that was largely left out of the process: Rural Vermonters are having this imposed upon them with no say,” he said. Ryan and his family have built their own farms for generations. He believes if the provisions take effect, it would be very difficult for future generations to accomplish what he has. “The difficulty of the Act 250 process, the costs associated with the Act 250 process, we wouldn’t have started those farms likely,” he said. However, Ryan said he does support the portion of Act 181 that allows towns to opt into being exempt from the permitting process altogether. This is meant to assist housing development. On Tuesday, regional planning commissions told lawmakers that many towns have opted in. Still, Vermont is not on track for its goal of 40,000 + homes by 2030. “We’re not saying rural housing growth should stop or slow,” Executive Director of the Northwest RPC Catherine Dimitruk said. “Were saying those additional units that we need, we should be doing all we can to encourage and incentivize.”The bill will remain in House environment for the foreseeable future.
This week, a bill that would make changes to Vermont’s Act 181 is receiving testimony in the House Committee on Environment.
Certain provisions in Act 181 could trigger a permitting process through Vermont’s land use protection law, Act 250.
A rule related to road building and some lands identified as “critical natural resource areas” by the state’s land use review board are expected to take effect this year.
Last month, legislation passed the Senate and is currently in the House to push those deadlines back by a few years. For Corinth resident Neil Ryan, that not enough.
“The group of people that was largely left out of the process: Rural Vermonters are having this imposed upon them with no say,” he said.
Ryan and his family have built their own farms for generations. He believes if the provisions take effect, it would be very difficult for future generations to accomplish what he has.
“The difficulty of the Act 250 process, the costs associated with the Act 250 process, we wouldn’t have started those farms likely,” he said.
However, Ryan said he does support the portion of Act 181 that allows towns to opt into being exempt from the permitting process altogether. This is meant to assist housing development.
On Tuesday, regional planning commissions told lawmakers that many towns have opted in. Still, Vermont is not on track for its goal of 40,000 + homes by 2030.
“We’re not saying rural housing growth should stop or slow,” Executive Director of the Northwest RPC Catherine Dimitruk said. “Were saying those additional units that we need, we should be doing all we can to encourage and incentivize.”
The bill will remain in House environment for the foreseeable future.
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