Ninety-eight of North Carolina's 100 counties have now been designated as Dental Health Professional Shortage Areas (Dental HPSAs), according to new data
released by Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (DHHS).
HRSA's 2020 update represents a 32.4 percent increase from 2019 Dental HPSA designations, which classified 74 North Carolina counties as dental HPSAs. Now, Stokes and Orange counties are the only two without Dental HPSA designations, and both counties are currently under review.
"The new data show a dramatic yet unfortunately unsurprising disparity in access to basic oral health care in North Carolina,"
said Dr. Zachary Brian, director of the North Carolina Oral Health Collaborative (NCOHC), a program of the Foundation for Health Leadership & Innovation (FHLI).
Counties are designated as Dental HPSAs when there are not enough oral health professionals to meet communities' needs. Dental HPSAs may be geographic, population, or facility-based, and all or part of a county may be designated. Among the new Dental HPSA designees are Wake and Buncombe counties, two of North Carolina's counties with larger urban populations.
"The data additionally underscore the idea that even in urban areas, access to oral health care is not available to all,"
said Brian. "Just because you live around the corner from a dentist doesn't mean you have access to care."
In addition to the number of dental professionals in a particular area, income, insurance coverage disparities, transportation insecurities, and a maldistribution of dentists across North Carolina's counties, among other factors, all contribute to the overall lack of access to essential oral health care services.
NCOHC, which works to increase equity in oral health care, believes that effective policy reform will play an important role in increasing access amidst the growing shortage of oral health professionals in relation to North Carolina's expanding population. In June 2020, NCOHC released a policy brief
outlining opportunities at the state level and providing a road map to workforce and payment modifications that could help increase access to care for underrepresented and underserved North Carolinians.
- HPSA designations can cover an entire county or a part of a county. For example, the dental HPSA designation for Wake County only covers the eastern part of the county, and while Mecklenburg County as a whole is not a dental HPSA, Charlotte is.
- HPSA reviews such as the ones currently happening for Stokes and Orange Counties are typically performed when the Office of Rural Health receives a request to do so. In early 2020, the Oral Health Section of the North Carolina Department of Health and Human Services requested review of all undesignated counties, which triggered the increase in dental HPSAs.