Background. Economic, demographic and social factors may be leading to a migration of pediatric dentists (PDs) to the continental United States. The current study was undertaken to assess the current and future availability and geographic distribution of pediatric dentists (PDs) in Puerto Rico and make policy recommendations.

Methods. Based on historical data, inflow and outflow of PDs from 1970 – 2012 were analyzed. Next, a forecast for the time period 2012 – 2045 utilizing sensitivity analyses was developed. Finally, their geographic distribution was assessed utilizing econometric analyses, Lorenz Curve and Gini coefficient (GC), to determine disparities in distribution.

Results. Puerto Rico’s pediatric dentistry workforce is composed mostly of graduates of the University of Puerto Rico or 72%. Beginning in 1982 the number of PDs entering the workforce has stalled. Retention of pediatric dentists at current levels would result in future decreased ratios when compared to the pediatric population. Pediatric dentists tend to locate their offices in more densely populated areas regardless of median income.

Conclusions. Continuous migration of pediatric dentists to the continental United States combined with high levels of accumulated needs among the pediatric population may lead to an ensuing oral health crisis. Dramatic changes in the financing of dental care and licensure of dentists may be necessary to attract and retain an adequate pediatric dental workforce. The supply of PDs must be monitored to ensure an adequate workforce.