By Susan Richards
It’s becoming exceedingly clear that the ongoing COVID-19 crisis will have an impact on the dental industry long past when practices were initially ordered to shut down in the spring of 2020. Recently, patient volume has bounced back to approximately 88% of pre-pandemic numbers in private dental practices, according to recent ADA Health Policy Institute poll results.
However, dentists and hygienists are seeing the fallout from months of delayed treatment and maintenance, as well as the added anxiety of the ongoing crisis. A study published last fall showed almost 50% of U.S. adults continue to delay dental care due to COVID-19, the majority being for regular checkups or cleanings. In fact, the ADA found dental care to be the most neglected healthcare service during the past year.
Additionally, changes in work and lifestyle have altered many people’s dietary and dental hygiene habits, while increased stress levels have led to bruxism issues and temporomandibular disorders (TMD). According to a poll conducted by the American Psychological Association (APA), U.S. adults are experiencing higher stress levels a year after the onset of the pandemic. Emotions related to prolonged stress, anxiety, sadness, and anger have elevated due to political unrest, education, and employment issues–as well as the virus.
“Without addressing stress as part of a national recovery plan, we will be dealing with the mental health fallout from this pandemic for years to come,” said Arthur C. Evans Jr., Ph.D., APA’s chief executive officer.
Very often, the first person to treat patients who’ve delayed their dental care is the hygienist. They’re on the frontline dealing with increased layers of plaque and tartar, new caries, and periodontal disease. They’re also the person patients are more likely to share their feelings with – and not just about anxiety over missed treatment.
“Shortly after returning to work, I noticed a change in my patients' emotions,” said Lauren Morrison, an RDH with Mount Pleasant Dental Care in Maine. “Many were elderly and so happy to simply go to the dentist! They hadn’t seen their family and friends, so we were the first human interaction they had in months. Many tears were shed, and I realized how vital my role was in their lives; not just as a hygienist providing a cleaning, but also as a compassionate human taking the time to listen.”
While it’s important to be supportive, hygienists and dentists must also be aware of the accumulative stress they take on at the end of the day. Arika Akhtar, BSHSA, RDH of Today’s RDH offered some tips for dealing with patient’s anxiety, as well one’s own. They include:
- Asking the patient what is making them anxious. It may be something you can address, or simply lend an ear.
- Breathing and grounding techniques. Find different tools to shift the patient’s focus from the source of their fear.
- Encouraging professional help if you feel it’s necessary. Keep a list of resources on hand for potential references.
Help Wanted: Dental Hygienists
Even prior to COVID-19, some regions were seeing a shortage of dental hygienists, a deficit that’s increased since state-mandated closures last year. The ADA Health Policy Institute survey showed an 8% reduction in hygienist employment due to the pandemic, with most of that voluntary. A National Institute of Health study on hygienist employment patterns concurred, finding reasons for leaving that included earlier-than-planned retirement, safety concerns, and childcare issues.
“The biggest challenge I have faced the past few months is time and scheduling,” said Morrison. “Where I once saw an average of one patient on the hour, every hour, I am now seeing overdue patients with a lot to catch up on. Sometimes just to get people in, we must do what we can in an hour just to get them re-established. Most patients are understanding and just happy to get back into their routine. Our office is looking to fill more assistant and administrator positions but finding the right fit has been difficult at this time.”
Hygienists and dental assistants are skilled positions with varying academic and clinical requirements, adding to the hiring difficulties as motivated patients continue to catch up on treatment. Many dentists are determining that additional office hours and increased compensation for staff often means passing the cost on to the patient.
It’s clear as dental practices struggle with staffing shortages, overdue appointments, and high emotions that there’s nothing routine about oral health. As ADA President had P. Gehani stated last August in response to the World Health Organization’s recommendation that “routine” dental care be delayed, “Oral health is integral to overall health. Dentistry is essential health care.”
For RDHs like Lauren Morrison, the pandemic has provided an unexpected perspective on patient care and personal connections.
“I thought I was an introvert until having to quarantine for three months at the beginning of the pandemic. After dealing with different people with different personalities almost every hour, four days a week, I came home exhausted, usually wanting to spend my off time in private. But I realized how much those day-to-day conversations made a huge difference in my life! Now I find myself saying yes to more invitations because I feel pre-pandemic, I missed out on a lot by being ‘too tired’.”
Author: Susan Richards is a staff writer at DOCS Education. With over 20 years of experience in local journalism and business marketing, Susan’s career includes award-winning feature writing, as well as creating content with context for a wide variety of industries.