Four ways rural communities are improving oral health equity

Rural communities across America face disproportionate oral health disparities driven by provider shortages, limited dental insurance coverage, and inadequate transportation, compounded by geographic and socioeconomic factors that contribute to broader health challenges. These unique barriers prevent rural residents from accessing timely, quality dental care that is essential to their well-being, resulting in significant consequences to overall health and quality of life.

The 2025 Compendium of Best Practices in Rural Oral Health presents a collection of innovative programs that leverage partnerships, technology, and community engagement to improve equity in rural dental care. Developed as part of the National Rural Oral Health Initiative, the compendium is a collaboration between NRHA and the CareQuest Institute for Oral Health, a national nonprofit that aims to advance oral health systems through grantmaking, research, education, and policy advocacy.

By offering a repository of successful strategies proven to support rural oral health, the submissions promote knowledge sharing between public health professionals, policymakers, and providers to foster continued improvement and inspiration.

Several recurring themes emerge among the featured best practices, each contributing replicable solutions for transforming oral health in underserved rural areas.

Integrating oral health into wider care systems

A common strength across programs is the integration of oral health within larger health delivery systems. In West Texas, the Texas A&M Rural and Community Health Institute (RCHI) embeds oral health education, screening, and referrals into its telehealth-based prenatal care platform. After their virtual visits, community health workers follow up with at-risk patients to navigate next steps and reinforce education. This model builds upon maternal and neonatal services in regions designated as maternity care deserts.

Similarly, the Mercy Foundation and CHI Mercy Health in Oregon have implemented school-based dental clinics as part of the Healthy Kids Outreach Program (HKOP). Following its initial success, the program was expanded to serve adults in the community by connecting dental hygienists to hospital staff and piloting nurse training.

Expanding and supporting the oral health workforce

Rural counties frequently contend with provider shortages, aggravated by limited Medicaid acceptance among private dental practices. Initiatives in the compendium detail how targeted training and incentives can bridge gaps in care. Virginia Health Catalyst partnered with educators from the Virginia Community College System, such as Mountain Empire and Germanna Community Colleges, to launch a satellite dental assistant II (DA-II) training program in Central Appalachia, where provider rates are less than half of the state and national average. This expansion doubles the state’s DA-II training capacity and offers free restorative care performed by students during clinical rotations.

The Fulfilling Iowa’s Need for Dentists (FIND) Project, established by the Delta Dental of Iowa (DDIA) Foundation, also leverages community partnerships to recruit and retain oral health professionals by offering loan repayment awards to dentists who commit to practice in underserved rural areas. Paired with hospital-based pediatric dental services, FIND augments health equity and Medicaid service delivery statewide.

Oral health in community networks: Schools and local collaboration

School-based oral health interventions critically expand preventative care and promote equitable access in underserved communities, helping reduce transportation barriers and parental scheduling conflicts that could impede treatment. In Virginia, Virginia Health Catalyst’s School-Based Oral Health Program (SBOHP) Learning Collaborative equips dental safety-net clinics to partner with local schools. This enables them to provide screenings, andpreventative fluoride varnish, and sealants to tens of thousands of students, many of whom would not otherwise receive dental care. By building trust and convenience into care delivery, school-based and community-led programs reduce absenteeism, encourage early intervention, and promote long-term health.

Broadening the reach of oral health services through teledentistry

The compendium highlights the diverse applications of teledentistry in addressing rural access barriers. As part of the Teledentistry for Access Learning Collaborative, the National Network for Oral Health Access (NNOHA) supports health centers in integrating virtual dental care into their clinical workflows to reduce travel and wait times, facilitate engagement and prevention activities, mitigate workforce shortages, and strengthen patient involvement in care.

Since 2020, participating centers have reported more than 85,000 virtual dental visits. Applications include triage, post operative follow-up, and synchronous exams in clinics with limited on-site providers. This submission underscores teledentistry’s capacity to support providers who are retired, medically limited, or working remotely, providing an increasingly flexible and scalable format that aligns with the challenges of rural service delivery.

Lessons from the compendium

The programs featured in the compendium demonstrate how integrated care models, collaboration, and synchronous virtual approaches can overcome rural oral health disparities.

“By strengthening resources, sharing expertise, and advocating for systemic change, we move toward our shared goal: accessible, high-quality oral health care for all who choose to call rural communities home,” says NRHA CEO Alan Morgan.

As rural health systems continue to evolve, these models offer valuable blueprints for public health professionals and policymakers dedicated to improving oral health for rural residents.