FULTON − There’s no secret rural communities struggle with health care access. Some of the most common care can be difficult to access, including dental care.
For full-time daycare owner and mother McKensay Vandelicht, the challenge of helping her family get the care that they need has been the most difficult it’s ever been.
“For my middle girl, she ended up having to have a root canal and that was a day out of school after having three appointments to try and find someone,” Vandelicht said.
Vandelicht said none of the providers in Fulton could get her daughter in at a decent time. Local providers were booked out for months, leaving Vandelicht to outsource to Jefferson City and even further out to Columbia.
She said the headache has been more costly than the dental bill.
“Taking the time off of work to have to drive further away because we don’t have enough dentists in the area to accommodate everyone’s needs,” Vandelicht said.
It’s not just people like Vandelicht experiencing the workforce shortage. Providers like Dr. Brett Parrott are witnessing people coming from as far as two hours away to seek treatment.
“Forty-two percent of our patients are driving from outside the Columbia area to get work done, because they don’t have the dental care that they need provided in the smaller cities that they are from,” Parrott, who owns Aspen Dental in Columbia and Jefferson City, said.
According to Census data, from 1990 to 2023, Missouri’s population grew by over 1 million, but the Missouri Department of Health and Senior Services said the number of dentists hasn’t kept pace with the population growth. Currently, there are over 6 million Missourians to 3,721 dentists.
On top of some communities not having enough dentists to meet demand, many of them are private practices, meaning they only accept certain types of insurance. If the patient can’t get their treatment covered, then they would have to pay out of pocket, which can cost thousands of dollars depending on what needs to be done.
Jacqueline Miller, director of Missouri Oral Health, said the main root of the shortage was the lack of dental schools for a period of time.
Success! An email has been sent to with a link to confirm list signup.
Error! There was an error processing your request.
“There were three dental schools, and we were down to one up until 10 years ago,” Miller said.
From 1960 through 1984, three dental schools – Washington University, St. Louis University and University of Missouri-Kansas City School of Dentistry – produced an average of approximately 240 dentists per year, according to DHSS.
Between 1979 and 1989, WashU and SLU closed their undergraduate dental schools. In the mid-1980s UMKC cut its class size from 160 to 80 students.
Between 1990 and 2002, Missouri lost 642 dentists due to retirements and other various reasons, according to DHSS. In the 19 years since, the state has only recovered half of the dentists lost.
Now dentists experience a 35% increase in the average workload, according to DHSS.
Kansas City University opened a new dental school this fall, and it is expected to produce 80 dentists when they graduate in 2027.
Miller expects the workforce to get better in the future with three dental schools in the state (UMKC, KCU and A.T. Still University) once again, but she said there is still more that needs to be done to keep graduates working in underserved communities.
“Increasing the funding for loan repayment to help areas of decreased access would be a huge help,” Miller said.
Miller said the average graduate walks out of dental school with $250,000 in loans. Incentivizing graduates to get their loans forgiven while also establishing connections in a new town could keep more dentists in underserved areas of the state.
Actions are being taken to address the issue, but for people like Vandelicht back at home, she and others need change sooner rather than later.
“You’re taking time off of work, you’re taking time away from the kids at school, that to me is the biggest thing,” Miller said.