By Lorenzo Marcil, BHSc
These are unprecedented times. The reality of the impact that COVID-19 will have on dentistry is just as murky as it is with every other part of the economy. Dentistry is going to recover, although there may be one to two slow years of repair ahead.1 But one thing that’s certain is that dentistry’s intra- and interprofessional relationships will be altered. It will take years to understand the real impact this virus had on the economy and dentistry, but the profession has a chance to evolve and emerge even stronger on the other side.2
Some predictions
General dentistry and its relationship to specialists will be dramatically altered during the next several years. As general dentists retain certain procedures in order to recover revenue, referrals will undoubtedly decrease.3 If a dentist has normally done one root canal per week, maybe now they will do two or three or even more. This will be specific to each clinic, but since specialists receive the majority of their patients from referrals, they will feel the effects until patients return to general clinics.
This isn’t to say that specialists are doomed; the data would suggest otherwise. Clear aligners and implants are the largest growing treatments in dentistry at 12% growth per year, pain-based procedures will keep endodontists and surgeons busy, and parents will always sacrifice their own health for the health of their children, so pediatric dentists and orthodontists will have patients.4 However, they will no doubt see decreases in profitability.
The corporate outlook
Corporate dentistry will not be immune from the economic downturn; it’s had the same issues with layoffs and reduced hours. In fact, corporate offices as a whole will be slower to recover than privately-owned clinics because their recovery will be tied more closely to how the markets and banks respond than how individual consumers respond.2
The corporate dental service organizations (DSOs) that are in the most trouble are the ones that are massively overleveraged in buying practices and ones that are still leveraging to buy practices in the wake of the pandemic.5 The DSOs that overpaid and overborrowed will be in trouble when they can no longer secure private equity. As many as 35% of solo owners are also overleveraged,6 and up to 20% may not reopen their clinics.5 Good practices that are poised for success—whether it be a solo owner, group practice, or corporate entity—will always recover first.5
DSOs also have a near constant influx of new associates as students graduate, and that, along with the recent layoffs, provides a very favorable labor market for corporate offices. Corporate dentistry is still dentistry, and it will be affected by this crisis, but it will also recover, and practice consolidation will continue.
Public opinion
Dentistry, as compared to medical procedures, will not be considered as vital in the public mind for the next several years. However, one benefit that dentistry may share with medicine is a renewed faith in expert opinion by the general public.7 The public may adopt a higher level of seriousness with regards to experts, and as such dentistry should present itself as close to medicine as possible to benefit from this. Dentistry also plays key roles with medicine by taking odontogenic emergencies out of the hospital and into the private clinic; just as social distancing is an effort to not overburden the health care system, dentists can do their part by treating as many emergencies as possible.
The future of billing
The future also presents challenges for billing and fees. The American Dental Association recommends that third-party benefit programs allow a standard fee per patient to accommodate the rising cost of personal protective equipment, which is already being reflected in the insurance guides as an “infection control fee.”8
Insurance needs to match the increased cost of dentistry, but this requires that dental schools decide what is necessary in terms of infection control post-COVID. All potential equipment purchases will matter once dental schools decide what’s necessary for clinical practice.
An optimistic outlook
Dentistry always plays an important part in the health-care machine, and dentists will always have a role in times of health crises. Dentistry may not always be considered a vital service, but we can all play a valuable part in helping patients avoid hospital care for odontogenic treatment when a hospital is not necessary. After all, dentistry has survived war, disease, famine, and recession several times over, so we should all remain hopeful that dentistry will prevail.
References
- Cordray R. Three reasons consumers can’t bring the economy back from covid-19. Washington Post. April 15, 2020. https://www.washingtonpost.com/opinions/2020/04/15/three-reasons-consumers-cant-bring-economy-back-covid-19/
- Bhatnagar P. What is the COVID-ified future for dentists? DentistryIQ. March 25, 2020. https://www.dentistryiq.com/covid-19/article/14172811/what-is-the-covidified-future-for-dentists
- O’Keefe J, Dolansky B, Jones P-A, Mahn J, Thomas J. CDA/FCDSA Verbal iscussion for new grads post COVID.
- Farran H. Dr. Howard Farran on dentistry post-COVID-19 era. Dentistry Uncensored.
- Costes M. Are DSOs and private equity doomed? The Dentalpreneur podcast, vol. 889.
- Costes M. Bear lessons. The Dentalpreneur podcast, vol. 886.
- Coronavirus will change the world permanently. Here’s how. POLITICO. March 19, 2020. https://www.politico.com/news/magazine/2020/03/19/coronavirus-effect-economy-life-society-analysis-covid-135579
- ADA coronavirus (COVID-19) center for dentists American Dental Association. https://success.ada.org/en/practice-management/patients/infectious-diseases-2019-novel-coronavirus
Lorenzo Marcil, BHSc, is a fourth-year dental student at McGill University in Montreal, Canada. He has been passionate about dentistry since childhood and is now able to live his dream every day. When not studying he can be found running with his dentistry running club (the ExTRACKtors), performing karaoke, or cheering for the Seattle Seahawks. Connect with him on LinkedIn at linkedin.com/in/lorenzo-marcil-03ba26115/.
