This week a television report about how the voters in the Appalachia region of the US could be crucial in swinging the US presidential election threw out some interesting facts. One of them dental.

The levels of poverty remain so acute in this area which touches on 13 states that many people (rednecks, hillbillies, call them what you will) cannot afford even basic dental care. The report began with a dentist (volunteer) cheerfully wending his way through the gummy horror of one local’s mouth. Nine extractions was his verdict. Reconstructive dentistry obviously is way beyond the means of most.

But the man with the Deliverance smile is one of over 20 million people who could put the bite on the big beasts of US politics come November.

According to the report that’s because, whether the poor white folks of Appalachia know it themselves or even accept it, they mostly belong to a defined ethnic group.

The Scotch-Irish. What we call over here Ulster Scots.

These were originally the “border reivers” from the English-Scottish border bandit country who migrated to Northern Ireland and eventually on to America. (The name “hillbilly” comes apparently from their allegiance to one William of Orange.)

They took with them their religion (mostly Presbyterianism) their affection for music (it became bluegrass) and their fondness for drink.

In American political terms these people have traditionally not been regarded as big hitters. They are a separate group from the much more influential Irish-Americans and separate too from the more Anglo and affluent WASPs whose ancestry was typically English. But suddenly attention is being focused upon the Appalachian vote. (If they’re doing news reports on it in the UK you can bet it’s definitely crossed the radar of party strategists in the US.)

Many of this section of the electorate traditionally vote Republican. But analysts point out that it may be a vote that’s taken for granted. Perhaps if the Democrats tried harder they could make inroads?

Barack Obama, for example, has only been there a couple of times for fleeting photoshoots. In the Democratic campaign Hillary Clinton polled much, much better than he is expected to in the election proper.

His skin colour may be a factor. But perhaps it’s also because the hillbillies warmed to Hill and Billy Clinton because the couple have previously shown an interest in the region. When Clinton was President he visited the area highlighting, and pledging support for, its economic woes. But if Obama doesn’t get the local vote, can McCain take it for granted? McCain, who is himself of Scotch-Irish descent can still probably count on big backing.

But it’s argued that the Republicans haven’t been trying too hard either. In fact you get a familiar sense of a unionist working class area that only gets sight of the odd visiting unionist politician come election time.

And that’s just one of the local parallels.

To the metropolitan elite Appalachians tend to be figures of ridicule and contempt. The metropolitan elite (including the media) know as much about daily life and its challenges in the region as they know about life in the Amazon basin. Indeed about as much as the liberal elite back here know about life in unionist working class areas.

If Appalachia emerges, as predicted, as an important force to be reckoned with in US politics it may even have an impact back here.

The “ethnic group”, if we are to call it that, is unlikely to have the clout of much more wealthy Irish America but it could nonetheless influence US policy on Northern Ireland. A point which presumably local unionist parties have already noticed.

And, if they have any nous, are already getting their teeth into.