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 closely linked to dental insurance and disposable income. Widespread economic uncertainty and health systems changes due to the coronavirus disease 2019 (COVID-19) thus may have a significant impact on dental utilization. Methods Using de-identified dental practice management data in 2019 and 2020, we observed variations in dental utilization among insured patients since the COVID-19 outbreak (during the period of practice closure and after reopening) by patient age, procedure types, insurance type, practice size, geographic area, and reopening status. We examined whether the rebound in procedure volumes at dental practices can be explained by county-level characteristics using hierarchical regression models. Results While dental utilization among privately insured individuals fully rebounded by August 2020, utilization still remained lower than the pre-pandemic level by 7.54% among the publicly insured population. Demand for teledentistry increased up to 60 times during practice closure. Geographic characteristics--such as median household income, percentages of rural or African American populations, and dental professional shortage designations --were significantly associated with the number of procedures performed at dental practices. Conclusion As a result of COVID-19, dental practices experienced substantial decreases in procedure volume, particular among patients covered by public insurance or residing in underserved areas. Practical Implications: During these economic downturns, state health officials would 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 mid-level dental providers in underserved areas.

Effects of the COVID-19 pandemic on dentists’ workforce confidence and workflow

“…28 Results of analysis of practice management data found that oral health care use has fully rebounded to prepandemic levels among privately insured patients. 29 These later studies, indicating adaptation to new safety procedures and rebounding dental demand, are consistent with our optimistic findings.…”

Endodontic Specialists' Practice During the Coronavirus Disease 2019 Pandemic: 1 Year after the Initial Outbreak

“…Previous studies showed that the COVID-19 pandemic resulted in substantial decrease in procedure volume for patients covered by public insurances in the United States ( 16 ). There are other socioeconomic factors that could contribute to patients’ behavior in this regard.…”

COVID-19 Effects on Income and Dental Visits: A Cross-sectional Study

“…The following sociodemographic characteristics, health-related behaviors, and health status were included in the model as covariates: age, sex, self-rated health (great, good, not bad, and bad), regular dental visit (at least once a year, at least once every 2–3 y, almost never went, and never went), and employment status (full-time employee, part-time employee or other, not working). The covariates included in this study were based on previous evidence on age (Koyama and Takeuchi 2020; Choi, Simon, Basu, et al 2021; Meisha et al 2021), sex (Thompson et al 2016; Koyama and Takeuchi 2020; Meisha et al 2021), self-rated health (Brennan and Teusner 2015), regular dental visits (Koyama and Takeuchi 2020; Meisha et al 2021), and employment status (Meisha et al 2021).…”