SIOUX FALLS, S.D. (KELO) — There are 445 to 450 actively practicing dentists in South Dakota, said Paul Knecht, the executive director of the South Dakota Dental Association.

Knecht said the number can vary as dentists retire or leave the state.

Data from the American Dental Association said there were 472 dentists actively practicing in the state in 2021. The numbers have been above 400 since 2008.

Although the number of active dentists has been increasing since at least 2005, the state still has fewer dentists than the national average, according to a 2021 report from the National Center for Health Statistics. The average number of dentists per 100,00 residents in the U.S. was 61.06. South Dakota had 50.75.

Dentagraphics breaks it down this way: South Dakota has an average of 4,469 residents per dental practice. The national average is 3,341.

The state had 418 dentists in 2010 which grew to 454 in 2020.

The state’s population was 814,180 in 2010, according to the Census Bureau. The 2020 population is 895,376.

For those who live in the Sioux Falls or Rapid City areas, the odds of finding a dentist likely improve even with the population growth of each city. The population of Sioux Falls was 153,888 in 2010 and 192,217 in 2020, according to the Census Bureau.

“We are seeing exceptional growth in the number of dentists in the Sioux Falls area, Harrisburg, Tea and (other) bedroom communities,” Knecht said.

The South Dakota Dental Association doesn’t specifically track the number of dentists by city or county but Knecht said he does know of the growth in dentists in the Sioux Falls area.

The opposite of growth in practices in the Sioux Falls area is the decline in practices in rural areas, Knecht said.

“Small towns are losing their dental practices,” Knecht said.

“Dental workforce shortages in rural communities are endemic, despite the research on best practices for enhancing the rural workforce.” said a 2020 study by The Oral Health Workforce Research Center (OHWRC) at the Center for Health Workforce Studies (CHWS) at the University at Albany’s School of Public Health.

According to the Kaiser Family Foundation, South Dakota has 71 Health Professional Shortage Area (HPSA) designations and needs 31 dentists to remove the designations. The HPSA and need are based on the number of dentists per 5,000 residents or 4,000 residents in unusually high need areas.

The S.D. dental associations closely tracked the number of active dentists in the late 1990s through the early 2000s, Knecht said.

“In 1998-1999 it was obvious to us we were going to see a major drop off in the number dentists,” Knecht said.

“The dental association got aggressive about recruiting young people into the dentistry and practicing here,” Knecht said.

The effort paid off as more students pursued dentistry and returned to work in South Dakota, Knecht said.

“Now, we’re passed that hump,” Knecht said.

In 2016, the average age of a dentist in South Dakota was 47.5 compared to the national average age of 50.1.

According to the Health Policy Institute, 24% of practicing dentists in the U.S. were 35 to 44 years old, 21.6% were 45 to 54, 21.1% were 55 to 64 and 16.3% are 65 and older.

The average age of retirement for dentists didn’t change much from 2010 to 2020. The average retirement age was 68.1 in 2010 and 68.2 in 2020.

Seeing patients at a basketball game

In contrast to Sioux Falls where it seems like there is a dental practice on nearly every intersection of streets such as 57th, small towns in South Dakota may not have dental practice.

Horizon Health Care operates eight dental clinics in rural areas of South Dakota.

As of Jan. 27, the health care provider just hired a dentist for a recent opening.

The dentist is a graduate of the Arizona School of Dentistry and Oral Health, said Dr. Michelle Scholtz, the chief dental officer for Horizon Health.

The Arizona dental program is specifically for students who will enter public health practices.

Horizon’s relationship with the Arizona university and several other dental schools has helped it hire needed dentists.

“We have students who rotate roles in clinics,” Scholtz said.

Fifty-one percent of the students who participated in rotations have returned to work in South Dakota, Scholtz said.

Scholz and Kendra Newbold, the chief operations officer at Horizon, said the students get exposed the particular characteristics of rural areas and benefits of a rural practice.

Some patients come in with very real needs, and “the (dentist) is able to help,” Newbold said.

The other impact is being able to connect to the community including seeing youth patients at basketball games, Newbold said.

Knecht and the Horizon staff said a South Dakota Department of Health rural dentist recruitment program has been a boost.

Five slots are available for the recruitment of dentists to rural areas. As of July 2021, successful slot candidates can receive an incentive payment of $248,098. 

Knecht said the program was created under former Governor Mike Rounds’ administration at least 15 years ago.

“We had three slots for a couple of years and filled those three slots so it was expanded to five,” Knecht said.

The slots are offered on a first-come-first serve basis. When the slots are filled there is no opening until the incentive program time expires for that dentist.

“It’s a very effective program,” Knecht said.

“For the first time the slots are filled,” Scholtz said. “I believe there is not an opening until 2023.”

Newbold said Horizon staff advocate frequently for the expansion of slots in the rural dentist recruitment program.

Despite recently securing a new dentist, Scholtz and Newbold said the need for dentists in rural areas continues.

Dental schools in neighboring states are in Lincoln, Nebraska, Iowa City, Iowa, or Minneapolis, Minnesota.

Scholtz said when students live and attend school in an urban area they may be inclined to practice in an urban, even if they return to South Dakota.

While there are challenges, there are also dentists such as Scholtz, who has worked for Horizon Health Care for 10 years, Newbold said.