In the months since the coronavirus (COVID-19) pandemic entered the United States, the future of the dental industry has been on relatively shaky footing. But despite fluctuating patient volumes, lower than normal dental spending and large-scale coverage losses across the country, outlooks for the future are looking positive as recovery from the pandemic gains momentum.

Patient volumes are increasing

For the first time since late March 2020, slightly more than 50% of dental practices are open with pre-pandemic patient volumes, according to the American Dental Association (ADA)’s report COVID-19: Economic Impact on Dental Practices, Week of March 15. With less than 1% of practices fully closed, over 99% of practices are now open and seeing patients.

A year ago, during the week of March 23, 2020, the ADA reported that 19% of practices were fully closed and 76% of practices were only seeing emergency patients. In the following months, practices began to reopen and saw slow but steady increases in patient volumes. By late August, almost half of practices were open with normal patient volumes. That percentage dipped down again in November, but slightly more than half of practices are now operating at their pre-pandemic levels.

Due to cancellations during the second and third quarters, many practices saw holes in their schedules during the fourth quarter of 2020 and the first quarter of 2021. Usually, a practice would have 80% or more of its schedule filled. The past year was much different, with the average schedule only 50% full. This dip occurred in part because some appointments in the first half of 2020 were cancelled due to the pandemic and then the appointments were not immediately rescheduled.

In good news, nearly three in every four patients believe that routine dental appointments are still important during the pandemic, according to a September 2020 survey by the Delta Dental Institute. Most respondents said they were worried about the long-term side effects of missing appointments. The results of this survey may suggest that patients will continue to return to dentists.

Dental care spending dipped in 2020

The dip in patient volume also a contributed to a projected dip in yearly dental spending. The ADA’s Health Policy Institute predicted in its June 2020 industry model that dental care spending would dip by up to 38% in 2020 and 20% in 2021. Their models didn’t take into account additional waves of COVID-19 cases. However, dental spending in 2020 dropped by 20%, a large drop but significantly less than the amount predicted by the ADA.

Compared to other health services, dental services had the largest decline in spending, possibly related to practice closures and patient anxieties about infection while receiving care.

Changes in coverage may have contributed to decline

Disruptions of the job market and financial instability caused by the pandemic have altered the insurance market. Almost 7.7 million workers with employer sponsored insurance (ESI) lost their coverage due to the pandemic. An additional 6.9 million dependents lost their insurance coverage when their family members lost jobs.

In the past year, 39% of Americans have chosen to reduce or eliminate their insurance for financial reasons. Some people see dental insurance as an additional cost that isn’t worth it when their oral health is currently good or their dentist isn’t in-network.

The strong link between employment and health insurance coverage has important implications for Americans’ insurance coverage and access to health care, as ESI is the most common form of health insurance in the United States. It’s also crucial that patients understand the connection between oral health and overall health as they make choices about their coverage.

Low risk of infection in dental practices

Despite dentistry being flagged as a high-risk profession for COVID-19 infections, the estimated rate of COVID-19 cases among dentists was less than 1%, according to a November 2020 study in JADA. Low rates of infection, about 3%, were identified in dental hygienists as well, according to a study published in the February 2021 issue of The Journal of Dental Hygiene.

These statistics suggest that enhanced infection control measures implemented by almost 99% of practices helped prevent infections in dental settings. Low rates of infections paired with the fact that nearly 80% of dentists have now received at least one dose of a COVID-19 vaccine, dental practices are very safe for patients and staff.

Positive outlooks for the future

There’s a bright light at the end of this long tunnel. About 44.9 million people have been fully vaccinated in the US and an additional 82.7 million people have received at least one dose of a COVID-19 vaccination. A large push to have enough vaccine doses for every American by May 1 may contribute to higher patient volumes in the second half of 2021. Additionally, 70% of Americans intend to get vaccinated or already are. Economic supplements and stabilizers from the federal government will potentially ease stress for some Americans who may be avoiding appointments for financial reasons. With fears of COVID-19 infection at the dentist easing, the future is looking bright for dentists who want patients back in their chairs.