HARRISBURG — Pennsylvania has a growing problem with access to dental care.

From the number of practicing dentists to the cost of care when it’s available, rural parts of the state lag behind the suburbs and cities.

A report released by the Joint State Government Commission analyzed the state of dentistry in rural Pennsylvania and found some worrisome trends. In 2019, the state had over 7,000 active dentists, but the number of dentists per capita has fallen by 7% over the last 20 years.

For every rural dentist, there are 15 non-rural dentists. “Rural areas are struggling to attract dentists,” the report noted.

Younger dentists, instead, look to the suburbs and cities.

Dental graduates gravitate to available employment options in non-rural areas, according to the report. In 2019, only 6% of the graduates from Pennsylvania-based dental schools practiced in rural areas.

And, as older dentists retire, not enough dentists have replaced them, which widens the access gap between rural and non-rural areas.

“Rural communities are likely to be further underserved because new dentists are not locating to rural areas to begin their practice,” said Stephen Fickes, the project manager of the JSGC report, in a presentation to the commission.

The small numbers of rural dentists is one part of the problem; the other is cost. Residents on Medicaid Assistance (MA) are more common in rural areas, which can mean smaller reimbursements from those patients.

“Rural counties have 39% more MA recipients for every dentist participating in Medicaid compared to non-rural areas,” the report noted. “There are also significantly fewer Medicaid dentists in rural counties that bill at least $10,000 in claims annually, which is the threshold set by some public health officials to be considered a Medicaid ‘meaningful provider.’”

To combat those trends and problems, the report suggests some financial changes, as well as expanding technological use.

First, though, to train more rural dentists, it could help to recruit young people from rural Pennsylvania.

“As research indicates, students that have a direct tie to a rural area are much more likely to return to practice in that area,” Fickes said.

While the Pennsylvania Department of Health has a loan reimbursement program up to $80,000 already, the report suggests adding longer commitments and more incentives for rural dentistry to boost numbers as well.

Expanding mobile dentistry and teledentistry could be put to more use, too.

“Mobile dentistry and teledentistry could help to expand access to basic dental services for rural Pennsylvanians,” the report noted.

To do so, however, requires strong broadband internet access, and those approaches have profitability and financial concerns. The report recommended the General Assembly codify and reconsider some existing definitions and laws surrounding the practice.

The report’s recommendations are similar to some made by the Pennsylvania Coalition for Oral Health. As The Center Square previously reported, access to dental care in rural areas has been a longstanding concern, and the Coalition has advocated for more youth outreach, as well as local water fluoridation.