Changes in dental visits and oral health for children by race and ethnicity during the COVID-19 pandemic

Abstract

Background: The COVID-19 pandemic created new barriers to oral health care, which may worsen oral health and exacerbate disparities. The authors quantified changes in children's dental care receipt and oral health outcomes during the pandemic and examined differences among racial and ethnic groups.

Methods: Using the National Survey of Children's Health (163,948 child observations from 2017-2021), the authors used weighted modified Poisson models to examine caregiver-reported receipt of a dental visit (for any reason and for preventive care) and adverse oral health outcomes (teeth in fair or poor condition; difficulty with toothaches, cavities, or bleeding gums) from 2017 through 2019 (prepandemic) compared with 2020 and 2021. The authors examined outcomes within and across racial and ethnic groups.

Results: Children from all racial and ethnic groups experienced declines in receipt of dental visits, but there were limited changes in adverse oral health outcomes during 2020 and 2021. Prepandemic disparities in receipt of dental visits persisted for Black children and Asian children compared with White children. Hispanic children experienced larger increases in risk of experiencing both adverse oral health outcomes compared with White children in 2020 and in having teeth in fair or poor condition in 2021.

Conclusions: The pandemic did not create new disparities in receipt of dental visits or oral health outcomes, but disparities in care persisted, and the oral health of Hispanic children was affected differentially.

Practical implications: Continued monitoring of dental visits and adverse oral health outcomes by race and ethnicity is critical to ensuring all children have access to oral health care. This information can help develop targeted interventions to improve children's oral health, including for minoritized racial and ethnic groups.

Keywords: COVID-19; access to care; children; dental care for children; oral health; racial and ethnic disparities; vulnerable populations.