by JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA
January 7, 2025

Limited studies have addressed geographic barriers and the availability of dentists in underserved areas. These barriers can affect the ability of individuals to access dental care and hours of travel for routine visits, impacting delays in seeking care and poor oral health outcomes.

Spatial accessibility refers to the availability of clinics and providers as well as the accessibility and travel distance or time to health care facilities. A new cross-sectional study led by Harvard School of Dental Medicine looks at the spatial accessibility to dental care nationally using the IQVIA national dentist’s database which includes dentists from all 50 states and Washington, DC. This database includes all active dentists, including safety-net clinics, federally qualified health centers, and university-based clinics. The IQVIA database from October 2023 included 205,762 dentists including 196,756 general dentists and 9,006 specialists. An advanced gravity-based approach referred to as the enhanced 2-step floating catchment area (E2SFCA) was used to consider the availability of clinicians in both location and size of clinics, accessibility in terms of travel time and distance, and adjustments for demand and supply factors through distance-decay weights.

While findings revealed that four states, Connecticut, Delaware, Indiana, and New Jersey, and Washington, DC, did not have dental deserts, they also revealed that there were disparities in other specific areas of the U.S. Alaska had the highest percentage of the population living in dental desert areas followed by Montana and North Dakota. Arkansas, Alabama, Mississippi, and West Virginia showed an unequal distribution of dental clinics.

Almost 1.7 million people did not have access to dental clinics within a 30-minute drive and an additional 24.7 million lived in dental care shortage areas while 387 counties had significant disparities in access to dental clinics. Most groups with extensive access to dental clinics were in urban areas. One dentist was found for every 3,850 people in rural areas compared with 1 dentist for every 1,470 people in urban areas. Further, approximately 2.5 million people with Medicaid or Medicare health insurance were living in shortage areas. It was estimated there were 2,818 counties where at least 10% of people lived in dental care shortage block groups and were more likely to be rural, have an uninsured population, and be socioeconomically deprived.

Another finding was that more white populations lived in counties with a shortage of dentists largely due to these rural areas have a higher concentration of white residents. In urban areas, Black and Hispanic individuals were more likely to live in areas with a shortage of dental care.

The authors noted that this study showed a geographic shortage and maldistribution of the dental workforce. Further, dental workforce planning efforts and targeted interventions at the federal and state levels are needed to encourage dentists to practice in underserved areas to reduce disparities in access to dental care.

To learn more, access the fill paper here.

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This article summarizes the original investigation “Dental Clinic Deserts in the US: Spatial Accessibility Analysis,” as published online in JAMA Network, December 23, 2024, (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2828397.) 

JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA, is the ADHA Director of Education, Research and Advocacy, professor emerita in the Department of Dental Hygiene at Idaho State University, and past president of the American Dental Hygienists’ Association, 1990-1991.