Impact of COVID-19 on Dental & Oral health

Populations disproportionately plagued by coronavirus disease 2019 (COVID-19) also are at higher risk for oral diseases and experience oral health and oral health care disparities at higher rates. COVID-19 has led to closure and reduced hours of dental practices apart from emergency and urgent services, limiting routine care and prevention. Dental care includes aerosol-generating procedures which will increase viral transmission. The pandemic offers a chance for the dental profession to shift more toward no aerosolizing, prevention-centric approaches to worry and faraway from surgical interventions. Regulatory barrier changes to oral health care access during the pandemic could have a favourable impact if sustained into the future.

Direct effects of COVID-19 on oral health include ageusia (an official symptom of COVID-19). The ageusia related to COVID-19 is transient and reports of other oral manifestations are based on low-grade and disputed evidence. The direct effects of COVID-19 are likely to be of modest consequence for population oral health.

The indirect effects are more complex and extensive.

The dental profession has re-organised service provision during lockdown. ‘Teledentistry’ has been widely used to assess and triage patients for urgent dental care, provide advice and monitor patients remotely. Fear of infection and limited appointment availability have promoted this technology to clinicians and patients, moving it a step closer to fulfilling its potential to improve the early detection of oral lesions, reduce costs, the need for specialist referral, waiting times and improve access for those with geographic, economic or cultural barriers to care. The ability to triage patient symptoms may also help to limit the provision of unnecessary care. The pandemic also offers an opportunity to revolutionise dental care by breaking the ‘restorative cycle’ of restoration and repair and shifting public investment towards personalised disease prevention.

Reduced service availability may have negatively impacted on both the acceptability of the service (patients waiting with pain and infection) and long-term oral health of affected patients (the inability to provide continuous care). Greater polarisation of behaviours and the lower accessibility and affordability of care pose the risk of greater oral health inequalities.

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