Geographic areas with low socioeconomic status may experience status may experience less access to oral health promotion and oral health care. Approximately 40% of the licensed dentists in Mississippi practice in two metropolitan areas, Jackson and the Gulf Coast. As a result, 38 of the 82 counties in Mississippi have 4,000 or more persons per dentist. With minimal incentives attracting dentists to underserved areas, and with little public health intervention providing first-rate care, education, and prevention, promotion of case referrals for oral health care should be implemented. Several states have loosened restrictions on the level of dental hygienist supervision required in order to extend care to populations in need. For the predominantly rural state of Mississippi, less restrictive supervision of dental hygienists might help address the acute problems of poor oral health and access to care issues.