Just like the COVID-19 pandemic created numerous challenges for the medical field, it did the same for the $139 billion a year dental industry.
Pandemic led to temporary office closures
When the pandemic hit in March, 2020, many dental practices were forced to temporarily shut down for all but emergencies. As a result, nearly nine in 10 dentists experienced increased operating costs and reduced revenue, according to a survey from Guardian Life.
It has been hard to judge the true financial impact of COVID-19 on the dental industry. But SoftwarePundit, a technology research firm that advises dental practices on software, and Dental Intelligence, a leading dental practice analytics provider that serves more than 8,000 clients in the U.S., partnered on a study of the economic impact of the pandemic on dental practices. The findings included the following points::
- Collected revenue in dental practices declined 6% year-over-year in 2020.
- This was much less than the 38% decline the American Dental Association predicted last June.
- Dental hygiene appointments declined by 47% year-over-year in spring 2020 before recovering in the summer and dipping again in the fall
- The top 10% of practices performed better in 2020 than in 2019 in terms of revenue, average patient value, and patient growth
Other negative impacts of Covid-19 include:
- Increased operating costs
- Reduction in visits
- Loss of patients
- Reduction in staff
Industry not immune from workforce challenges
Now, as the world moves to the next stage of the pandemic, dental practices are working to find their footing again. Few areas of the workforce have been left untouched by the pandemic, and the dental industry is not exempt as more dentists are retiring and more dental hygienists are exiting the workforce.
“Throughout the U.S. economy, we are seeing major ripple effects through the job market, often referred to as the Great Resignation,” said Marko Vujicic, Ph.D., American Dental Association (ADA) chief economist and vice president of the Health Policy Institute (HPI). “The whole healthcare sector is struggling with labor shortages; dentistry is no different.”
For the first time in years, dentist retirements are on the rise, according to the ADA. In 2021, 6,641 dentists over age 55 exited the workforce compared to 4,785 in 2017. However, it’s important to note that the number of dentists entering the workforce continues to outnumber dentists exiting the workforce. Also, the supply of dentists is expected to increase through 2040. But still, the increase in dentist retirements is likely contributing to job losses in the dental sector, according to an analysis from the ADA and HPI.
At the same time, dental hygienist employment has declined since September 2020. About 5% of hygienists who had been working at the onset of the COVID-19 pandemic were unemployed as of August 2021, leaving a considerable void in the dental workforce. In March 2022, one in three dentists were recruiting dental hygienists, and 92% indicated recruitment was extremely or very challenging, according to HPI data.
As of August 2021, less than half of dental hygienists that left employment during the pandemic had returned to work. According to the study, 7.9% of respondents that had been employed in March 2020 were not working six months later in September 2020. When the study concluded in August 2021, that number decreased to 4.9%, according to the ADA.
While the number of hygienists who left the workforce rebounded from a high of 7.9% in 2020 to 4.9% in 2021, a total of 1.6% of those study participants no longer intended to work as dental hygienists, possibly representing a permanent reduction of 3,300 dental hygienists nationwide.
“Not unlike many other professions in the United States, challenges persist in dental hygienist employment. The COVID-19 pandemic has exacerbated a voluntary reduction in the dental hygiene workforce, which may persist, as some dental hygienists are choosing to permanently leave the profession,” said Rachel W. Morrissey, M.A., senior research analyst with the ADA and HPI.
Although it’s not entirely clear what is causing so many dental hygienists to leave the industry, burnout could be one cause.
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Impacts of the pandemic
It’s no secret that the isolation in the early days of the pandemic had a profound impact on the mental health of many – and dental professionals were among them. For dental practitioners, that isolation may have been especially difficult due to the sudden lack of contact with patients. Many providers may have experienced some level of burnout due to lack of control and uncertainty about the future of practice and patient contact.
Other stressors that may be contributing to burnout are:
- Treating difficult children
- Constant time pressure
- Maintaining high levels of concentration
A study by the ADA reports that 86% of dentists claim to experience one or more of these stressful conditions in any given year. This equates to 60 days/year that dentists are significantly stressed and disengaged at work.
Additionally, an unpublished survey of dental professionals in North Carolina between September and November 2020 conducted by the North Carolina Caring Dental Professionals and North Carolina Dental Society found that 43.5% of dentists and 38.5% of dental hygienists were fully engaged in their work. By comparison, 18.8% of dentists and 14.0% of dental hygienists reported professional burnout during the COVID-19 pandemic time frame. The remaining respondents fell somewhere in between, reporting feeling either ineffective, overextended, or disengaged.
Embracing changes and new technology
Despite the ups and downs of the past two-and-a-half years, the dental industry is emerging from COVID-19 stronger than before. According to Guardian Life, in early 2021, dental visits exceeded the number of pre-pandemic appointments, particularly because patients were booking appointments to make up for lost time.
Many dentists are taking the opportunity to embrace changes in a post-pandemic era. This includes an alternative to in-office care, such as teledentistry, which has resulted in a shift in patient behavior. Although 26% of dentists say it is not a satisfying way to practice, the number of U.S. adults and children embracing teledentistry is rising – up 20% from 2020. And dentists themselves are embracing change, with 22% of dentists saying there are new opportunities that have emerged in the midst of the pandemic.
A new era of safety
Just like the HIV/AIDs crisis in the ’80s ushered in a new era of safety procedures for dental offices, Covid-19 has done the same for dental safety. More than eight in 10 dentists say they adopted new safety processes and procedures during the pandemic. And a study by Oral Health found that 36% of dentists believe that Covid-19 allowed them to learn more about infection control. But these enhanced safety protocols came at a cost. From purchasing additional personal protective equipment for staff to acquiring equipment that minimized aerosols, many practices struggled to afford these protocols amid lower patient volumes.
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