The NCSL Blog


By Erik Skinner

Rural areas make up a staggering 97% of the United States’ landmass, yet they contain just over 19% of the U.S. population. The demographics and geographically dispersed areas require different approaches to delivering high-quality health care, including oral health care in rural areas.

Child with dentistNCSL’s new LegisBrief, “Boosting Oral Health Care in Rural Communities,” summarizes recent state legislation addressing oral health in rural populations and policy considerations for state lawmakers.

Rural communities face a range of barriers to accessing oral health care. There are geographic barriers, such as long distances to services or difficult terrain, but also societal barriers, such as a lack of public transportation, insufficient health insurance options and a shortage of oral health providers.

State legislators craft and support oral health policies to reduce provider shortages and improve access in a variety of ways to address rural disparities.

For example, legislators may consider bills that reduce physical barriers to accessing care, finance oral health services, increase the number of providers, and establish oral health services in primary care and virtual settings for rural communities. Boosting the health care workforce, access to dental insurance coverage, and teledentistry are common approaches to increasing oral health services in rural communities.

The LegisBrief also provides information about federal programs and resources that state legislators can consider to address the oral health of rural residents in their states. The federal government works in collaboration with states on oral health issues affecting rural populations. For example, the Health Resources and Services Administration works broadly on Oral Health Workforce Development. The agency bolsters state efforts to attract providers to underserved and rural areas, expand facilities and services, establish teledentistry programs and train the existing workforce, among other activities.

As with many practices and settings, COVID-19 changed how providers and states deliver care. Rural oral health stakeholders can consider guidance for dental settings from the Centers for Disease Control and Prevention. This guidance addresses infection risks specific to dentistry, including transmission through procedures requiring aerosolized material and practices to mitigate community spread while providing necessary care, such as teledentistry.

NCSL Oral Health Resources

Erik Skinner is a policy associate in NCSL’s Health Program.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.