Thanks to dental associations, there has been a steady stream of information about how dental practices have fared during the COVID-19. There has also been a regular cadence of surveys that have revealed dental professionals' mixed feelings toward the pandemic. But information about dental patients has been more difficult to come by. That's why results from a recent 2,000-person-plus survey conducted by the North American Dental Group (NADG) merit closer examination. The findings help us complete our understanding of how the dental landscape has changed since COVID-19 descended last March.
I had a chance to discuss five key data points from the survey with Frank F. Nia, DMD, MSEd, of McDonough Center for Family Dentistry in McDonough, Georgia. Dr. Nia is a partner in the NADG, which consists of a network of 230 dental practices in 15 states. NADG conducted an initial patient survey in April and the recent follow-up survey in July.
Here's a look at the data points and my discussion with Dr. Nia.
Data point 1: 60% of respondents said they were comfortable visiting a dentist for a routine cleaning or check-up, more than double the percentage in April, when just 29% said they were comfortable.
ZK: In April, there were a great number of unknowns about COVID-19 and there was a general state of confusion about how long the country would remain closed. What do you think happened from then to now that would change patients' minds? Do you think it was a general easing of fears about COVID-19 or something about dentistry that changed? Also, how do you recommend reaching the 40% of people who still believe going to the dentist is unsafe?
Dr. Nia: I do not believe there has been an easing of concern about COVID-19. However, for the patients who have made and kept their appointments for oral care during the pandemic, it has been due to the trust they have put in their dentist. We recognize that, and we accept that responsibility. Dentists have not taken lightly the immense responsibility we have to our patients during this current crisis.
I believe our returning patients have noticed our sincere steps to ensure they get the care they need in the safest environment possible. Under the leadership of our advisory board of doctor partners known as the Professional Dental Alliance, McDonough Center for Family Dentistry and practices across the North American Dental Group network have put in place exhaustive new safety procedures, including head-to-toe personal protective equipment for staff and thorough sanitizing of evaluation rooms for patients, to ensure a safe environment that minimizes the risk for everyone.
As for reaching patients who may still be leery about visiting the dentist, again, the concern surrounding this virus is serious and so we understand. We can only do our part to ensure that we provide the safest environment possible and share with them all of the safety procedures we have put in place, emphasizing that we are ready to welcome them back in whenever they are ready to get the care they want and need.
Data point 2: 64% of respondents believe their dentist knows how to prevent the spread of COVID-19. That’s up from 42% in April.
ZK: This data point seems to suggest that more people are trusting dentists to take infection control precautions, or that they see dentists as competent health-care providers. Yet if 64% of respondents believe dentists can stop COVID spread, 36% believe they cannot. Do you think this has anything to do with more patients learning about aerosols and how COVID-19 is transmitted, or do you think it's just a belief that the COVID-19 virus is highly virulent?
Dr. Nia: Concern about the risk of transmission of COVID-19 in a dental setting, or any setting for that matter, is understandable. This is a new virus, and scientists are learning new things about it every day.
It’s true, dental settings have unique characteristics that warrant specific infection control considerations. Dental care includes aerosol-generating procedures that can increase viral transmission. However, dentists across the country have been treating patients for months, and so far there is no evidence that routine dental care has contributed to the spread of COVID-19.
I think it’s important to reinforce that dentists don’t just clean teeth. We are health-care experts trained in infectious disease control. Dentists across the NADG network and beyond have implemented extraordinary safety measures and advanced infection control procedures to ensure patients can get the essential dental care they need in the safest environment possible.
In our office, we have added high efficiency particulate air (HEPA) filter air purifiers with UV protection and enclosed aerosol-producing rooms to minimize the risk of transmission. It is these steps, along with thorough prescreenings, that have helped us to build trust and keep our patients and team members as safe as possible.
I think it is encouraging that, as time passes, more patients feel comfortable visiting their dentist. We see this in the dental activity at some practices that has already returned to prepandemic levels.
Data point 3: 65% of respondents plan to schedule and visit a dentist within the next six months.
ZK: This data point seems to show that there are still a healthy number of people who will delay nonemergency care. What are your practices doing to reach those people who are hesitant to come back? Put another way, what would you advise practices to do to regain the trust of patients based on your experience of trying to do the same?
Dr. Nia: I think we have to acknowledge that these are unprecedented times. We are in the middle of a worldwide pandemic. There is still a lot of uncertainty surrounding COVID-19 and what is going to happen next. I think people are scared.
But I don’t think dentists have lost the trust of their patients. The survey showed that a majority of Americans do trust their dentists and believe they know how to stop the spread of the virus in their practices.
The survey also revealed patients felt more at ease returning to the dentist when they knew the practice was following CDC guidelines and completing prescreenings for COVID-19. In order to make sure patients are comfortable resuming regular dental care, we have to make sure they understand the advanced measures we are taking to keep them safe.
I think we also need to remind patients that oral care is essential health care. Evidence has proven that poor oral health can lead to other systemic health problems and a lesser quality of life. Preventive care is extremely important in helping to avoid oral infections and diseases, which can hinder our patients’ ability to live happier and healthier lives.
Many dental practices are calling their patients, reminding them of routine oral care appointments and sharing with them the immense safety protocols they will notice upon arrival to our offices. This is what resonates with our patients – they want to receive the dental care they desire, and they want to know that they can receive this care in a safe and reassuring environment.
Data point 4: 81% of Gen Z respondents say they are comfortable visiting the dentist for either a regular checkup, non-time-sensitive procedure, or dental emergency, but only 68% of Baby Boomer respondents are comfortable doing the same.
ZK: I think you could look at this data point two ways. You could say that Gen Z is more comfortable than the Baby Boomers in visiting dentists now. Or you could say that those percentages are remarkably close, given that younger people are generally more open to high-risk behaviors. How should providers interpret this data point and take action related to it?
Dr. Nia: We know the risk of severe illness from COVID-19 increases with age. So, it isn’t surprising that Baby Boomers would be more hesitant to resume routine dental care.
I think it highlights the importance of clearly communicating all the safety protocols and measures we have put in place so our patients, who might be at higher risk, feel comfortable knowing they don’t have to delay their next appointment. They can get the essential dental care they need now, in a safe environment.
Data point 5: While 76% of male respondents are comfortable visiting a dentist, only 68% of female respondents are comfortable visiting for a regular checkup, non-time-sensitive procedure, or dental emergency.
ZK: Does this statistic tell us anything about general perceptions about COVID-19, or are men generally more comfortable visiting the dentist than women? Or is this a statistic that is surprising and needs further investigation, perhaps giving insight into the perceptions of men versus women when it comes to dental care or COVID-19 itself?
Dr. Nia: I think this data point speaks more to the general perceptions of how families address their medical needs. The reality is that the women tend to be more disciplined when it comes to routine dental care, and they are typically the people who will manage the family’s visits. In fact, it reinforces the fact that men are more relaxed about health-related risks and prevention.
About the interviewee
Frank F. Nia, DMD, MSEd, graduated from the University of Pennsylvania School of Dental Medicine. While at the University of Pennsylvania, Dr. Nia received a scholarship to the graduate school of education, where he earned an master's in higher education. As part of his training, he holds active membership with multiple organizations that focus on improving both clinical and care standards. He is actively involved in the community and believes that the connection between a dentist and patient is more about overall health then just healthy teeth.
Zachary Kulsrud is the editorial director for Endeavor Business Media's dental group, publishers of Dental Economics, DentistryIQ, Perio-Implant Advisory, and RDH magazine.