Providing care to those who need it most

UNC dental study aims to close healthcare gap in rural N.C.


SILER CITY — Vidas De Esperanza has partnered with UNC to provide free dental care to low-income residents in Siler City — and an additional $200 in cash — if they participate in the dental school’s study examining the progression of oral diseases.

Dr. Julie Marchesan from UNC’s dental school is one of the head researchers for UNC’s study. She said this study is among the first looking exclusively at the gene that triggers periodontal disease, more commonly known as gum disease.

“It’s the leading cause of tooth loss in the world in adults,” Marchesan said. “About half of the American population has some type of periodontal disease, so it’s very prevalent.”

UNC’s Dental Research Project Manager S.T. Phillips said the study — which started in January and will run until June — would provide participants with free treatment for moderate to advanced gum disease, which would normally cost thousands of dollars.

“What we’re passionate about with this is we’re able to still do the research we need, but we can still do care at no cost to those who need it,” he said. “This is more of a satellite study to reach a different population … we’re grateful to be working with a clinic that’s accommodating and willing to have people come in at whatever means to provide care for the community.”

Vidas De Esperanza, located at 401 N. Ivey Ave., was founded in 2009 and serves as a local nonprofit health clinic designed to help address the burden of high-cost healthcare for low-income individuals by providing free or minimal-cost care. The clinic sees between 45 to 60 patients a day and has both medical and dental clinics. Most served by Vidas De Esperanza only speak Spanish.

When Marchesan was looking for a place where her research could have the biggest impact on rural and marginalized populations, she reached out to Vidas De Esperanza’s founders, Arcary Arias and Dr. John Kizer, about the study.

“It’s difficult to be able to combine research, teaching and community service, which is something we’ve tried to do,” Marchesan said. “And so we found out about the clinic, and we really enjoy working with that community and leaders of the Siler City clinic.”

Interested patients must undergo an evaluation to determine if they qualify to participate in the study, with the main requirement being they must have moderate to severe periodontal disease.

Once a patient is accepted into the study, they will have a dental exam and have an impression made of their teeth to create a stent — which will block off a certain area of the patient’s mouth to study the progression of gum disease.

From there, a patient will wear the stent and brush their teeth as normal. They will also go in for weekly cleanings and exams.

After three weeks of wearing the stent, a biopsy will be taken of the underbrushed area. The patient will then receive a full cleaning and scaling procedure to fully treat their diagnoses.

Phillips said the study was designed to ensure there’s no further gum disease progression in participants during the three-week-long period of wearing the stent.

“There’s a lot of safety involved as we want to continue to monitor their oral condition,” Phillips said. “That window of time has been thoroughly researched to know that we’re not increasing any risk of an increase in cavities or progression of gum disease — it’s why it’s the length that it is.”

Rural communities like Siler City typically don’t have access to specialized care, such as dental care, or it’s very limited.

The Centers for Disease Control and Prevention published a study in 2017 examining the disparities in healthcare between urban and rural areas. The study showed minorities suffered the most — almost 25% of non-Hispanic Black populations and 23% of Hispanic populations couldn’t see a physician because of costs, compared to 15% of their white counterparts.

Marchesan said she wanted to make sure her research was able to reach those who need care the most, and as a Brazilian immigrant herself, she wants to help out an immigrant community she feels a close connection with.

“What we’ve been seeing also is there is more than a need — a lot of our patients have never ever gone to a dentist,” she said. “There’s a trust there that we establish with them to be able to have the problems fixed or taken care of … these are people that don’t normally have access to this type of dental care, that’s why we served this area.”

For Marchesan, she said she’s glad her research was able to benefit others and in some cases, change lives for the better.

“Reaching the people that actually need care and have severe disease is not so easy, and so I think that going to this clinic really gave us the perspective and the ability to be able to do research that has an impact,” she said. “It allows us to see that there are different types of gum disease … we’re actually finding out that gum disease in men may not be the same as gum disease in women, and it’s the same for different races. You can’t treat everybody the same, and so that’s where care is being taken in general.”

UNC’s study will continue at both the dental school in Chapel Hill and at Vidas De Esperanza until June, according to Phillips and Marchesan.

Reporter Taylor Heeden can be reached at or on Twitter at @HeedenTaylor.