A majority of participating dentists have seen a rise in stress-related oral health conditions in their patients since the onset of the COVID-19 pandemic, according to data from the ADA Health Policy Institute's COVID-19 impact poll for the week of Sept. 21.

More than half of the polled dentists reported increases in the prevalence of bruxism (59.4%), chipped and cracked teeth (53.4%), and temporomandibular disorder symptoms (53.4%) among their patients, and more than a quarter saw a rise in other conditions, including 26.4% who reported an increase in caries and 29.7% who reported an increase in periodontal disease.

As of the week of Sept. 21, more than 99% of dental offices in the U.S. were open, and patient volume was leveling off at just over 80% of pre-COVID-19 levels. Staffing was at 95% of pre-COVID-19 levels. These values have been roughly unchanged over the past two months and suggest practices are reaching a "steady state" of economic activity.

HPI's poll findings on patient volumes match a preliminary report released Sept. 23 by the Centers for Medicare & Medicaid Services on service use among Medicaid and Children's Health Insurance Program beneficiaries aged 18 and younger during the pandemic. The report shows the number of dental services for children declined through April and started to rise in May but were still substantially lower than prior years’ rates. Dental services declined by 69% between March and May, compared to the same period in 2019, a more significant drop than the decreases seen in vaccinations, overall health screenings and mental health services.

Many dentists have needed to take measures to maintain the financial stability of their practices since reopening during the pandemic. The poll for the week of Sept. 21 found 44.6% have borrowed from a bank, 29.6% have raised fees, roughly 20% have reduced their dental team hours, downsized their dental team or changed their supplier or lab, and 8.3% have disenrolled from dental benefits plans.

The poll also asked dentists what additional measures they would seriously consider implementing to maintain financial sustainability if patient volume remains what it is through the end of the year. More than half would consider raising fees, about one-third would reduce their dental team hours, about a quarter would consider changing their supplier or lab or disenrolling from dental benefits plans, and about 8% would consider joining a dental service organization or large group practice.

HPI has posted complete results comparing data for the 14 waves over the previous six months, including results broken down by dental service organization affiliation, practice size and state.