1.  Treatment of oral disease begins with availability to oral health professionals.  With a state population of 1.8 million, the distribution of these dental professionals is essential to ensure access to dental care.  In 2012, almost half (26) of the state’s 55 counties had five providers or less. Additionally, these areas generally corresponded with higher rates of chronic disease and poor health.  The OHP utilizes the State Oral Health Plan as its primary planning tool, and has been working to achieve the objectives set forth in the plan.  Within the 2010-2015 State Oral Health Plan, priorities included a multitude of topics, the dental workforce being among those in the forefront.  Objective four of the 2010-2015 State Oral Health Plan called for the Program to strengthen and improve the dental health workforce.  In response, a survey was created by the West Virginia University School of Dentistry and the West Virginia Department of Health and Human Resources Oral Health Program (OHP). The survey was distributed to West Virginia dentists and dental hygienists during the 2012 license renewal by the West Virginia Board of Dentistry. The primary purpose of this voluntary survey was to gain insight on clinically active dentists and dental hygienists working in the State.  In November 2012, the OHP released the first ever dental and dental hygiene workforce survey. This document has served to guide and address issues throughout the Project period, including the following two key findings which have informed Project methods. RETENTION REBOUND – KEEPING DENTAL PROFESSIONALS IN WEST VIRGINIA Teresa Marks BA 1, Jason Roush DDS 1, Gina Sharps MPH, RDH 2, Richard Crespo PhD 2 1 WV Oral Health Program, OMCFH-WV DHHR, Charleston, WV, USA 2Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA Funding provided by the Health Resources and Services Administration Introduction Methods Conclusions Project Background Among the respondents, 81% of dentists graduated from West Virginia University School of Dentistry while only 18% graduated from other schools. When asked, 261 (37%) of respondents reported that they plan to retire within the next ten years. Results  Over the Project period (2012-2015), the OHP has been successful in placing a total of 18 recent West Virginia University School of Dentistry graduates to practice in identified DHPSAs  The retention rate of in-state dental graduates has increased to over 20 graduates in the class of 2014 (from a low of 6 graduates in 2010). Trend in West Virginia University Dental Student Retention, 2007-2012  Based on findings from the 2012 Workforce Survey, the Project was aware that most dental practitioners in WV operate in solo practices. Processes for awarding federal funds to private dental practitioners proved to be time- consuming and cumbersome.  While the Project required loan repayment recipients to accept Medicaid patients, our 2012 findings show that close to 1 in 3 practicing dentists see no Medicaid patients (29%) and just over half (55%) of dentists accept Medicaid as a form of payment. Table 1. Objective 4.1 of the West Virginia State Oral Health Plan Figure 1. West Virginia Oral Health Program Dental and Dental Hygiene Workforce Survey and Key Findings  In 2012, the West Virginia Oral Health Program (OHP) was awarded approximately $1.5 million over a three- year period from the Health Resources and Services Administration (HRSA) to implement the Dental Workforce Project.  The goals of the Project are to increase the number of dental school graduates choosing to provide services in West Virginia and to increase the number of persons with an identified dental home within dental health provider shortage areas. GOAL 1: Increase the number of dental graduates choosing to provide services in West Virginia.  Initiate a loan repayment program for new graduates choosing to practice in identified dental Health Professional Shortage Areas (DHPSAs);  Work with both federally-qualified health centers (FQHCs) and private practice dentists to serve placement sites for new dental school graduates;  Advertise Project to third- and fourth-year West Virginia University School of Dentistry students to recruit potential loan recipient candidates;  Chosen candidates serve in the DHPSA for up to two years in exchange for up to $50,000 in loan repayment. GOAL 2: Increase the number of persons with an identified dental home within dental health provider shortage areas.  Place new dental graduates in DHPSAs, thereby increasing potential access to dental care;  Provide technical assistance in the areas of billing, practice management, and workplace efficiency through a support team consisting of a dentist, dental office manager, dental hygienist, and dental billing specialist. Obstacles Figure 2. West Virginia Oral Health Program Dental and Dental Hygiene Workforce Survey Key Findings  Dental loan reimbursement can be a powerful tool for states to retain health professionals in-state.  More efforts need to be explored to create sustainable loan reimbursement projects, specifically at the legislative level through policy change.  To provide access to more patients and increase persons with an identified dental home, more practitioners need to accept Medicaid as a form of payment.  Federal funding needs to be available to private practice dentists to encourage recruitment and retention efforts in DHPSAs.