The early days of the pandemic brought a tidal wave of changes to the dental industry. As a broker, you know that those shockwaves ripple out to affect your business. Understanding how COVID-19 impacted patients, dentists and the dental insurance industry helps you plan for the future and informs how you can best serve your clients. Let’s take a deep dive into claims data, patient surveys and expert opinions.

The rise of teledentistry

During the early stages of the pandemic in the United States, dental offices were closed to physical appointments for weeks. This led to a massive surge in the popularity of teledentistry services. Synchronous appointments (those with live phone or video interaction between dentists and their patients) saw a 3,000% increase between 2019 and 2020, according to Delta Dental claims during that period. Asynchronous appointments (where patients took photos or videos that were sent to a dentist for later review) saw a 1,000% increase in the same time period.

The use of teledentistry has declined as the pandemic has worn on and dentist offices have reopened, but 2021’s synchronous and asynchronous appointment numbers still remain six times and two times higher than 2019 levels, respectively.

More states also updated their teledentistry laws during the pandemic. Based on Delta Dental’s internal tracking, fourteen states added teledentistry regulations to their laws or expanded existing regulations, including states like Texas that had previously not allowed the practice of teledentistry at all.

Most importantly, in a phone survey of teledentistry patients during the pandemic, patients expressed widespread satisfaction with their options. This aligns with pre-pandemic expectations that patients had about teledentistry, in which 78% of patients surveyed expected to use teledentistry within the next five years. That same group anticipated that working people, children and people with disabilities would benefit the most from teledentistry.

Dentists also had praise for teledentistry, with over 80% of dentists identifying it as useful for improving access to oral care, increasing specialists’ access to rural and underserved communities and as a time-saving technique. Virtual visits may not replace in-person checkups, but they remain a valuable tool for both dentists and patients, and an important consideration for your clients.

Keeping dentists (and you) in business

The beginning of the pandemic was marked by profound economic uncertainty as dental practices closed and people sheltered in place. General practitioner income dropped nearly 18% in 2020 compared to 2019.

Recognizing that without adequate resources dentist offices may be forced to close, Delta Dental was able to assist with loans, reimbursements for personal protective equipment (PPE) costs and free teledentistry tools that allowed dentists to see patients remotely.

Loans offered in partnership with Provide (formerly Lendeavor) allowed dentists to make practice acquisitions, expand to new locations, purchase commercial real estate and equipment, build out their practices and refinance existing practice and commercial real estate debt. These loans featured favorable terms and conditions, such as covered interest for 24 months, deferred payments for 6 months, repayment terms of 10+ years and working capital of up to $200,000.

Delta Dental also offered a supplemental reimbursement for qualifying evaluations and consultations during the second half of 2020. This Return to Care reimbursement led to an additional $80 million for dentists last year to help offset the costs of PPE and office cleanings.

The pandemic saw the rollout of two teledentistry options for Delta Dental members: Delta Dental – Virtual Consult and Toothpic.

  • Virtual Consult is a synchronous service where members can use a smart device to have a live video chat with a Delta Dental dentist.
  • Toothpic is an asynchronous service that allows members to take photos of problem areas and get an assessment from a Delta Dental dentist within 24 hours.

These services are free for members and dentists. Most importantly for your clients, these options expand access to assist patients who may have difficulty making it to in-person visits or prefer a remote appointment.

How patients used their benefits

The early stages of the pandemic saw a drastic decline in the number of patients going to the dentist’s office. One of the main reasons for the decline was that the sharp economic shutdown led to over 20 million Americans losing their jobs (PDF) and their dental coverage as well. Of these 20 million, nearly half found themselves without insurance at all. The remaining jobless got dental coverage through resources like Medicaid.

This decline in visits to the dentist office had a profound effect on patients’ oral health. 

In 2019, the most common procedures according to Delta Dental claims data were either routine preventive care or evaluations for specific issues. This shifted in 2020, when some of the most common procedures were fillings and root planing, which help address the effects of dental neglect.

In addition to the economic hardships COVID-19 brought to patients, COVID also increased mental and emotional strain. Since the pandemic began, the number of adults reporting symptoms of anxiety or depressive disorders has risen from about 10% to over 40%.

These symptoms can manifest in jaw clenching and teeth grinding; based on Delta Dental claims data, the number of patients requiring occlusal guards to prevent damage rose nearly 10% in the second half of 2020 compared to the same period in 2019. 

Anxiety and depression can also worsen an unhealthy diet or substance abuse, which can lead to oral health issues such as cavities. This may also help to explain the surge in fillings and scaling and root planing procedures in 2020.

Health and safety in the dental office

Even though COVID-19 is spread by exhaled aerosolized droplets, visits to the dentist’s office proved safer than visiting any other medical professional during the pandemic. Nearly 100% of dentist offices rapidly adopted enhanced infection control measures like pre-appointment screenings, in-office air purification and antiviral mouthwashes. Once vaccines became available, they saw widespread adoption amongst dentists, even before state and federal mandates. By the second quarter of 2021, over 90% of dentists had received at least one vaccination shot for COVID-19.

Patients also view dentists as valuable sources of information about their overall health in addition to their oral health. Two-thirds of dentists reported receiving questions from patients about the COVID-19 vaccine (PDF), according to the ADA. 

Dentists rose to the occasion, with over 80% reported feeling prepared for these discussions and 95% believing it was important to have such discussions with patients.

What did we learn from COVID-19?

Here are three key takeaways for you and your practice as you look to the future.

  • Encourage group clients to choose plans that truly meet their needs. A “Cadillac” insurance plan can be an attractive proposition for you and your clients, but it may be more coverage than they need. Conversely, in periods of economic uncertainty, individuals may decide that they should forego dental insurance entirely, but this can lead to small issues going untreated and becoming major ones. Helping your group and individual clients identify a plan that fits their needs (and their wallets) early on can go a long way towards keeping them healthy and happy no matter the economic forecast.
  • Foster relationships with individual clients that are about more than just sales. One thing COVID-19 showed was that in the face of uncertainty, people were desperate for answers. As an insurance industry expert, you can be well-suited to advise your clients and help them identify their needs, choose a plan that fits and seek care. Being able to offer advice on wellness and on current topics, such as the safety of vaccines, can go a long way towards building lasting relationships with your clients.
  • Have a resiliency plan in mind in case of an economic downturn.  The pandemic demonstrated that massive disruptions to the way we do business and live our lives aren’t just a possibility but an inevitability. Even if we don’t see another global pandemic within our lifetimes, there will undoubtedly be more localized disruptions from natural disasters like hurricanes, major storms and wildfires. Diversifying your client base (such as by selling to individuals if you currently focus on group clients) can help you to weather periods of economic uncertainty.