Changes in dental care use patterns due to COVID-19 among insured patients in the United States

Abstract

Background: Demand for dental services has been known to be linked closely to dental insurance and disposable income. Widespread economic uncertainty and health systems changes due to COVID-19 thus may have a significant impact on dental care use.

Methods: Using deidentified dental practice management data from 2019 and 2020, the authors observed variations in dental care use among insured patients since the COVID-19 outbreak (during the period of practice closure and after the reopening) by patient age, procedure type, insurance type, practice size, geographic area, and reopening status. The authors examined whether the rebound in procedure volumes at dental practices can be explained by county-level characteristics using hierarchical regression models.

Results: Although dental care use among privately insured patients fully rebounded by August 2020, use still remained lower than the prepandemic level by 7.54% among the publicly insured population. Demand for teledentistry increased 60-fold during practice closure. Geographic characteristics-such as median household income, percentages of rural or Black populations, and dental care professional shortage designations-were associated significantly with the number of procedures performed at dental practices.

Conclusions: As a result of COVID-19, dental practices experienced substantial decreases in procedure volume, particularly among patients covered by public insurance or residing in underserved areas.

Practical implications: During economic downturns, state health officials should be encouraged to adopt policies to expand access to oral health care for vulnerable populations via oral health promotion strategies and increasing the supply of dentists or midlevel dental care providers in underserved areas.

Keywords: COVID-19; access to care; dental utilization; health services research; neighborhood effect; oral health.