How COVID-19 has disrupted children’s dental care

A third of parents say the COVID-19 pandemic has made it difficult to get dental care for their children, a new national poll suggests.

But some families may face greater challenges than others. Inability to get a dentist appointment during the pandemic was three times as common for children with Medicaid versus those with private dental coverage, according to the C.S. Mott Children’s Hospital National Poll on Children’s Health at Michigan Medicine.

“Regular preventive dental care helps keep children’s teeth healthy and allows providers to address any tooth decay or dental problems before they become more serious,” says Mott Poll co-director Sarah Clark, M.P.H.

“Our findings highlight how the pandemic may have disrupted families’ dental care and exasperated potential disparities among those with insurance barriers.”

Some parents attempted to continue their child’s regular dental check-ups, only to find a lengthy wait time for an appointment, Clark says. Others found that the dental office had closed or reduced patient visits to urgent cases.

But the Mott Poll report revealed a silver lining too: One in four parents described improvements in how their children are taking care of their teeth and gums at home during the pandemic.

The nationally representative report is based on responses from 1,882 parents with at least one child ages 3-18.

Here, Clark speaks more about the Mott Poll findings and dental care recommendations for families:

1 in 3 parents cite challenges getting preventive dental care   

The American Association of Pediatric Dentists recommends that children receive regular teeth cleaning and exams every six months, starting when their first tooth comes in. Check-ups provide a consistent opportunity to identify and treat tooth decay, to apply protective treatments like sealants and fluoride varnish, and to educate parents and children about good dental hygiene.

But to protect patients and staff, some dental offices have changed or limited their operations to limit the spread of COVID-19.

Sixty percent of parents in the poll have tried to get preventive dental care for their child since the pandemic started. While most got an appointment in the usual timeframe, 24% experienced a delay, and 7% could not get an appointment at all.

Overall, one in three parents (32%) feel COVID-19 has made it harder to get preventive dental care for their child.

Clark says a challenge for parents during the pandemic has been keeping up to date on the many changes in schedules and operations, from schools to stores to health care providers.

“Parents who were unable to get a dental appointment for their child should check back with their regular dentist, as lengthy wait times or patient restrictions may have changed,” she says.

COVID-19 safety concerns may delay dental care for children

This Mott Poll suggests that some parents are worried about the risk of COVID-19 exposure during a dental visit and are delaying making a dental appointment for their child.

The majority of parents who didn’t attempt to schedule preventive dental care for their child during the pandemic cited COVID-related reasons. Some 40% don’t want to risk getting exposed, while 23% say the dentist office was closed or only seeing urgent patients.

Other parents say they did not call for an appointment because their child wasn’t due for dental care or wasn’t having any dental problems.

Most parents (67%) believe it’s safe for their child to get dental care at this point in the pandemic, while 14% feel it’s unsafe and 19% are unsure.

Clark recommends parents who are concerned about COVID exposure to contact their child’s dentist to learn about what types of precautions have been put in place. These may include patient and staff screenings and temperature checks, and having patients wait in their cars rather than the waiting room.

“It may be helpful for dental providers to be proactive in reminding parents about the importance of regular dental check-ups for children,” she says. “Reminder notices and website updates outlining changes to practice operations may also help more parents feel safe bringing children in for their visit.”

Insurance barriers contribute to dental health accessibility

Barriers to dental appointments occurred more frequently for children with Medicaid dental coverage compared to those with private dental insurance.

Among parents who tried to get their child in for preventive dental care, 15% of parents of children with Medicaid dental coverage reported not being able to get an appointment, compared to 4% of those with private dental insurance and 5% who had no coverage.

Clark notes that even outside the pandemic, these children often have difficulty finding a dentist, as many providers don’t accept Medicaid payment. Some children receive preventive dental services through school or public dental clinics, but those services have decreased during the pandemic.

Among parents who didn’t try to schedule a preventive dental appointment, cost was the reason for 23% of parents who lacked dental insurance, compared to very few of those with private or Medicaid coverage.

“Insurance barriers may lead to unequal opportunities for families to receive dental care critical to keeping their children’s teeth healthy,” Clark says. 

1 in 4 parents see improvements in child’s oral health habits during pandemic

An unexpected finding from the Mott Poll report was that a fourth of parents reported improvements in their child’s oral health habits during the pandemic.

This included more frequent brushing (16%), flossing (11%) and use of fluoride rinse (9%), and less drinking of sugary beverages (15%).

Overall, 28% of parents say their child has made at least one positive change, including more parents of children with Medicaid (37%) or no dental coverage (32%) compared to private dental insurance (24%).

“We were pleased to find parents describing positive changes in how their children are taking care of their teeth at home,” Clark says. “Daily brushing and flossing and avoiding sugary drinks are important ways to prevent tooth decay.

“Parents whose child is not getting regular dental check-ups should take extra steps to improve daily oral health habits, particularly if regular dental care has been delayed or disrupted,” she adds.