Dentistry's rebound levels off -- with a potential patient drop on the horizon

Dentistry's recovery from COVID-19 is creeping toward an expected plateau, and a drop-off in patients may be on the horizon, according to new data from the ADA's Health Policy Institute (HPI).

Patient volumes continued to hover at about 73% of prepandemic levels at the end of July, but about one-third of the 4,000 dentists who responded to HPI's poll anticipated seeing those numbers fall in September and October. About 40% expected levels to stay the same, and the rest anticipated seeing more patients in the fall, the data showed.

"We are going to monitor this," said Marko Vujicic, PhD, HPI's chief economist and vice president, during a webinar on August 5. "We don't know if there's a fall lull and what it will look like."

The journey

While numerous industries have been unable to resuscitate themselves, dentistry's return has made significant gains quickly. As states began reopening, so did practices. By mid-May, 65% of practices had reopened, and the numbers continued to click up steadily. About 99% of practices have reopened and are experiencing varying patient volumes depending on when their states gave the green light to reopen. Nevertheless, industry experts have warned over the past few weeks that the recovery has started to wane. In mid-July, patient volumes were at 71%, which is an approximate 2% increase from around the end of June. Patient collections also have rebounded to 70% of pre-COVID-19 levels, according to the HPI data.

Full recovery? Probably not

Though nobody knows exactly what to expect as the days move on, Vujicic continues to project that dentistry is unlikely to reach 100% pre-COVID-19 levels by the end of the year. He continues to believe it will stall at about 85%, which would mean dental spending would take a projected hit of approximately $56 billion. Why? There are many unknowns, including when a vaccine will become available, how many people will get inoculated, whether workers will continue to lose their jobs, and whether they will use their savings to go to the dentist.

There's also consumer sentiment and practices working at smaller capacities due to new infection control measures.

About 12% of patients who visited the dentist within the past year have reported that they will not return until there is a vaccine. In addition to those losses, the peak number of patients that dentists can see daily has shrunk considerably due to new protocols implemented to control the spread of COVID-19. Therefore, patient volumes remain close to maximum levels, Vujicic said.

"Current patient volume is what is close to maximum capacity," he said. "I'm not sure it's even feasible to get back to 100%."

Another wave, another lockdown

Because practices have been operating for a few months with little to no evidence of transmission of the virus between providers and patients, there is hope that dentists won't have to postpone all nonemergency procedures again, said Kirk Norbo, DDS, who owns a private practice in Virginia and is the chair of the ADA's COVID-19 task force.

Though Dr. Norbo believes practices have proved that they are safe and essential, he said it would be a guess as to how each governor in every state will react.

"I hope we don't go down that road again," Dr. Norbo said. "I've seen my patients' oral health deteriorate in that little bit of time. They need major treatments. I don't think we'll go down that road again. If we do, it will be bad times for all of us."