Why your dental bills could be rising
Dentists leave as patients still fear virus infection
Millions of Americans are delaying dental appointments over concerns about coronavirus infection, and that’s likely to trigger increased fees for patients, job cuts for workers and fewer family practices.
When the pandemic began this past spring, essentially all dentists temporarily shut down for all but emergency appointments, putting hundreds of thousands of Americans out of work. While 99% of dentists have reopened, the number of patients visiting offices remains about 20% below usual levels, according to the American Dental Association.
And dentists don’t expect it to improve much anytime soon despite significant safety measures they’ve rolled out to protect themselves and patients from COVID-19.
Spending on dental care could fall by up to 38% in 2020 and 20% in 2021, the ADA projects. Of dentists surveyed by the trade group, more than 46% said their patient volume was down at least 15% from usual levels during the week of Oct. 5.
About 15% to 20% of regular dental patients say “they’re not going to go back to the dentist until there’s a vaccine or a proven treatment,” said Marko Vujicic, chief economist for the ADA.
“They’re a segment of the population that’s very cautious, and they’re waiting for COVID to pass, so to speak,” Vujicic said. “They’re simply not returning to usual activities, period.”
Katia Lee is among them.
Lee, a self-employed professional photographer in Columbia, South Carolina, hasn’t gone to the dentist since before the pandemic began, in part because she doesn’t want to risk getting infected and passing it to her 76-yearold mother.
“The practice I go to, they are lovely, don’t get me wrong – I really like my dentist and my dental hygienist,” she said. “But I know at least half of them have families – that means you’re trusting not just them but their kids, their husbands, that’s why it’s so scary. I have to trust everybody else to keep myself safe.”
With COVID-19, can I visit the dentist?
In August, the World Health Organization angered dentists by advising that “routine nonessential oral health care – which usually includes oral health check-ups, dental cleanings and preventive care – be delayed until there has been sufficient reduction in COVID-19 transmission rates from community transmission to cluster cases or according to official recommendations at national, sub-national or local level.”
The ADA said it “respectfully yet strongly disagrees” with the WHO’S guidance, pointing to numerous safety measures dentists have set up to reduce the risk of transmission, steps advised by the Centers for Disease Control and Prevention.
Those measures include heightened use of personal protective equipment (PPE) such as N95 masks and surgical masks, disposable gowns, air purifiers, cleaning solutions, temperature checks, hand-washing and social distancing, including forcing patients to wait in their cars until their appointment is ready to begin.
Dental industry leaders have said they’re not aware of any documented cases of COVID-19 outbreaks stemming from dental offices, but they acknowledge that patients remain concerned about opening their mouths wide in the presence of others for extended periods of time.
Sharon Parsons, president of the Ohio Dental Association and a dentist with a practice in Bexley, said she has not experienced a slowdown in business.
Rather, she said she has been dealing with an increasing number of patients with cracked teeth – a result of the increased stress people are under during the pandemic, she said.
“It’s all the clenching and grinding,” Parsons said. “It’s unreal, I definitely didn’t see that one coming. It shocked me.”
Consolidation coming
If patient volume remains at current levels, dentists say they’ll give serious consideration to raising their fees, including for insured patients, as well as cutting jobs or selling their practices, according to the ADA.
“We’re at a very important next couple of months,” said Vujicic, the ADA economist. “I do think we will see additional layoffs and some exits in the market. It’s suggesting to me that it’s not a sustainable situation.”
The ADA estimated that the average dentist is spending an extra $15 to $20 per patient due to measures related to COVID-19 prevention. Some are passing those costs along to patients in the form of fee hikes.
Parsons, the Bexley dentist, said she has added a PPE fee to certain procedures (not basic cleanings). She declined to say how much she adds, but said that fee will end once the need for extra PPE subsides.
Dentists are also unable to see as many patients as normal due to the extra time they need to devote to cleaning and spacing out patients to ensure they don’t come into contact with each other.
The upshot is that family dental practices are struggling the most since they are unable to spread out the costs of PPE. Industry leaders and analysts say dentists are increasingly likely to sell their family practices to private equity companies or other investors.
Dispatch reporter Ken Gordon contributed to this story.