Since the start of the pandemic, 40% of parents have avoided seeking care at all, citing concerns about infection, office closures and costs.
That’s not good, said pediatric dentist and American Dental Association spokesman Dr. Jonathan Shenkin. “Delays in preventive care can cause children to develop more tooth decay,” he said. “The problem with tooth decay is that when it starts in childhood, it’s really the strongest indicator of adult risk.”
Despite fears of Covid-19 transmission in dental offices, Shenkin said infection control measures have proven effective in protecting patients and staff.
Although dentists are classified by the U.S. Occupational Safety and Health Administration as having a very high risk of exposure to Covid-19, actual infection rates among dentists have remained low, according to a November study published in The Journal of the American Dental Association. .
That means parents can book pediatric dental appointments with confidence, Shenkin said. However, many who do seek help are delayed. Of the parents who tried to book pediatric dental care since the pandemic, nearly a quarter reported waiting times were longer than normal, the CS Mott survey reported.
Some parents couldn’t get their children to the dentist at all. Of the families with private dental insurance who sought care, 4% could not make an appointment. That jumps up to 15% for families whose children depend on Medicaid coverage, who are more likely to be black, multiracial, or Latino than their private insurance counterparts.
Here’s why the delays are so widespread, and how parents can make sure their kids’ teeth stay healthy until the next checkup.
Why care became so scarce
The nationwide closure of dental offices last March caused a ripple effect, Shenkin said. It was chaotic and no one knew when offices would reopen. By the time dentists rebooked in late April or May, the minor issues had gotten worse.
“Some kids who needed fillings now needed extractions,” he said. “We also had to cancel appointments for children who had prevention appointments and send them away.” This resulted in a backlog of visits that offices are still trying to catch up.
When the practices reopened, they faced a shortage of personal protective equipment. That shortage is ongoing, and 91% of respondents to a recent study from the American Academy of Pediatric Dentistry said they didn’t have enough N95 ventilators to replace them between each patient.
Not only that, some measures to prevent Covid-19 transmission limit the number of patients dentists can accommodate, Shenkin explained. “A lot of children’s practices are open clinics and the kids are very close together, which of course we can’t do anymore. We have to be separated; we have to have barriers; we have to separate children,” he said.
According to the AAPD, on Sept. 21, only three-quarters of pediatric dental care providers were 76% or more of their pre-pandemic size. Another 17% of providers reported operations between 51% and 75% of the pre-pandemic numbers.
Overcoming obstacles to give children the care they need
Before the pandemic, some American children received oral care or school education, and many such programs were disrupted as well. That’s especially difficult for families with children who are insured through Medicaid or the Children’s Health Insurance Program. They are faced with additional barriers to obtaining care.
Less than half of dentists in the United States accepted Medicaid or the CHIP in 2019, the American Dental Association’s Health Policy Institute found. A 2015 report by the HPI found that only 38.5% of children living below the poverty line had visited a dentist in the past 12 months.
That lack of treatment has real consequences for children. Children with poor dental health are more likely to miss school and get lower grades, found a 2011 study in the American Journal of Public Health.
Although the pandemic is causing some shortages of care, it is still possible to receive dental treatment. The government website InsureKidsNow.gov has a Dentist Locator tool to search for providers in your area that accept Medicaid or CHIP. (You can also call 1-877-KIDS-NOW or learn more about enrolling kids in dental insurance programs here.)
The ADA provides additional support for disadvantaged children through the Give Kids a Smile program, which includes free screenings, preventive care, and treatments. While GKAS usually hosts large, busy events, this year’s rollout offers a mix of virtual education and Covid-safe, in-person services at dental offices. (Call the ADA at 1-844-490-4527 for information on GKAS services in your area.)
Many community health centers, some of which are federal funded, offer dental care for free or at a discounted price. Another option is to make an appointment at a dental school or dental hygienist school near you, where students will receive preventive care as part of their education.
If you are looking for a dentist to see your children, their visit may be a little different than usual. In addition to standard practices to reduce covid-19 transmission in medical settings, some dentists are changing their treatments. Powerful nozzles once used to remove tartar and plaque send droplets into the air, which is why the CDC has recommended alternatives using hand tools.
Take good care of your teeth at home
Arrangements about preventive dental care are key to oral health, dentist said Shenkin. They are an opportunity for children to learn how to care for their teeth. But whether you’re ready to book or choose to delay care, he added that now is a critical time to enforce best practice at home.
That starts with a low-sugar diet, which feeds the harmful bacteria that cause tooth decay. “The only drink (kids) should drink during the day is water and maybe milk,” Shenkin said.
It’s best to avoid sugary drinks altogether, he said, but if your child is drinking one, timing matters. “If you want it, eat it with a meal.”
Next is brushing twice a day with a fluoride toothpaste and a soft-bristled toothbrush that fits in a child’s hand. “Brushing once a day puts yourself in a higher risk category,” said Shenkin.
By the time a child’s teeth touch, it is time to start flossing. According to the AAPD, children can usually floss unsupervised by age 10.
Such advice is known to many parents. But Shenkin said he understands why proper nutrition and oral hygiene can slip into a hectic time, where many families juggle with disrupted school, work and family life.
However, by adhering to the basics of careful hygiene, you will ensure that your child has good oral health – whether or not you take him to the dentist.
