Geographic Access to Dental Specialists in the United States

Abstract

Access to general dental care remains a widespread challenge in the United States. In addition, many oral health conditions require treatment by dental specialists. Little is known about the geographic distribution and accessibility of these providers, particularly in rural areas. A national, block group–level analysis of geographic access to 6 core dental specialties—endodontics, oral and maxillofacial surgery, orthodontics, pediatric dentistry, periodontics, and prosthodontics—was conducted. The provider locations from a 2023 national database of practicing dental specialists (N = 38,698) were geocoded. An enhanced 2-step floating catchment area model was applied to generate spatial accessibility scores and drive-time estimates from population-weighted centers. The analysis of these data showed that on average, more than one-third of the US population had adequate access to specialty clinics, while less than 15% resided more than 30 min away from these specialists. Adequate accessibility was highest for orthodontics (61.6%, n = 204.1 million) and lowest for prosthodontics (6.7%, n = 22.2). Rural residents faced average driving times 3.2 times longer than urban residents do. The disparity was most severe in states such as Alaska, Montana, Nevada, North Dakota, South Dakota, and Wyoming, where driving times to specialists often exceeded an hour. More than 98% of dental specialists practice in urban areas, leaving rural regions consistently underserved. These findings indicate pronounced and widespread geographic disparities in access to dental specialists across the United States, driven by geographic concentration in metropolitan areas. These gaps have serious implications for access to timely diagnoses, treatment quality, and oral health–related quality of life. Workforce policies must expand beyond general dentistry to address dental specialty shortages. Integrating dental specialists into shortage designations, loan repayment programs, and training pipelines is essential for achieving equitable access to comprehensive oral health care nationwide.