We chose the following states to include in our assessment: Colorado, Iowa, New Mexico, North Carolina, Pennsylvania, and South Carolina. These states were chosen because they (a) represent each region of the country, (b) reflect different models of health care reform implementation, and (c) were identified as actual or potential implementation states for a national public-private initiative focused on improving oral health inter-professional practice in rural health clinics. Where appropriate, we also document how states are using public-private partnerships to advance rural oral health equity. Two programs were operative in all or some of the states studied: The Health Resources and Services Administration Oral Health Service Expansion grant program (all states) and the Medical Oral Expanded Care (MORE) program of the DentaQuest Foundation (Colorado, Pennsylvania and South Carolina). The states studied reported promising practices for improving oral health in rural communities through a variety of approaches: expansion of oral health programs at Federally Qualified Health Centers, marketplace dental plans, inter-professional practice pilot projects, and access to care improvements. In all instances, the State Offices of Rural Health appear to play important programmatic roles either as the source of technical assistance, systems integrator, or connector of partners. As individual states and federal agencies continue to follow the HHS Oral Health Framework, it is essential to involve partners who understand the uniqueness of rural health systems as well as oral health issues.