The early days of the pandemic brought a tidal wave of changes to businesses and their employees. Navigating this new normal can be tricky, especially since the situation seems to be changing daily. Looking at the changes that occurred during the pandemic can help you understand what trends to anticipate and how to prepare your benefits offerings accordingly.

Let’s take a high-level look at how COVID-19 impacted workers, dentists and the dental insurance industry, as well as a deep dive into claims data, patient surveys and expert opinion.

The rise of teledentistry

During the early stages of the pandemic in the United States, dental offices were closed to physical appointments for weeks. This led to a massive surge in the popularity of teledentistry services. Synchronous appointments (those with live phone or video interaction between dentists and their patients) saw a 3,000% increase between 2019 and 2020, according to Delta Dental claims during that period. Asynchronous appointments (where patients took photos or videos that were sent to a dentist for later review) saw a 1,000% increase in the same period.

The use of teledentistry has declined as the pandemic has worn on and dentist offices have reopened, but 2021’s synchronous and asynchronous appointment numbers still remain six times and two times higher than 2019 levels, respectively.

More states also updated their teledentistry laws during the pandemic. Based on Delta Dental’s internal tracking, 14 states added teledentistry regulations to their laws or expanded existing regulations, including states such as Texas that previously hadn’t allowed the practice of teledentistry at all.

Most importantly, in a phone survey of teledentistry patients during the pandemic, patients expressed widespread satisfaction with their options. This aligns with pre-pandemic expectations about teledentistry. Of those surveyed before the pandemic, 78% expected to use teledentistry within the next five years. That same group anticipated that working people, children and people with disabilities would benefit the most from teledentistry.

Dentists also had praise for teledentistry, with over 80% of dentists identifying it as useful for improving access to oral care, increasing specialists’ access to rural and underserved communities and as a time-saving technique. 

Virtual visits may not replace in-person checkups, but they remain a valuable tool for employees to get expert opinions and feedback when they can’t make it into the dentist office or prefer a remote appointment.

Providing alternatives for employees who can’t make it to the dentist office

The beginning of the pandemic was marked by profound economic uncertainty as dental practices closed and people sheltered in place. General practitioner income dropped nearly 18% in 2020 compared to 2019.

To help keep dental practices open and seeing patients, Delta Dental offered network dentists loans and reimbursements for personal protective equipment (PPE) costs and made free teledentistry tools available to members.

Loans offered in partnership with Provide (formerly Lendeavor) allowed dentists to make purchases, stay on top of debts and pay staff to ensure that they could keep their doors open. Delta Dental also offered a supplemental reimbursement to help offset the costs of PPE and office cleanings, ensuring that dentist offices remained safe for staff and patients alike.

The pandemic saw the rollout of two teledentistry options for Delta Dental members:

  • Virtual Consult is a synchronous service where members can use a smart device to have a live video chat with a Delta Dental dentist.
  • Toothpic is an asynchronous service that allows members to take photos of problem areas and get an assessment from a Delta Dental dentist within 24 hours.

These teledentistry tools allowed Delta Dental members to get expert advice and feedback on their dental needs even when they couldn’t make it into the office.

How people used their benefits

The early stages of the pandemic saw a decline in the number of patients going to the dentist’s office. One of the main reasons for the decline was that the sharp economic shutdown led to over 20 million Americans losing their jobs (PDF) and their dental coverage as well.

This decline had a profound effect on the nation’s oral health. In 2019, the most common procedures according to Delta Dental claims data were either routine preventive care or evaluations for specific issues. This shifted in 2020, when some of the most common procedures were fillings and root planing. 

Instead of staying on top of their dental health with low-cost diagnostic and preventive care, people instead required more expensive procedures to address the effects of dental neglect.

In addition to the economic hardships COVID-19 brought to patients, COVID also increased mental and emotional strain. Since the pandemic began, the number of adults reporting symptoms of anxiety or depressive disorders has risen to over 40% from about 10%.

These symptoms can manifest in jaw clenching and teeth grinding. Based on Delta Dental claims data, the number of patients requiring occlusal guards to prevent damage rose nearly 10% in the second half of 2020 compared to the same period in 2019.

Anxiety and depression can also lead to an unhealthy diet or substance abuse, which can in turn lead to oral health issues such as cavities. This may also help to explain the surge in fillings and scaling and root planing procedures in 2020.

Health and safety in the dental office

Even though COVID-19 is spread by exhaled aerosolized droplets, visits to the dentist’s office proved safer than visiting any other medical professional during the pandemic. 

Nearly 100% of dentist offices rapidly adopted enhanced infection control measures like pre-appointment screenings, in-office air purification and antiviral mouthwashes. 

Once vaccines became available, they saw widespread adoption amongst dentists, even before state and federal mandates. By the second quarter of 2021, over 90% of dentists had received at least one vaccination shot for COVID-19.

Patients also view dentists as valuable sources of information about their overall health in addition to their oral health. Two-thirds of dentists reported receiving questions from patients about the COVID-19 vaccine, according to the ADA (PDF).

Dentists rose to the occasion, with over 80% reported feeling prepared for these discussions and 95% believing it was important to have such discussions with patients. For employees who may be hesitant to get the COVID vaccine, speaking with trusted health professionals like dentists may help persuade them of the efficacy of getting vaccinated.

What did we learn from COVID-19?

Here are three key takeaways for employees and your business as you look to the future.

  • Encourage employees to use their benefits even during times of crisis. During the early stages of the pandemic, going to the dentist for a teeth cleaning was likely far from most people’s minds. Letting oral health slide in the short term can lead to costly and painful issues in the long term. Teledentistry tools can help employees get expert evaluation, even when they can’t make it into the dental office.
  • Let employees know what resources are available to them. Studies have shown that most people don’t really understand how insurance works. Your help as an insurance expert can go a long way towards letting employees know what kind of coverage and resources are available to them. There are plenty of benefits materials available for you to download and share with employees. Additionally, initiatives like Smile On can help employees maintain their coverage even in the face of economic uncertainty.
  • Consider benefits as part of your employees’ total wellness. Dental benefits are essential for helping employees maintain their overall health and wellness. Many ailments have symptoms that manifest in the mouth, including stress and anxiety. Valuable employee benefits can also help ease employees’ stress about staying healthy and paying for care. When your employees know how to make the most of those benefits, they’re more likely to catch and treat minor issues before they become major ones.