Children go without dental care during the pandemic


Since the start of the pandemic, 40% of parents have avoided seeking treatment, citing concerns about infection, office closures and costs.

It’s not good, said pediatric dentist and American Dental Association spokesperson Dr. Jonathan Shenkin. “Delays in preventive care could lead to children developing more dental cavities,” he said. “The problem with tooth decay is that when it starts in childhood, it’s really the best indicator of risk in adulthood.”

Despite fears about the transmission of Covid-19 in dental practices, Shenkin said infection control measures have proven effective in protecting patients and staff.

While dentists are designated as being at very high risk of exposure to Covid-19 by the US Occupational Safety and Health Administration, actual infection rates among dentists have remained low, a researcher has found. November study published in The Journal of the American Dental Association.
This means parents can book pediatric dental appointments with confidence, Shenkin said. However, many who seek care face delays. Among parents who have tried to book pediatric dental care since the pandemic, nearly a quarter reported longer than usual wait times, according to the CS Mott survey.
Some parents have not even been able to bring their children to the dentist. Of the families with private dental insurance who requested care, 4% were unable to get an appointment. That goes up to 15% for families whose children depend on Medicaid coverage, who are more likely to be black, multiracial or Latino than their counterparts with private insurance.

Here’s why delays have become so prevalent and how parents can ensure their child’s teeth stay healthy until the next checkup.

Why care has become so scarce

The nationwide closure of dentists’ offices last March had a ripple effect, Shenkin said. It was chaotic and no one knew when the offices would reopen. By the time the dentists resumed their appointments in late April or May, the little problems 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 kick them out.” This has left a backlog of visits that offices are still struggling to catch up with.

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As practices reopened, they faced shortages of personal protective equipment. This shortage continues, and 91% of respondents to a recent American Academy of Pediatric Dentistry survey said they did not have enough N95 respirators to change between patients.

Not only that, some measures to prevent transmission of Covid-19 limit the number of patients dentists can accommodate, Shenkin explained. “A lot of pediatric practices are open clinics, and the children are very close to each other, which of course we can’t do anymore. We have to have separation; we have to have barriers; we have to separate the children,” he said.

As of Sept. 21, only three-quarters of pediatric dental providers were operating at 76% or more of their pre-pandemic volume, according to the AAPD. An additional 17% of providers reported operations between 51% and 75% of pre-pandemic figures.

Overcoming barriers to getting the care children need

Before the pandemic, some American children were receiving oral health care or education at school, and many such programs have also been discontinued. It’s especially difficult for families with children insured by Medicaid or the Children’s Health Insurance Program. They face additional barriers to obtaining care.
Less than half of dentists in the United States accepted Medicaid or CHIP in 2019, the American Dental Association’s Health Policy Institute found. A 2015 HPI report showed that only 38.5% of children living below the poverty line had seen a dentist in the previous 12 months.
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This lack of treatment has real consequences for children. Children with poor dental health are more likely to miss school and get lower grades, a 2011 study in the American Journal of Public Health found.
While the pandemic is creating healthcare shortages, it is still possible to get treatment. The government website has a dentist finder tool to find providers in your area who accept Medicaid or CHIP. (You can also call 1-877-KIDS-NOW or find more information about enrolling children in dental insurance programs here.)
The ADA provides additional support for underserved children through its Give Kids a Smile program, which includes free screenings, preventative care, and treatment. While GKAS typically offers large, crowded events, this year’s rollout offers a mix of virtual education and Covid-safe in-person services at dentists’ offices. (Call the ADA at 1-844-490-4527 for more information about GKAS services in your area.)
Many community health centers, some of which are federally funded, offer free or reduced-cost dental services. Another option is to book an appointment at a dental school or dental hygienist school in your area, where students perform preventative care as part of their training.
If you find a dentist to see your children, their visit might be a little different from normal. In addition to usual practices to reduce the transmission of Covid-19 in medical settings, some dentists are modifying their treatments. Powerful sprayers once used to remove tartar and plaque send droplets into the air, so the CDC has recommended alternatives using hand tools.

Take care of your teeth at home

Preventative dental appointments are key to oral health, dentist says Shenkin. They are an opportunity for children to learn how to take care of their teeth. But whether you are ready to book or choose to postpone care, he added that this is a critical time to maintain best practices at home.

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It starts with a diet that restricts sugar, 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 says, but if your child drinks one, timing is important. “If you’re going to have it, take it with a meal.”

Then, brush your teeth twice a day with fluoride toothpaste and a soft-bristled toothbrush that fits in a child’s hand. “If you brush your teeth once a day, you’re already putting yourself in a higher risk category,” Shenkin said.

The moment a child’s teeth touch, it’s time to start flossing. By age 10, children can generally floss unsupervised, according to the AAPD.
Such advice is familiar to many parents. But Shenkin said he understands why good nutrition and good oral hygiene can slip in a turbulent time when many families juggle disrupted school, work and home life.

Sticking to the basics of good hygiene will set your child up for good oral health, whether or not you take them to the dentist just yet.

Jen Rose Smith is a Vermont-based writer. Find his work on, or follow her on Twitter @jenrosesmithvt.


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