Millions of Americans living in rural areas face significant barriers to accessing specialized dental care, according to research released by the Harvard School of Dental Medicine on Apr. 17.
The studies show that these challenges are particularly severe for rural residents, who often have to travel long distances for dental treatment. This situation can lead to delayed or even forgone care for many families.
Hawazin Elani, associate professor of oral health policy and epidemiology at Harvard School of Dental Medicine, said, “We found that rural residents must drive, on average, more than three times longer than urban residents for specialty dental care. Where you live can determine whether you receive timely treatment — or end up in the emergency room.”
Research published in the Journal of Dental Research and SSM Population Health reveals that over 24 million people live in areas with a shortage of dental providers and nearly 50 million adults lack public transit access to a dental clinic. The gap is especially wide when it comes to specialists: more than 98 percent practice in urban settings. In some states such as Alaska, Montana, Nevada, North Dakota, South Dakota, and Wyoming, drive times to reach a specialist often exceed an hour.
Rural areas have about one dentist per 3,850 people compared with one per 1,470 people in cities. Prosthodontics—essential for patients needing dentures or implants—was identified as the least accessible specialty; around 85 million Americans live more than half an hour from a prosthodontist.
The studies also examined workforce trends affecting these shortages. Early career dentists are more likely to work in underserved communities but tend not to stay as their careers progress. Financial factors play a role: moderate educational debt increases the likelihood of practicing in shortage areas while very high debt discourages it.
“These patterns point to a structural workforce challenge,” Elani said. Marko Vujicic from the American Dental Association added: “Policy interventions need to incorporate this kind of evidence because at the end of the day we have not made much progress at all as a nation in addressing rural area shortages.”
Elani concluded that solutions will require expanding specialty training pipelines and supporting programs aimed at improving long-term stability among providers serving underserved communities.
