title: Geographic access to dental care varies in Missouri and Wisconsin.
abstract: OBJECTIVE
  To examine geographic access to dental providers for the general population and children with public insurance in Missouri and Wisconsin.
  
  
  METHODS
  Using a newly constructed dentist office database from the American Dental Association master file and other sources, we use the two-step floating area catchment area method to calculate population to provider ratios at the census block group level. These ratios are used to determine potential geographic dentist shortage areas. We utilize street network data to estimate travel times and catchment areas between population centers and dental offices. This methodology accounts for the actual spatial distribution of dental providers and potential dental patients.
  
  
  RESULTS
  Within and across Missouri and Wisconsin, there is some variation in geographic access to dental offices for the general population and publicly insured children. More than 90 percent of publicly insured children have access to dental providers within 30 minutes. Among the states examined, Missouri has more geographic disparities to dental care.
  
  
  CONCLUSIONS
  The Health Resources and Services Administration, which designates dental health professional shortage areas, relies on administrative boundaries to calculate population to dental provider ratios. These boundaries may not reflect actual or "real-time" dental care markets. The methods employed in this paper may give policymakers a template to better determine geographic dentist shortage areas.
authors.affiliation: American Dental Association, Health Policy Institute, Chicago, IL, USA.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Nasseh
authors.affiliation: American Dental Association, Health Policy Institute, Chicago, IL, USA.
authors.forename: Yochai
authors.initials: Y
authors.lastname: Eisenberg
authors.affiliation: American Dental Association, Health Policy Institute, Chicago, IL, USA.
authors.forename: Marko
authors.initials: M
authors.lastname: Vujicic
mesh_terms: D000293:Adolescent; D002391:Catchment Area, Health; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D003770:Dental Offices; D003815:Dentists / Q000600:supply & distribution*; D062306:Geography, Medical; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007347:Insurance, Dental; D008507:Medically Underserved Area; D008923:Missouri; D014195:Travel; D014922:Wisconsin
keywords: Medicaid; dental care; dentist shortage; geographic access; two-step floating catchment area method