The Pandemic Was Bad for Our Teeth. Will It Change Oral Health Forever?

Early signs suggest the pandemic is causing serious and potentially long-lasting damage to our oral health. In September, even before the U.S. winter coronavirus surge, an American Dental Association survey found that more than half of dentists surveyed had seen an increase in stress-related conditions among their patients. These symptoms include teeth grinding, cracked and chipped teeth, and symptoms of temporomandibular joint dysfunction, such as jaw pain. More than a quarter of dentists report an increase in tooth decay and gum disease, which is likely the result of changes in people's diet and hygiene habits. Americans also have trouble accessing dental care: A report last month from the CareQuest Oral Health Institute, a nonprofit research and advocacy group, found that 6 million adults lost dental insurance because of the pandemic, and more than 1 in 10 Dental insurance.

A major challenge for providers is that routine dental procedures generate aerosols that increase the risk of viral transmission. How much is unclear. (There are “currently no data to assess the risk of SARS-CoV-2 transmission during dental practices,” according to the CDC, which provides guidance for dental settings on its website.) As a precaution, many practices have increased space and hours reducing the number of patients they can see between appointments. This and other issues exacerbate long-standing disparities in access to oral health care: As of mid-April, nearly 60 percent of private clinics were operating at full capacity, compared with about 35 percent of public clinics, according to an ADA poll.

But the pandemic has also spurred distal adaptations—which may help address these inequalities. “We have to start thinking differently about how to meet the needs of children and families who are unable to go to a clinic or receive care in schools or other community settings,” said Antonina Capurro of Nevada Dental Health Police, “And how we can contact them.”

Throughout the history of modern medicine, rather curiously, the mouth has been viewed as separate from the rest of the body. Unlike annual visits to your primary care doctor, preventive visits to the dentist are generally not covered by health insurance. Only in the past few decades have researchers begun to realize that oral health is inextricably linked to a person's overall physical, emotional, and mental health. Gum disease has been linked to a variety of conditions, including diabetes, Alzheimer's disease, cardiovascular disease, premature birth and even respiratory infections. In addition to tooth decay, it is also associated with poor socioeconomic outcomes. For example, children with cavities tend to miss more school and perform worse academically than children without cavities.

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