ArticleJournal of dental anesthesia and pain medicine2026
Geographic accessibility to board-certified dental anesthesiology specialists in Japan: visualizing "medical deserts" in dental anesthesia.
Article in Journal of dental anesthesia and pain medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Systemic management by board-certified dental anesthesiology specialists from the Japanese Dental Society of Anesthesiology plays an essential role in ensuring the safety, comfort, and quality of dental care. However, these specialists are most commonly located in urban areas. This study provides a nationwide analysis of geographic accessibility, identifying "medical deserts" (operationally defined as travel time ≥ 120 min) in dental anesthesia by calculating actual travel times to facilities with dental anesthesiology specialists across Japan. Methods: Data from 355 dental anesthesiology specialists and 1,878 municipalities were analyzed. Travel times from each municipal office to the nearest facility with a dental anesthesiology specialist were calculated using the Google Maps Directions Application Programming Interface. The Dental Anesthesia Rurality Grade (DARG) was defined as follows: Grade A (accessible, < 60 min), Grade B (intermediate, 60 ≤ 120 min), and Grade C (rural, ≥ 120 min). A Strategic Priority Index (SPI) was developed to identify Strategic Priority Areas (SPAs) where interventions may have greater population-level impacts. Results: Grade A status encompassed 87.9% of the population, but occupied only 48.1% of the land area. Conversely, 11.8% of the municipalities (n = 221) were classified as Grade C, representing 20.1% of the land area. A significant positive correlation was found between travel time and aging rate (r = 0.61, P < 0.001), suggesting a pattern consistent with the Inverse Care Law in dental anesthesia. The SPI suggested candidate SPAs such as those in Matsuyama and Hakodate. Conclusions: There are major differences in the geographic accessibility of facilities with affiliated dental anesthesiology specialists across different regions in Japan. Classification by DARG and detailed analysis using the SPI from this study could serve as a helpful model for evaluating geographic access and guiding future resource planning in areas with geographic limitations and an aging population.
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