The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Abstract

Introduction: Early childhood caries burdens children, their families, and the health care system. Utilizing fluoride varnish at medical well-child visits with non-dental primary care providers can be an interprofessional strategy to combat early childhood caries. The COVID-19 pandemic dramatically altered preventive health care delivery and the effects on preventive oral health care delivery have not been previously described.Methods: This analysis used descriptive statistics and non-parametric Wilcoxon Mann-Whitney tests to compare preventive oral health utilization among 1 to 5-year old children in two state Medicaid agencies before and during the pandemic. Fluoride utilization rates at dental visits and medical well-child visits were calculated as number of users per 1,000 enrolled children. Additionally, the proportion of well-child visits that included fluoride application was calculated for each state.Results: During the pandemic, the quarterly fluoride utilization rate significantly decreased at dental visits (pre-pandemic = 153.5 per 1,000 enrolled children; pandemic = 36.1 per 1,000 enrolled children, p < 0.001) and signficantly decreased at medical well-child visits (pre-pandemic = 72.2 per 1,000 enrolled children; pandemic = 32.3 per 1,000 enrolled children, p = 0.03) during the pandemic.Conclusions: The findings highlight the importance of interprofessional collaboration among non-dental primary care providers and dental providers to provide access to preventive oral health services, particularly when access to dentists is limited. Future directions might include rigorous evaluations of co-located medical and dental services or the use of interprofessional telehealth technologies.

Dental safety net providers’ experiences with service delivery during the first year of COVID-19 should inform dental pandemic preparedness

“…46 As observed elsewhere, 13,25 participants depended on collaboration to troubleshoot safe service delivery and engender trust with internal, public-sector, and private-sector partners that facilitated revenue maintenance and multidisciplinary health care delivery. Indeed, our findings support experts' calls to finally normalize medical-dental integration and preventive dentistry [13][14][15][16]47,48 and formalize dental care professionals' broader roles during public health emergencies, including infection control leadership, epidemiologic surveillance management, and common clinical duties, such as vaccination delivery. [27][28][29][30] Although the DSN's frontline status indicates the salience of these findings for that subsector, applications to dental private practice as part of dental PHEPR should also be considered.…”

Factores asociados al covid-19 desencadenantes de infecciones bucodentales en la población infantil

“…Una consecuencia de estos cierres y medidas de distanciamiento social fue la interrupción del acceso de los niños a los servicios de atención médica. El estado de salud bucal de los niños fue probablemente uno de los dominios de la salud infantil más afectados negativamente debido a las restricciones impuestas tempranamente en el acceso a los servicios dentales (Maupome et al, 2020;Meyer & Danesh, 2021). Los dentistas pediátricos jugaron un papel importante en la eliminación del dolor y sufrimiento durante las emergencias dentales en niños, y en el caso de la odontología americana (ADA) estableció que las emergencias dentales son potencialmente mortales y requerían tratamientos inmediatos para detener el tejido en curso, sangrado, aliviar el dolor intenso o la infección.…”

Time series analysis of COVID-19's impact on physician and dentist visits in Iran

“…The overwhelming demand of the public health emergency led to the deferring of regular preventive care and maintenance of non-critical conditions which were considered non-essential 14 . However, while the impact of COVID-19 on physician and dentist visits has been extensively studied 7 , 15 , 16 , its specific effects on these types of health services have not yet been examined in Iran either at the national or subnational levels. This analysis identifies opportunities for more effective and efficient support of the healthcare workforce, systems, and patient care delivery for future public health crises across a lower and middle income country.…”