Oral Health Impacts of the Pandemic
As to the pandemic’s impact on oral and systemic health, clearly, patients must take responsibility for their own care.
Of interest on both a professional and personal level, a recent article in The New York Times Sunday Magazine suggests COVID-19 has taken a “serious, potentially long-lasting toll on oral health.” The article explores the oral and systemic issues generated by the COVID-19 pandemic, and offers possible solutions. It also points to a survey by the American Dental Association in which half of dentists say they have seen an increase in bruxing, fractured teeth and temporomandibular joint issues since the pandemic began. Additionally, 25% of respondents report seeing increasing numbers of patients with caries and periodontal disease.
The respondents attribute these problems to poor dietary choices and a lack of proper oral hygiene during the pandemic, not to mention reduced access to care during the lockdowns. The article suggests access issues were exacerbated by several factors, including the fact that 6 million Americans lost their dental insurance as a result of COVID-19. One in 10 delayed dental care due to cost, lack of insurance, or fear of getting the virus — or a combination of these concerns. Adding to the problem was the closure of most dental offices during the early stages of the pandemic. When these offices were allowed to reopen, regulations required appointments to be spread out, thus reducing the number of available patient visits.
DENTISTS SAY THEY HAVE SEEN AN INCREASE IN BRUXING, FRACTURED TEETH AND TEMPOROMANDIBULAR JOINT ISSUES SINCE THE PANDEMIC BEGAN
In addition, one third of U. S. adults are not receiving preventive dental care, according to an annual review of public health cited in The Times article. It was suggested that if dentists refocused their care to place more emphasis on prevention, this problem could be drastically reduced. However, the authors also note that preventive dental visits are not routinely covered by insurance plans, in spite of the fact periodontal disease has been linked to diabetes, Alzheimer’s, cardiovascular disease and respiratory infections.
Another pandemic-related toll is that caries rates increased when children had to shift to remote learning due to COVID-19. Of course, this also impacted access to care because school-based oral health initiatives were put on hold until such time the pandemic could be brought under some semblance of control. In terms of solutions, the authors assert that wider implementation of teledentistry could promote preventive outreach, and suggest that, among other therapies, parents and caregivers could be shown remotely how to apply fluoride varnish to their children’s teeth.
While there is no question the pandemic has negatively impacted our patient’s oral health, and that prevention can reduce morbidity, until the current reimbursement system is modified to include prevention in a way that makes economic sense for providers, traditional approaches will continue.
As to the pandemic’s impact on oral and systemic health, clearly, patients must take responsibility for their own care. Yet the article fails to mention the need for patients to be proactive about their diet, oral hygiene and seeking professional care. In this regard, the media — as well as oral health professionals — can do a better job of educating patients about the importance of self-care, preventive dental services, and ongoing maintenance visits. Only through such awareness and action can we hope to limit the long-term impact of the COVID-19 pandemic on oral and systemic health.
Thomas G. Wilson Jr., DDS
Editor in Chief
From Decisions in Dentistry. July 2021;7(7)5.