Hutchinson ? Ten Kansas counties — including six in the southwest part of the state — have no dentist. Twelve other counties have no full-time practitioner.

Meanwhile, Johnson County in eastern Kansas has 265 dentists, or 27 percent of all who practice in the state.

It’s a classic case of haves versus have-nots, rural versus urban. And short of an influx of new dentists who don’t mind being the only practitioner for miles and miles, the problem threatens to get more acute as dentists in rural areas ponder retirement.

C. Robert Jensen of Greensburg is one of those people. After 20 years as Kiowa County’s only dentist, he has been looking for a replacement for almost seven years.

It’s just a matter of time before he gives up the search and closes the door, he said. His dilemma points to a hidden health crisis that is brewing in the rural parts of the state.

“I have had a few young people come and take a look, but no one showed much interest,” Jensen said. “It’s hard to attract them to rural areas.”

Kevin Robertson, executive director of the Kansas Dental Assn., said the average dental student graduates with more than $100,000 in student loan debt. Dental schools are in urban areas, he said, and students get used to the convenience of the city.

“They don’t think they can make it in rural areas,” Robertson said. “That is the perception, but I don’t know how accurate it is.”

Jensen said it’s not accurate at all. With no competition, he has a virtual monopoly in Kiowa County.

“I just don’t understand it,” he said. “I think many young dentists have the perception you can’t make money in rural areas. That is not true. Things cost a lot less here, so dentists are able to keep a lot more of the money they make.”

The U.S. Department of Health and Human Services is addressing the problem by designating counties as Dental Health Professional Shortage Areas, allowing them to attract dentists to the county with the promise of student loan reimbursement.

That reimbursement was a big reason Joanne Brown started a dental practice in Leoti, in Wichita County. She was graduating with more than $150,000 in loans and wanted to start her career in a county that had the shortage-area designation.

“It was extremely important to me,” Brown said. “Dental school costs so much money that it’s hard for many students to justify it. The program has helped tremendously.”

In western Kansas, many dentists serve patients from several counties. Brian Headrick splits his time between offices in Meade and Gray counties, where he is the only dentist for either.

“There is an extremely high need for dentists in rural areas,” he said. “I can’t take on additional patients because I serve so many now.”

He doesn’t hold much hope for selling his office at retirement. He said he has seen other dentists fail at trying to recruit young professionals to the area.

“We have a hard time attracting them because of the misconception of rural life,” Headrick said. “There are advantages. I don’t have to run people through like cattle because my cost of living is less. People don’t understand that.”