IT’S NOT known for certain how job and income losses have led to children missing dental care during the pandemic.
Now comes a study showing that American children missed dental care most during the pandemic, more than medical care in general.
It was based on a household survey of 348 families in Pittsburgh, Pennsylvania, in mid-2020 – or about three months into the pandemic.
The study was led by Dr. Jacqueline M. Burgette, Assistant Professor at the Department of Dental Public Health and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh in Pennsylvania.
It found that three times as many households reported unmet dental care for a child compared with medical care. It’s more common in households where pandemic-related job or income loss occurred.
Approximately 40 percent of caregivers reported job loss or a decrease in household income due to the pandemic.
The implications are that if the pandemic persists, strategies must be considered to improve dental care for children.
With decreased access to dental care, the consequences of untreated child caries include pain, infection and poor academic performance. It also leads to more visits to Emergency Rooms for acute dental pain and serious life-threatening issues.
To prevent caries or tooth decay in children, the American Academy of Pediatrics, American Academy of Pediatric Dentistry and the American Dental Association recommend early visits to the dental clinic no later than 12 months of age.
Cost remains the major barrier to receiving dental care that leads to unmet dental care needs. Additional barriers include difficulty finding a willing dental provider, transportation and geographic proximity to dental providers.
When dental practices complied with the strict safety protocols recommended by the U.S. Centers for Disease Control and Prevention, more than 95 percent of dental practices were closed or opened only for emergency care by April 2020.
The national and independent nonprofit organization FAIR Health found that caries rose from the fifth- to the fourth-most common dental-related diagnosis in hospital emergency departments from January and February 2020 through March and April 2020.
When lockdowns eased somewhat, 97 percent reopened by mid-June 2020. Dental clinics reported backlogs in dental visits, resulting in delayed visits for patients seeking dental care.
“We found a significant association between caregiver-reported unmet child dental care and job loss or decreased income in the household due to the COVID-19 pandemic,’’ the researchers write in the The Journal of the American Dental Association.
As it was before the pandemic, unmet dental care was the greatest unmet child health care need.
Before COVID-19, more people in the United States reported financial barriers to receiving dental care than any other type of health care.
‘’Financial barriers to dental care are now magnified during a time of job loss and decreased household income during the COVID-19 pandemic,’’ the study observes.
These findings are supported by a poll conducted by National Public Radio, Robert Wood Johnson Foundation and the Harvard T. H. Chan School of Public Health. This survey found that more than one-half of the 3,500 US households reported serious financial problems during the pandemic.
The study highlights the impact of the pandemic for all families in the study, whether they receive care through private or public dental health care system.
In America, private dental practices serve approximately two-thirds of the population. They are financed by employer-provided commercial dental benefits with high out-of-pocket dental health care expenses compared with overall out-of-pocket health spending.
In the public dental care delivery system, the dental safety net system includes government-funded and school-based health centers. It covers dental care for the remaining one-third of the population who may be underserved due to income, lack of dental insurance, rural location and systematic disadvantage due to race, ethnicity and immigration status.
For families in the private dental health care system, changing financial circumstances may have made high out-of-pocket expenses no longer affordable. This results in unmet child dental care.
The study calls attention to the consequences of financing oral health care through employee-sponsored dental insurance that may no longer be there when jobs are lost.
It recommends a health delivery system that will still be there in times of changing financial situations.
***
Dr. Joseph D. Lim is the former Associate Dean of the UE College of Dentistry, former Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515./PN
