Dental Health Professional Shortage Areas Extend Into Almost Every North Carolina County

SEPT. 14, 2020

CARY — 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. 

A close up of a map

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HRSA’s map of Dental HPSAs in North Carolina. 
Any county with a score greater than 1 is considered a shortage area.

Additional Information

  • 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. 


About FHLI’s North Carolina Oral Health Collaborative 

The North Carolina Oral Health Collaborative works to advance systems change, improving the overall health and well-being of all North Carolinians by increasing access and equity to oral health care. NCOHC seeks to influence policy at a statewide level, and through collaboration, listening, and knowledge-sharing, NCOHC works to provide maximum impact in achieving optimal oral health care for all North Carolina communities.

For more information, contact: 
Marni Schribman, Director of Communications & Public Relations

Zulayka Santiago, Director of the North Carolina Oral Health Collaborative recently spoke at the Institute for Emerging Issues (IEI) panel about health in childhood. The panel, which took place at NC State University, was a part of IEI’s kidoNomiCs kickoff Tuesday. It was moderated by Kathy Higgins, president of the Blue Cross and Blue Shield of North Carolina Foundation and vice president of BCBSNC Corporate Affairs.

Along with Zulayka, the panel included the following guests:

  • Michelle Hughesexecutive director, NC Child
  • Jamie Kilpatrick, associate manager, Public Consulting Group
  • David Reesepresident and CEO, East Durham Children’s Initiative

While discussion surrounded overall childhood health, Zulayka weighed in on the oral health sector. She discussed the importance of oral health care at a young age, noting that tooth decay is the most common chronic disease of early childhood,  and is two to three times more common than asthma or obesity. She also touched on the importance of health equity.

To view the full panel discussion, see below:



ZulaykaWe are thrilled to announce that Zulayka Santiago, Director of the North Carolina Oral Health Collaborative, was recently selected as an inaugural fellow for the Leaders for Health Equity Fellowship program. The fellowship, offered by George Washington University’s Health Workforce Institute, honors health sector professionals with a commitment to health equity and demonstrated leadership potential. Zulayka was selected as one of 16 fellows from a competitive group of applicants from all over the United States and other countries.

The year-long program will begin in January, and is designed to provide fellows with the necessary skills and experience to identify disparities, combat inequities, strengthen individual leadership, and build a network of like-minded leaders from a wide array of institutions. In addition to online meetings and training, fellows will convene in-person a total of three times, with initial and final meetings in Washington D.C., and a mid-year convening in Rwin Kwavu, Rwanda.

With a career and passion centered around oral health, Zulayka will focus her fellowship on exploring health workforce options to increase access to oral health care and reduce oral health disparities.

[box] “I am delighted and honored to be a part of this phenomenal group of people. I look forward to deepening my knowledge about the intersections of health equity and particularly excited about gaining a global perspective to generating solutions to these complex problems.” [/box]

For more information about the Leaders for Health Equity Fellowship program, click here.