How will the pandemic affect patient access to dental care and what can we do about it?

We discuss what the twin public health and economic crisis of the COVID-19 pandemic means for your patients’ oral care.

As we saw during the last major recession, it is a well-established fact that access to dental care declines during an economic crisis. Now, as we find ourselves in the middle of not just an economic crisis, but also a public health one, we’re bracing ourselves for the long-term impact of this unprecedented event on the dental industry. Here, we discuss what this means for both patients and dentists, and more importantly, what you can do about it.

COVID-19 and patient access to dental care

Few people have been left financially unscathed by the pandemic. Many have lost jobs, some losing their access to dental insurance or affordable care along with them. Many more have lost income due to mandated closures, furloughs, or reduced working hours.  

As a recent study published in the Journal of the American Dental Association (JADA) found, when budgets tighten, dental care is one of the first things to suffer. In households that experienced pandemic-related job or income loss, there was a significantly higher likelihood that the dental needs of children went unmet. 

Affordability aside, there will continue to be patients who do not seek out care due to health anxieties or vulnerabilities. Unfortunately, these vulnerable patients – the elderly and those with systemic illnesses like cardiovascular disease – are among the most at-risk groups for oral health disease.  

When the patients who need us most are the ones least able to access care, what does this mean for long-term health outcomes?

What reduced access means for patients…

Patients are often unaware of the early stages of oral diseases like caries, periodontitis, and oral cancers. Routine dental visits are essential for early diagnosis and management, but in their absence, these diseases will inevitably advance unchecked. 

As oral health conditions progress, there is a risk that patients will delay seeking care until symptoms become severe. At this stage, the patient risks serious complications like a periodontal abscess, irreversible pulpitis, and tooth loss.

…and what it means for dentists

Dentists are already financially reeling from the one-two punch of reduced patient volumes and increased PPE costs. Even as practices reopen, dentists cannot yet return to pre-pandemic capacity thanks to enhanced infection control protocols.

The combination of reduced patient demand and lower capacity is proving to be financially untenable for dentists. In 2020, the British Dental Association reported that only 8% of its members were confident in their ability to maintain their financial sustainability without additional government support. 

Dentists are now in a difficult position: they desperately need patients to start coming back, but when they do, they may be experiencing poorer oral health due to unmanaged conditions. That means more pain, more treatment, and greater expense for the patient, who may well direct their dissatisfaction towards the dentist.

As a dentist, what exactly can you do to protect your patient outcomes and your practice’s bottom line?

1.    Double down on prevention 

With the pandemic ongoing and the road to recovery uncertain, we can expect reduced care access to continue for some time. With that in mind, dentists must double down on prevention now to reduce the burden of disease later. 

According to the World Health Organization (WHO), untreated dental caries in the permanent teeth is already the most prevalent health condition worldwide, and 530 million children globally have caries of the primary teeth. Long-term, we will no doubt see even more patients presenting with advanced lesions, including those with pulpal involvement.

In the clinic, you can prevent or arrest the development of dental caries by administering fluoride sealants or varnishes to high-risk patients. However, with fewer opportunities for face-to-face intervention, you will also need to think beyond the practice in order to engage your vulnerable patients. 

The aforementioned JADA article found that families are less likely to forgo medical care than dental care. This presents an opportunity for you to reach patients using an interprofessional approach. The authors recommend engaging non-dental health professionals like physicians, social workers, and community health workers to educate families on oral health and caries prevention. 

2.    Make every visit count 

With patients hesitant to book an appointment, you must make every visit count. That means exploring solutions to keep teeth vital for longer, while also maximizing cost-efficiency and minimizing treatment time. 

One such solution is Septodont’s Biodentine™, an innovative, bioactive dentine substitute. 

Take the example of endodontic treatment. Conventional options, like root canal treatment, are very time-consuming and require multiple visits. There is an increased risk of complications, e.g. bacterial infiltration and deterioration of the crown seal, which may require retreatment and even more sessions. For patients with financial or health concerns, this is far from ideal. 

On the other hand, you could provide vital pulp therapy with Biodentine™. When applied to pulp cells, Biodentine™ has been shown to promote pulpal healing and preserve the vitality of the tooth – the optimal outcome, particularly for immature teeth

Vital pulp therapy with Biodentine™ requires shorter treatment times and fewer sessions than traditional endodontic treatments. Because the material is highly biocompatible, there is a reduced risk of tissue or pulp reaction and minimal post-operative pain. And thanks to the high pH, bacterial propagation is limited and the risk of odontogenic infection is lowered. 

While it will still require additional expense for the patient, the cost of vital pulp therapy is lower than that of endodontic therapy, particularly when you take into account the latter’s potential complications and need for retreatment. 

Altogether, performing vital pulp therapy with Biodentine™ allows you to maximize patient satisfaction and long-term outcomes, while minimizing their expenditure, discomfort, and treatment time – something that benefits both you and the patient, throughout the pandemic and beyond. 

3.    Embrace technology

Throughout the pandemic, telehealth has emerged as a valuable way to stay in touch with patients. While it is not a substitute for in-person dental care, telehealth minimizes time spent in the chair by allowing you to conduct triage, anamnesis, and follow-ups digitally. 

Telehealth has proven particularly helpful to those in high-risk groups who might otherwise have fallen through the cracks. For your economically hard-hit patients, telehealth is more affordable and means less time off work and less money spent on transportation. For your vulnerable patients, it means they can access care from the safety of their own homes. For both groups, it could be the difference between receiving treatment or delaying until their symptoms become unmanageable. 

4.    Remove other barriers 

With health concerns and economic difficulties foremost in their mind, the prospect of a painful treatment can be the final straw for those wondering whether to postpone that visit. 

Don’t give your patient one more reason to avoid treatment! 

We find that many dentists overlook a golden opportunity to manage pain – the pre-injection topical anesthetic. Needles add an extra layer of fear to the patient experience, so anything you can do to minimize that will be welcomed. While it might involve a little extra time and money, it will give your patient one less reason to avoid the chair.  

Septodont is leading the charge when it comes to dental pain management. From lower-deflection needles to the highest-quality injectable anesthetics, our products are designed to give your patients the most comfortable experience possible. We also provide a comprehensive range of programs and tools to help you strengthen your pain management approach. 

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