Here's How the Pandemic Affected America's Dental Health

For many of us, the furthest thoughts from our minds the last two years have been, I need to see a dentist. During a reeling pandemic, people tend to prioritize safety, doing as much as they can to avoid catching COVID. Visiting the dentist can already be a frightening experience, from the sharp instruments to the ear-piercing drills, but the pandemic has given new reasons for Americans to avoid their check-ups: fear of viral transmission. Despite confirmation that the odds of catching COVID from your dentist remains low, many Americans have stayed away—and are seemingly paying for it. Since March 2020, the U.S. has seen a steep decline in oral health. One study showed that “nearly half of US adults reported delaying going to the dentist or receiving dental care due to the COVID-19 pandemic.” And a survey commissioned by the American Association of Endodontists revealed that not only has the pandemic caused Americans to delay going to the dentist, but many have altered their daily oral hygiene routines, with 31% “snacking more on sweets," 24% flossing less frequently" and 23% not flossing at all. 

Oral hygiene is crucial to staying healthy; studies have shown that gum disease has been linked to dementia and heart disease. Though the decrease in dental hygiene during the pandemic is substantial, there are ways to save your oral health. We spoke with experts who are here to help. 

What are the risks in delaying your next dentist visit? 

According to Dr. Matt Nejad, DDS, “A lot of problems can be avoided with proper maintenance and preventative care.” He says that not seeing a dentist for over a year “increases the chances that something small could have been prevented or identified early enough to avoid more invasive treatment.” While Nejad says problems don't always develop within one year, often the “first sign of the problems that can be detected on radiographs or examination will appear once the problem hits a certain threshold that is detectable.” He adds that “detection as soon as possible is the best way to either reverse small cavities from needing treatment or doing smaller, more conservative treatment options which typically last longer.” As for how often you should be going to the dentist, Dr. Michael Apa, DDS says you should normally see your dentist for check-ups every 3-4 months.

Now that so many Americans are working remotely and not having to "get ready," it can be easy to skip our morning tooth-brushing. What are the dangers in brushing your teeth once daily? 

Since brushing is meant to remove plaque and bacteria, Apa says that decreasing from twice-daily to once-daily brushing means bacteria will spend more time in your mouth and on your teeth. “This can have aesthetic consequences,” he says, “like staining, and jeopardize your oral health, as plaque buildup makes way for tooth decay and gum disease.” Nejat adds that our saliva is “important to provide some natural defense, but without daily tooth-brushing twice-a-day, the exposure time will be higher and more likely to result in complications.” 

Can mouthwash be a sufficient substitute for brushing?  

While using mouthwash is better than doing nothing, both Apa and Nejad agree it’s not enough to replace brushing. “Mouthwash can be used to mask bad breath and its antiseptic, like alcohol or menthol, can break down some bacteria, but it is not a replacement for brushing and flossing,” Apa says. Nejad adds that “the results would be negligible without brushing and flossing.”  

What other dental issues have occurred during the pandemic and how can you combat them?

Apa says that since the pandemic began he has seen an increase in “problems that occur in the mouth due to clenching and grinding.” Stress is one of the major triggers for this. “ This level of stress, categorically, is something we’ve never seen before, and it can lead to the simplest problems like swollen gums, to the most complex problems like tooth loss and everything in between.” He says the best way to combat this issue is to wear a standard night guard.  “We typically like to use a hard night guard that patients can’t squeeze into because it de-triggers the muscle and decreases the tension in the joint,” he says. Nejad, in addition to seeing more grinding in patients, says he’s noticed cavities, bad breath, and gum disease. “The only way to minimize these problems is to prevent them with meticulous oral hygiene including brushing and flossing.” 

What would you say to patients who are reluctant to visit the dentist during the pandemic?

For those who are concerned about going back to their dentists, Nejad says that a dental office is "one the safest places you can go." He explains that since the pandemic started, “most dental offices have implemented additional protocols, protective attire, screening, and equipment/technology to protect everyone in the office from exposure/infection.” These protocols include limiting patient interaction in common areas and waiting rooms to keep a safe distance.