The U.S. appears to have a shortage of orofacial pain (OFP) providers compared to other types of dental professionals, possibly leading to less effective pain management. The study was recently published in the Journal of the American Dental Association.
Some areas, especially rural communities, have no access to OFP providers and may have greater treatment needs, the authors wrote.
“The shortage of OFP providers is likely affecting access to OFP care,” wrote the authors, led by Rachel Esposito of the Midwestern University College of Dental Medicine in Illinois (JADA, February 6, 2026).
Researchers evaluated how OFP providers are distributed across the U.S. by state and the level of rurality compared with the underlying population. Data were collected between July and September 2024 from publicly available sources. Provider counts and ZIP codes were obtained from the American Academy of Orofacial Pain and the American Board of Orofacial Pain websites, they wrote.
Population estimates by state and rural-urban classification were drawn from the 2023 U.S. Census Bureau American Community Survey and the U.S. Economic Research Service. Area codes were used to categorize provider ZIP codes as urban, large rural, small rural, or isolated and were compared with corresponding population data.
There were 531 OFP providers in the U.S. serving a population of approximately 333 million people, a national ratio of 0.016 providers per 10,000 residents, or about 1 provider per 627,000 people. OFP providers were overrepresented in Minnesota, Arizona, Kentucky, California, and Massachusetts, with prevalence ratios ranging from 1.7 to 2.9 and provider-to-population ratios between 0.027 and 0.045, they wrote.
Furthermore, seven states, including Alaska, Hawaii, Idaho, Nebraska, New Hampshire, North Dakota, and Wyoming, had no OFP providers. Only 3.4% of OFP providers practiced in rural areas (prevalence ratio, 0.3; 95% confidence interval, 0.2 to 0.4; provider-to-population ratio, 0.004), including 2.3% in large rural areas, 0.9% in small rural areas, and 0.2% in isolated areas. Overall, the OFP provider ratio of 0.016 per 10,000 residents was substantially lower than that of orthodontists (0.336) and prosthodontists (0.065).
The study, however, had limitations. Geographic distribution alone may not fully reflect access to care, as factors such as insurance coverage and socioeconomic barriers may also play a significant role, the authors added.
“Context-specific analyses and targeted incentives may be necessary to improve access to, and quality of, OFP care nationwide,” Esposito and colleagues concluded.
