Since the beginning of the pandemic, 40% of parents have avoided seeking care, citing concerns about infection, closing offices and costs.
This is not good, said the pediatric dentist and American Dental Association spokesman, Dr. Jonathan Shenkin. “Delays in preventive care can result in children developing more cavities,” he said. “The problem with tooth decay is that, when it starts in childhood, it is really the strongest risk indicator in adulthood.”
Despite fears about the transmission of Covid-19 in dental offices, Shenkin said that infection control measures have proven effective in protecting patients and staff.
Although dentists are considered to be at high risk for exposure to Covid-19 by the U.S. Occupational Safety and Health Administration, actual infection rates among dentists have remained low, revealed a November study published in The Journal of the American Dental Association.
This means that parents can schedule pediatric dental appointments with confidence, said Shenkin. Many who seek care, however, face delays. Of parents who tried to schedule pediatric dental care since the pandemic, nearly a quarter reported longer than normal waiting times, the CS Mott survey reported.
Some parents were unable to take their children to see the dentist. Among families with private dental insurance that sought care, 4% were unable to make an appointment. This reaches 15% for families whose children depend on Medicaid coverage, who are more likely to be black, multiracial or Latino than their private insurance counterparts.
See why the delays have spread so far and how parents can ensure their child’s teeth stay healthy until the next exam.
Why care has become so scarce
The closure of dental offices across the country last March had a ripple effect, said Shenkin. It was chaotic and no one knew when the offices would be reopened. By the time dentists started to reschedule, in late April or May, small problems had increased.
“Some children who needed fillings now needed extractions,” he said. “We also had to cancel appointments for children who had preventive appointments and expel them.” This left an accumulation of visits that the offices are still struggling to keep up with.
With the reopening of practices, they faced shortages of personal protective equipment. This shortage is ongoing, and 91% of respondents to a recent survey by the American Academy of Pediatric Dentistry said they did not have enough N95 respirators to switch between each patient.
In addition, some measures to prevent transmission of Covid-19 limit the number of patients that dentists can accommodate, explained Shenkin. “Many pediatric clinics are open clinics and children are very close to each other, which is clear that we cannot do more. We have to have separation; we have to have barriers; we have to separate the children ”. he said.
As of September 21, only three quarters of pediatric dental care providers operated with 76% or more of their pre-pandemic volume, according to the AAPD. Another 17% of providers reported operations between 51% and 75% of pre-pandemic numbers.
Overcoming obstacles to getting children to take care of what they need
Before the pandemic, some children in the United States received education or oral health care in schools, and many of these programs were also discontinued. This is especially difficult for families with children insured by Medicaid or the child health insurance program. They face additional barriers to obtaining care.
Less than half of dentists in the United States were accepting Medicaid or CHIP in 2019, the American Dental Association’s Health Policy Institute found. A 2015 report from the HPI showed that only 38.5% of children living below the poverty line had visited a dentist in the previous 12 months.
This lack of treatment has real consequences for children. Children with oral health problems are more likely to miss school and get lower grades, a 2011 study found in the American Journal of Public Health.
Although the pandemic is causing a shortage of care, dental treatment is still possible. The government website InsureKidsNow.gov has a Dentist Locator tool to search for providers in your area who accept Medicaid or CHIP. (You can also call 1-877-KIDS-NOW or find more information on how to enroll children in dental insurance programs here.)
The ADA offers additional support for underprivileged children through its Give Kids a Smile program, which includes free exams, preventive care and treatments. Although GKAS generally offers large, crowded events, this year’s launch offers a combination of virtual education and secure face-to-face services by Covid in dentists’ offices. (Call the ADA at 1-844-490-4527 for information on GKAS services in your area.)
Many community health centers, some of which are financed by the federal government, offer free or reduced-cost dental services. Another option is to make an appointment at a dental school or dental hygienist in your area, where students do preventive care as part of their training.
If you find a dentist to see your children, their visit may be slightly different than normal. In addition to standard practices to reduce Covid-19 transmission in medical settings, some dentists are changing their treatments. Powerful sprayers previously used to remove tartar and plaque send drops into the air, so the CDC recommended alternatives using hand tools.
Taking good care of your teeth at home
Preventive dental consultations are essential for oral health, said the dentist Shenkin. They are an opportunity for children to learn to care for their teeth. But, whether you are ready to schedule or choose to postpone service, he added that this is a critical time to maintain best practices at home.
This starts with a sugar-limiting diet that feeds the harmful bacteria that cause tooth decay. “The only drink (children) they should be drinking during the day is water, and maybe milk,” said Shenkin.
It’s better to avoid sugary drinks altogether, he said, but if your child drinks one, the timing is important. “If you’re going to eat, eat with a meal.”
The next step is brushing twice a day with fluoride toothpaste and a soft bristle brush that fits in a child’s hand. “If you brush once a day, you’re already putting yourself in a higher risk category,” said Shenkin.
When a child’s teeth are touching, it’s time to start flossing. At age 10, children can usually floss without supervision, according to the AAPD.
This advice is familiar to many parents. But Shenkin said he understands why good nutrition and oral hygiene can decline in a hectic time, when many families are struggling with disruption to school, work and home life.
By following the basic principles of careful hygiene, however, you will set your child up for good oral health – whether or not you take him to the dentist yet.
