Kids are going without dental care during the pandemic

Some 40% of parents have avoided seeking dental care for their kids.

(CNN)Children are missing out on preventative dental care including teeth cleaning and checkups during the pandemic, according to a new survey.

Covid-19 is a barrier to getting kids the dental care they need, said a third of parents responding to the survey released by C.S. Mott Children's Hospital National Poll on Children's Health.
Since the pandemic began, 40% of parents have avoided seeking care at all, citing concerns about infection, office closures and cost.
    That's not good, said pediatric dentist and American Dental Association spokesperson Dr. Jonathan Shenkin. "Delays in preventative care could result in kids developing more tooth decay," he said. "The problem with tooth decay is that when it starts in childhood, it's really the strongest indicator of risk into adulthood."
      Despite fears about transmission of Covid-19 in dental offices, Shenkin said infection control measures have proved effective in protecting patients and staff.
        While dentists are designated as very high risk for Covid-19 exposure by the US Occupational Safety and Health Administration, actual infection rates among dentists have remained low, found a November study published in The Journal of the American Dental Association.
        That means parents can book pediatric dental appointments with confidence, Shenkin said. Many who do seek care, however, face delays. Of those parents who tried to book pediatric dental care since the pandemic, nearly a quarter reported longer than usual wait times, the C.S. Mott survey reported.
          Some parents were unable to get their kids in to see the dentist at all. Among families with private dental insurance who sought care, 4% were unable to secure an appointment. That shoots up to 15% for families whose children rely on Medicaid coverage, who are more likely to be Black, multiracial or Latino than their counterparts with private insurance.
          Here's why the delays have become so widespread, and how parents can ensure their kids' teeth stay healthy until the next checkup.

          Why care became so scarce

          Nationwide closure of dentists' offices last March caused a ripple effect, Shenkin said. It was chaotic, and no one knew when offices would reopen. By the time dentists were booking again in late April or May, small problems had grown larger.
          "Some kids that needed fillings now needed extractions," he said. "We also had to cancel appointments for kids that had prevention appointments and push them out." That left a backlog of visits that offices are still scrambling to catch up with.
          As practices reopened, they faced shortages of personal protective equipment. That 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 change them between every patient.
          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 kids are really close to each other, which of course we can't do any more. We have to have separation; we have to have barriers; we have to separate kids," he said.
          By September 21, only three-quarters of pediatric dental care 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 numbers.

          Overcoming hurdles to get kids care they need

          Before the pandemic, some US children received in-school oral health care or education, and many such programs have been disrupted as well. That's especially hard on families with children insured through Medicaid or the Children's Health Insurance Program. They face additional barriers to getting care.
          Less than half of dentists in the United States were accepting Medicaid or the CHIP in 2019, found the Health Policy Institute of the American Dental Association. One 2015 report by the HPI showed that just 38.5% of children living below the poverty line had visited a dentist in the previous 12 months.