The state of rural dental care in Pennsylvania
By Marnie Oakley, D. M. D., Dean, University of Pittsburgh School of Dental Medicine
A potent cocktail of demographic, geographic, economic, and policy challenges has rural healthcare in a state of crisis, teetering on the brink of collapse. Oral health, which is critical to population health, is facing the same macro challenges and a dire workforce shortage. This is especially true in the Commonwealth of Pennsylvania, which has the third largest rural population in the nation.
The University of Pittsburgh School of Dental Medicine is raising our hand and stepping forward to be part of the solution with an innovative approach. We are creating regional training centers( RTCs) that will not only increase access to oral healthcare but also improve the overall economic and social health of communities by creating new career pathways for residents where a center is located.
The initiative is rooted in our 129-year history of dental education and aligns with our mission of improving oral health through teaching, research, and service. But success of the RTCs will require deep collaboration with local partners and an approach tailored to the needs of the students and patients in rural communities.
The state of rural dental care in Pennsylvania
Access to dental care has been a growing concern in much of America, with rural communities being the hardest hit, leaving residents at risk for oral health complications. These concerns can be directly attributed to the availability of dental care, or lack thereof, in rural counties stretching across the state with more than 1.5 million residents living in counties designated as dental health professional shortage areas. Those shortages are only expected to increase, as over 55 % of dentists plan to retire over the next 10 years and one-third of dental hygienists and dental assistants reported they were planning to retire in the next five years.
“ As the director of a rural dental center, I can attest to the difficulties that exist with hiring dental auxiliaries,” says Dr. James Mancini, Clinical Director at Meadville Dental Center and a Pitt Dental alumnus.“ We have over 15,000 patients in this rural dental center. Our office is inundated with patients due to the lack of oral health providers. The needs of our community are not decreasing but we have had to reduce our patient volume due to a lack of staff.”
Dr. Mancini added,“ The lack of dentists to fill positions is also especially troubling. I am 65 years old and planning my pending retirement, but I truly fear that they won’ t be able to find a replacement. Our last search for a dentist took three years.”
Currently, the enrollment in dental schools is up 11 % across the country. However, it remains a challenge to incentivize dental practitioners to work and live in rural communities after completing their training in urban areas. Even individuals who are originally from rural communities often do not return to those communities after graduation, opting for positions at urban and suburban dental offices. And some rural Pennsylvanians don’ t even consider healthcare careers because of limited training options and the prohibitive costs of education.
The human impact of this misalignment of supply and demand is severe, with evidence increasingly showing the connection between poor oral health and serious conditions such as cardiovascular disease and diabetes. The lack of access to dental care in rural Pennsylvania today will likely contribute to lifelong health conditions that will impact children and adults in the Commonwealth for decades to come.
SEPTEMBER / OCTOBER 2025 | PENNSYLVANIA DENTAL JOURNAL 17