Reimagining access: A dental hygienist-coordinated clinic model transforming rural oral health

For decades, the Health Wagon has been recognized as a national leader in mobile health care, operating what grew to become the largest dental outreach system in the United States as part of the Move Medical Mission Outreach (formally RAM Wise & MOM Projects). The dental services brought vital preventive and restorative dental services into some of the most remote communities of Central Appalachia, regions where transportation barriers, deep poverty, and persistent provider shortages made traditional dental care nearly unreachable.

In 2023, the Health Wagon marked a historic milestone with the construction of its first brick-and-mortar dental clinic, expanding its capacity to deliver consistent, year-round care. This approach reshapes oral health delivery by creating a stable clinical infrastructure that supports high-volume care, modern technology, and year-round services, transforming what was once fragmented outreach into a comprehensive, continuous care system for underserved communities.

Additional reading: What it means to be a registered dental hygienist in 2026

My community health background and preventive-care expertise led to the creation of a dental hygienist-coordinated clinical model, now driving efficiency, accessibility, and interdisciplinary collaboration across the region. The hygienist-influenced model directs interdisciplinary collaboration by serving as the central coordinator who links dental care with medical, pharmacy, behavioral health, and outreach teams, aligning screenings, referrals, and care plans to create a fully integrated, patient-centered system.

From rural roads to a permanent home: A legacy of access

Before the construction of the stationary clinic, the Health Wagon’s dental services were entirely mobile, reaching school campuses, churches, coalfield communities, and large multiday mission events. These mobile clinics delivered thousands of encounters each year and became a trusted source of care for individuals who had gone decades without a dental home.

Yet as need continued to grow—especially among uninsured adults and medically complex patients—the organization required a structure that could sustain higher patient volume and provide continuous preventive care.

The 2023 permanent clinic became that structure, serving as the foundation for a new era of innovation and system redesign.

Introducing the hygienist-coordinated model

When I joined the Health Wagon, I recognized the need to bridge the strengths of mobile outreach with the capabilities of a modern clinic. Drawing on my training in community health and my firsthand understanding of rural patients’ unique needs, I developed a hygienist-coordinated model designed to:

• Streamline patient flow
• Expand preventive services
• Strengthen medical-dental integration
• Improve clinic consistency during high-volume periods
• Increase the number of patients seen each month

In this innovative approach, the dental hygienist plays a central role in care planning, workflow design, patient education, triage, outreach coordination, and interprofessional communication—core functions that directly address gaps in rural access.

My goal was to build a system where preventive care could truly flourish. Rural patients deserve a model that meets them where they are—and that begins by giving dental hygienists the space to lead.

A model rooted in mission

The transformation of the Health Wagon’s dental program is not merely operational; it is deeply mission driven.

“Caitlin’s model reflects exactly what rural health care should be,” says Teresa Tyson, DNP, MSN, FNP-BC, president and CEO of the Health Wagon. “It is efficient, compassionate, preventive, and rooted in equity. Her leadership ensures that no patient is ever turned away because of cost or circumstance.” Dr. Tyson emphasizes that the evolution of the dental program is directly tied to expanding access for families who have never had a dental home.

This vision is shared by Dr. Paula Hill-Collins, DNP, MSN, FNP-BC, vice president and clinical director, whose decades of leadership in mobile health care built the foundation for today’s system. “Dental care is health care—period,” says Dr. Hill-Collins. “Our communities deserve models that lift barriers and bring providers closer to the people. Caitlin’s hygienist-coordinated clinic honors our history while shaping a new future for rural oral health.”

Real-world impact in Central Appalachia

Since its launch, the hygienist-coordinated model has produced immediate, measurable improvements:

• Increased daily patient capacity
• Reduced delays for preventive and restorative treatment
• Expanded access for uninsured and underinsured adults
• Consistent school-based prevention delivered by dental hygiene personnel
• Strengthened continuity between mobile outreach and the stationary clinic

Patients who once received care only during episodic mission events are now returning for regular cleanings, periodontal maintenance, and ongoing treatment—representing both a cultural and clinical shift.

A rural model with national implications

Across the US, rural communities face severe dentist shortages and overwhelming unmet oral health needs. As policymakers and health systems look for scalable solutions, innovative workforce models like the Health Wagon’s are gaining national attention.

This clinic demonstrates that dental hygienists, when empowered with leadership roles, collaborative practice, and team-based support, can safely and effectively coordinate high-impact, prevention-focused clinical systems.

The Health Wagon represents a broader transformation in the profession: a future in which dental hygienists are recognized as essential architects of accessible oral health care.

Conclusion

The Health Wagon’s journey—from decades of mobile dentistry to the establishment of a state-of-the-art permanent clinic illustrates a powerful truth: Innovation grows where compassion leads.

The development and implementation of this hygienist-coordinated model has helped establish a sustainable system for preventive oral health in Central Appalachia, strengthening a mission that has served generations. This work represents not only the evolution of one clinic, but a vision for what is possible across rural America.