New Study Maps Dental Deserts Across the U.S.

USA: Access to dental care remains a significant challenge for millions of Americans, particularly those living in underserved and rural areas. A recent study published in JAMA Network Open reveals that nearly 1.7 million people in the U.S. live in “dental deserts,” where accessing even routine dental services requires traveling long distances or enduring lengthy wait times.

Led by Hawazin Elani, assistant professor in oral health policy and epidemiology at Harvard School of Dental Medicine, the research offers one of the most comprehensive analyses to date of geographic disparities in dental care access. By examining data at the block group level — the smallest geographic unit used by the U.S. Census Bureau — the study paints a detailed picture of where dental services are lacking.

“These areas are really ‘dental deserts’ where you’d have to go to great distances to find a dentist,” Elani explained. “Our findings highlight a concerning geographic maldistribution of dentists, with many rural and disadvantaged communities left without access to care.”

The study’s innovative approach builds on previous efforts, such as the Health Resources and Services Administration’s designation of Health Professional Shortage Areas for dental services. However, it goes further by employing an advanced gravity-based method to assess clinician availability, accessibility, and adjustments for demand and supply factors.

“We were able to identify areas with limited access to dental care that may have been missed by previous studies,” said Md. Shahinoor Rahman, co-author of the study.

Stark Disparities Between Rural and Urban Areas

The disparity in access to dental care is stark when comparing rural and urban regions. The study found that rural areas have one dentist available for every 3,850 people, while urban areas boast more than 2½ times as many dentists, with one available for every 1,470 individuals.

By state, Alaska had the highest percentage of its population (10.4 percent) residing in dental deserts, followed by Montana (7.8 percent) and North Dakota (7.7 percent). Conversely, only four states — Connecticut, Delaware, Indiana, and New Jersey — along with Washington, D.C., were identified as having no dental deserts.

The researchers also analyzed socioeconomic data, including racial and ethnic composition, age distribution, poverty levels, educational attainment, median household income, and health insurance coverage. Their findings revealed that nearly 24.7 million people live in areas with a shortage of dental care. In these regions, approximately 15.6 percent of the population lives below the federal poverty level.

Racial disparities were evident as well. While predominantly white populations were more likely to reside in rural areas with a shortage of dentists, Hispanic and Black individuals in urban areas faced greater challenges due to segregation and concentrated poverty. Additionally, uninsured individuals in rural shortage areas were disproportionately affected by spatial disparities in access to care.

Implications for Oral and Overall Health

The lack of access to dental care has serious consequences for both oral and overall health. Elani emphasized the compounded barriers faced by Medicaid and Medicare beneficiaries, who often encounter low dentist participation rates.

“The situation is likely even more dire for Medicaid and Medicare beneficiaries, who face additional barriers due to low dentist participation, worsening existing disparities,” she said. “This can lead to people putting off much-needed care due to access challenges.”

Delayed or forgone dental care can result in untreated cavities, gum disease, and other oral health issues that may contribute to broader health problems, including cardiovascular disease and diabetes.

Informing Policy and Workforce Planning

The researchers hope their findings will inform targeted interventions to address these disparities. By providing precise data on underserved areas, the study aims to guide federal and state-level efforts to encourage dentists to practice in regions with limited access.

“With this more precise data, we hope our findings can inform dental workforce planning efforts and targeted interventions at the federal and state levels to encourage dentists to practice in underserved areas and reduce disparities in access to dental care,” Elani stated.

The study was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award No. R01MD017093.