What legacy will COVID-19 leave on dentistry? 8 dentists weigh in

Economic stress, burnout and workforce shortages are among the top legacies dentists expect COVID-19 to have on dentistry.

Here, eight dentists shared with Becker's what lasting effects COVID-19 will have on dentistry:

Editor's note: Responses were lightly edited for clarity and length.

Peter Chien, DMD. Edgewood (Wash.) Family Dentistry: Covid-19's impact on dentistry is multifactorial, likely politically motivated at the state level. States that placed COVID vaccine mandates as condition of employment contributed to auxiliary and clinical staff quitting and/or moving to other states without the vaccine mandate. Some states also deemed dentistry "non-essential" and forced multiple months of closure, [which] really economically damaged dental offices, possibly long-term and irreparable. Fear of contracting COVID-19 has caused patient delays in returning to the dental office.

COVID-19 has also exacerbated staffing shortages. Staff who were close to retirement or wanting a different career path have quit due to COVID-induced stress. Child care issues have also prevented staff from returning to the workforce.

Economic stress has weighed heavily on dentists, likely contributing to mental health decline and career burnout. Social media stigma may be preventing full disclosure of the negative impact COVID-19 had and is having on dentists.

The good news is that as with all pandemics, the COVID-19 pandemic will, or has already possibly, end and will eventually enter an endemic phase. Dentists will graduate with a fresh state of mind and renewed sense of energy. There is hope for dentistry and for all of humankind.

Michael Davis, DDS. Smiles of Santa Fe (N.M.): There is no question the COVID-19 pandemic impacted the dental industry. The additional overhead costs in personal protective equipment and looser scheduling forced the dental industry to more acutely examine their operating expenditures.

Fewer practitioners could afford the financial losses generated by Medicaid participation and PPO participation with the more discounted plans. Those serving these populations will become a narrowing segment of the dental industry. This does not bode well for quality of care for the disadvantaged. 

Staffing shortages and the rise in cost of dental labor also forced numbers of practices to reevaluate their overall degree of insurance participation. This will accelerate the polarization trend between practices offering highly personalized services versus those focused on volume care.

I doubt in 10 years if any real "middle ground" style of practice can survive, except represented in external marketing hype, which will only get louder. 

Bradley Dykstra, DDS. CEO of MI Smiles Dental (Hudsonville, Mich.): The one most important is that now dentistry is considered essential and an integral part of a patient's overall systemic health. Dentistry is resilient and adaptable — we have survived the HIV epidemic and came out stronger, and now the same with COVID-19. We are stronger and have better protocols after COVID-19 than before. In general, everyone is looking more critically at the work world — where and how much they want to work, which does affect dentistry significantly.

Tim Goodheart, DDS. Goodheart Dental (Raytown, Mo.): I think the legacies will be two-fold.

One: This has completely changed the staffing and economic landscape of dentistry. Many auxiliary staff have left the profession. Wages for those that remain have dramatically increased. The days of getting employees for a lower-end wage are gone, forever. We now have more offices chasing after fewer skilled employees. I believe the standards for compensation and the typical percentages of practice production will be significantly higher over the next three to five years. Second: This has, by default, placed more of a premium on offices with good infection control practices and standards. No longer can we simply go on auto-pilot and say "dentistry is safe." It now requires us to be proactive and be aware.

Robin Henderson, DDS. (Clarkston, Wash.): Unfortunately, COVID-19 has created a legacy of fatigue in dentistry. The close relationships that I once felt with the large majority of my patients, team and outside sales support used to bring much energy to the day. Now, we wear masks the entire time in the office and that barrier is palpable. The initial physical fatigue from wearing respirator masks and face shields has improved, yet the overall fatigue remains, as there is much less certainty to what tomorrow will bring … or even today. There are more last-minute schedule changes and staffing shortages than ever thought possible in the pre-COVID-19 dental office.

I also used to attend a lot of in-person continuing education events, which was invigorating to always be learning and growing. I live in a remote area so I try to be optimistic about opportunities for virtual CDE; however, Zoom fatigue is real and it is shown to not only lead to exhaustion but to even contribute to burnout.

Dentistry has already been so far ahead of other fields in terms of infection control, so we were prepared with how to adapt to the demands of COVID-19 in that regard; now I hope we can use what we have learned from feelings of fatigue and use that for good as there is a new focus on mental health of the dental team. As dentistry is a profession centered around wellness, I am hopeful the overall well-being of dentists and members of the dental team will improve with an awareness of the importance of mental health.

Mina Kim, DDS. Bryant Park Dental Associates (New York City): I will never forget the fear, uncertainty and constant changes we faced in the early days of COVID-19. COVID-19 forced doctors and staff members to re-evaluate their existing systems and be flexible in their duties. One substantial change was that we started screening and following up with patients remotely. We also bolstered our already stringent infection control protocols. These efforts helped dentists have lower transmission rates than the general public, even though our profession has us in front of unmasked patients for extended periods of time. Lessons learned from COVID-19 will help us mitigate the effect of the next flu season and whatever is to come. 

Flavia Lamberghini, DDS. Apple Dental Care (Chicago): COVID-19 has had a tremendous impact on dentistry. Its effect can be seen at multiple levels, from the infection control protocols that every office has updated and reviewed in detail, to workforce shortages that we needed to adapt. We are also very aware of the urgency of treatments, where trauma and infection need to be treated right away [and] others can be deferred. Materials such as silver diamine fluoride has become routine to treat carious sensitive teeth on children that will receive care later or while they wait for treatment under general anesthesia. Teledentistry was rarely used before the pandemic [and] is now a helpful tool for triage or follow up. 

Rajdeep Randhawa, DDS. Innovative Dentistry (Colts Neck, N.J.): COVID-19 will influence both the clinical and business aspects of dentistry, more so the business of dentistry differentiating the small independent participating providers who are highly dependent on the insurance companies for their patients, and the DSOs who are aggressively fishing in the same pond for both insurance and private patients. The insurance companies will over a period of time squeeze the small participating providers so much with decreasing compensation, while the cost and risk of doing business has increased substantially due to COVID-19.

Staff shortages and burnout are not going to improve soon and may aggravate in the future. The DSOs know how to play this game differently, so they have used COVID-19 as an opportunity to expand substantially and do have massive expansion plans to increase their market penetration even further with the help of private equity and other investors jumping into the dental profession, while dental organizations claiming to represent the profession are taking a long nap, totally oblivious to the corporate and private equity takeover.

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