COVID-19 Economic Impact on Dental Practices

To better understand the impact of COVID-19 on U.S. dental practices, the ADA Health Policy Institute has initiated a biweekly poll on economic conditions during the pandemic. The poll aims to quantify the magnitude of the pandemic's impact on dental practices over time.

HPI collaborated with other researchers in new a JADA article to examine COVID-19 infection risks within the dental profession and the effectiveness of infection control measures.

Estimating COVID-19 Prevalence and Infection Control Practices Among US Dentists (November 2020)

HPI has updated its projections of how COVID-19 will impact the U.S. dental economy in the near future. Our latest modeling predicts that U.S. dental care spending could decline by up to 38 percent in 2020 and 20 percent in 2021. We model alternative scenarios as well and they have a more muted impact.

Modeling the Impact of COVID-19 on U.S. Dental Spending — June 2020 Update (PDF)

Wave 20, Week of December 14

• Full report including breakdowns by state, practice size, and DSO affiliation
• Special report with breakdowns by specialty
• ADA News - Highlights
• December 20 Webinar: The Impact of COVID-19 on the Dental Care Sector, Insights from Data for the Week of December 14
• December 20 webinar slides (PDF)
• Additional questions of the week:
  • Does your practice offer in-office rapid response COVID-19 testing for patients?
  • How important to you think it is for dentists to be vaccinated against COVID-19?
  • Now that a vaccine for COVID-19 is available, how soon do you think dentists SHOULD get vaccinated?

Public Health Wave 7: Week of November 30

• Results from a poll adapted for dentists in public health settings on how they are adjusting during the COVID-19 pandemic

Wave 19, Week of November 30

• Full report including breakdowns by state, practice size, and DSO affiliation
• Special report with breakdowns by specialty
• ADA News - Highlights
• Special webinar: Primary Care and Oral Health Delivery - What Have We Learned from the COVID-19 Pandemic? In collaboration with Harvard School of Dental Medicine
• December 11 Webinar: The Impact of COVID-19 on the Dental Care Sector, Insights from Data for Week of November 30
• December 11 webinar slides (PDF)
• Additional questions of the week:
  • Prior to the beginning of the COVID-19 pandemic, was your dental practice an enrolled Medicaid provider?
  • Has your practice disenrolled from Medicaid since the onset of the COVID-19 pandemic? If not disenrolled, is your practice considering disenrolling from Medicaid in the coming months?
  • Is your practice currently accepting NEW Medicaid patients?
  • How has the number of Medicaid patients your practice can accommodate changed since the onset of the COVID-19 pandemic?
  • Which PPE distributor(s) did your practice use PRIOR to the COVID-19 pandemic? Which PPE distributor(s) has your practice used SINCE the onset of the COVID-19 pandemic?
  • How much have prices changed for your practice since the onset of the COVID for categories of PPE supplies?
  • Specific to gloves, since the onset of the COVID-19 pandemic, how difficult has it been to find the correct size and material (e.g. latex, non-latex) of glove?

Wave 18, Week of November 16

• Full report including breakdowns by state, practice size, and DSO affiliation
• Special report with breakdowns by specialty
• ADA News - Highlights
• November 24 Webinar: The Impact of COVID-19 on the Dental Care Sector, Insights from Data for Week of November 16
• November 24 webinar slides (PDF)
• Additional questions of the week:
  • Currently, what is the maximum number of patients your practice could possible see in a week?
  • Last week, how many patients did your practice actually see?
  • Since you reopened, have you taken certain measures to maintain the financial stability of your dental practice?
  • Assuming your patient volume remains what it is through the end of the year, would you seriously consider additional measures?

Public Health Wave 6: Week of November 2

• Results from a poll adapted for dentists in public health settings on how they are adjusting during the COVID-19 pandemic

Wave 17, Week of November 2

• Full report including breakdowns by state, practice size, and DSO affiliation
• Special report with breakdowns by specialty
• ADA News - Highlights
• November 18 Webinar: The Impact of COVID-19 on the Dental Care Sector - Industry Roundtable
• November 18 webinar slides (PDF)
• Additional questions of the week:
  • How do your practice’s current operating costs compare to what was typical before the COVID-19 pandemic?
  • Please select the statement that best describes your practice’s profitability NOW.
  • Do you have any of the following types of student loans left to pay off?
  • On a scale from 1 to 10, please rate the level of stress your student loan situation placed on you personally BEFORE the COVID-19 pandemic and NOW.
  • Did the lenders for your PRIVATE student loan(s) offer deferment or any other type of support during the public health emergency?
  • In an effort to reduce aerosols, how has your practice’s use of the following changed compared to before the COVID-19 pandemic?

Wave 16, Week of October 19

• Full report including breakdowns by state, practice size, and DSO affiliation
• Special report with breakdowns by specialty
• October 29 Webinar: The Impact of COVID-19 on the Dental Care Sector, Insights from Data for Week of October 19
• October 29 webinar slides (PDF)

Public Health Wave 5: Week of October 5

• Results from a poll adapted for dentists in public health settings on how they are adjusting during the COVID-19 pandemic

Wave 15, Week of October 5

• Full report including breakdowns by state, practice size, and DSO affiliation
• Special report with breakdowns by specialty
• October 13 Webinar: The Impact of COVID-19 on the Dental Care Sector, Insights from Data for Week of October 5
• October 13 webinar slides (PDF)
• Additional questions of the week:
  • Have you recently or are you currently recruiting any staff positions in your dental practice?
  • Compared to before the COVID-19 pandemic, how challenging was it to recruit certain staff?

Wave 14, Week of September 21

• Full report including breakdowns by state, practice size, and DSO affiliation
• September 30 Webinar: The Impact of COVID-19 on the Dental Care Sector, Insights from Data for Week of September 21
• September 30 webinar slides (PDF)
• Additional questions of the week:
  • Compared to before the COVID-19 pandemic, how has the prevalence of certain conditions changed among patients in your dental practice?
  • Since you reopened, have you taken any measures to maintain the financial stability of your practice?
  • Assuming your patient volume remains what it is through the end of the year, would you seriously consider additional measures?

Public Health Wave 4: Week of September 7

• Results from a poll adapted for dentists in public health settings on how they are adjusting during the COVID-19 pandemic

Wave 13, Week of September 7

• Full report including breakdowns by state, practice size, and DSO affiliation
• September 16 Webinar: The Impact of COVID-19 on the Dental Care Sector, Insights from Data for Week of September 7
• September 16 webinar slides (PDF)
• Additional questions of the week:
  • Have you applied for funds from any relief programs?
  • What is the current status of your relief program application?
  • Why have you not applied to the HHS Provider Relief Fund?
  • Assuming that dentists in your state were permitted to do so, would you be willing to administer COVID-19 vaccines to patients in your office?
  • How important do you think it is to have rapid, point-of-care COVID-19 testing for patients, yourself, and dental team members?

Wave 12, Week of August 24

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - Highlights
• Special report with breakdowns by specialty
• Recording: The Impact of COVID-19 on the Dental Care Sector, Insights from Data for Week of August 24
• Week of August 24 slides (PDF) 
• Additional questions of the week:
  • As a result of the COVID-19 pandemic, dental practices now use enhanced Personal Protective Equipment (PPE). Please indicate if you have experienced any of the following types of physical reactions as a result of using enhanced PPE.
  • Symptoms experienced during the COVID-19 pandemic (e.g., depression, anxiety).
  • What issues are currently the most challenging to you during the COVID-19 pandemic?

Public Health Wave 3: Week of August 10

• Results from a poll adapted for dentists in public health settings on how they are adjusting during the COVID-19 pandemic
• September 1 Webinar: Will COVID-19 Weaken the Dental Care Safety Net?
• September 1 webinar slides (PDF)

Wave 11, Week of August 10

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - Highlights
• Recording: Economic Impact of COVID-19: Insights from Data for Week of August 10
• Week of August 10 slides (PDF)
• Additional questions of the week:
  • Do you schedule cases for dental treatment under general anesthesia in a hospital and/or surgery center?
  • [If schedules cases] Prior to the onset of the COVID-19 pandemic, what was the approximate wait time for these cases to be scheduled in the hospital/surgery center?
  • [If schedules cases] What is the current status of scheduling these cases in the hospital/surgery center, compared to before the COVID-19 pandemic?
  • What reasons did the hospital/surgery center provide for the limited or denied procedure time?
  • Prior to the beginning of the COVID-19 pandemic, was your dental practice an enrolled Medicaid provider?
  • Has your practice disenrolled from Medicaid since the onset of the COVID-19 pandemic?
  • Is your practice considering disenrolling from Medicaid in 2020?

Wave 10, Week of July 27

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - Highlights
• August 5 Webinar Recording: Impact of COVID-19 on Patient Attitudes Toward Visiting the Dentist 
• August 5 webinar slides (PDF)
• Additional questions of the week:
  • Pay status and unemployment benefits of associates, employees and independent contractors
  • How many day's worth of the following PPE does your practice have at this time: N95/KN95 masks, surgical masks, face shields, and gowns? 
  • Thinking ahead to your practice's expected patient volume in September and October, how do you expect it will compare to this week?
  • Please describe your practice's experience obtaining each of the following types of PPE and supplies over the past two weeks. If difficult, please indicate the primary reason why.

Public Health Wave 2: Week of June 29

• Results from a new poll adapted for dentists in public health settings on how they are adjusting during the COVID-19 pandemic
• July 28 Webinar Recording: How COVID-19 is Impacting Dental Care Delivery in Public Health Settings?
• July 28 webinar slides (PDF)

Wave 9, Week of July 13

• Full report including breakdowns by state, practice size, and DSO affiliation
• Special report with breakdowns by specialty
• ADA News - highlights
• July 21 Webinar Recording: Are Recovery Patterns Changing as Cases Increase in Certain Regions?
• July 21 webinar slides (PDF)
• Additional questions of the week:
  • Pay status and unemployment benefits of associates, employees and independent contractors
  • How many day's worth of the following PPE does your practice have at this time: N95/KN95 masks, surgical masks, face shields, and gowns? 
  • Is your dental practice back to pre-COVID levels for dentists, dental hygienists, dental assistants and other staff? If not, top reasons why.
  • Is your dental practice currently using virtual technology/telecommunications to conduct remote problem-focused evaluations (CDT Code D0140)?
    

Wave 8, Week of June 29

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - highlights
• July 7 Webinar Recording: Data for the Week of June 29 Shed Light on the "New Normal"
• July 7 webinar slides (PDF)
• Additional questions of the week:
  • Pay status and unemployment benefits of associates, employees and independent contractors
  • How many day's worth of the following PPE does your practice have at this time: N95/KN95 masks, surgical masks, face shields, and gowns? 
  • As a result of the COVID-19 pandemic, how has the number of hours per week your practice is open changed?
  • Number of patients seen in practice per day
  • As a result of the COVID-19 pandemic, how has the number of hours per week your practice is open changed?
  • What is the maximum number of patients your practice can see in a day currently?
  • Last week, how many patients did your practice see per day, on average?

Wave 7, Week of June 15

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - highlights
• June 23 Webinar Recording: The Dental Care Rebound - What the Data for the Week of June 15th Tells Us
• June 23 webinar slides (PDF)
• Additional questions of the week:
  • Pay status and unemployment benefits of associates, employees and independent contractors
  • How many day's worth of the following PPE does your practice have at this time: N95/KN95 masks, surgical masks, face shields, and gowns? 

Wave 6, Week of June 1

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - highlights
• June 11 Webinar Recording: The Dental Care Rebound: How Far Have We Gotten and How Far Will We Go?
• June 11 webinar slides (PDF)
• Additional questions of the week:
  • Pay status and unemployment benefits of associates, employees and independent contractors
  • How many day's worth of the following PPE does your practice have at this time: N95/KN95 masks, surgical masks, face shields, and gowns? 
  • [If practice closed or closed but open for emergencies] Do you expect your dental practice to reopen for elective care by the end of this month? 
  • How full is your practice’s appointment schedule this month?
  • Prior to the beginning of the COVID-19 pandemic, was your dental practice an enrolled Medicaid provider?
  • [If an enrolled Medicaid provider] Prior to the beginning of the COVID-19 pandemic, what percentage of patients in your practice would you estimate were covered by Medicaid?
  • [If an enrolled Medicaid provider] Looking ahead, does your practice plan to continue to be an enrolled Medicaid provider at the end of this month?

Public Health Wave 1: Week of May 6-19

• Results from a new poll adapted for dentists in public health settings on how they are adjusting during the COVID-19 pandemic
• June 4 Webinar Recording: How Will COVID-19 Impact Access to Dental Care for Vulnerable Populations?
• June 4 webinar slides (PDF)

Wave 5, Week of May 18

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - highlights
• May 18 Webinar Recording: COVID-19 Economic Impact: Positive Signs for the Third Week of "Reopening"
• May 18 webinar slides (PDF)
• Additional questions of the week:
  • [If owner dentist and practice is closed or closed except for emergencies] What is keeping you from reopening your dental practice for elective care?
  • Pay status and unemployment benefits of associates, employees and independent contractors
  • Have you received any financial assistance from private dental insurers (e.g., grants, advanced claims payment)?
  • How many day's worth of the following PPE does your practice have at this time: N95/KN95 masks, surgical masks, face shields, and gowns? 

Wave 4, Week of May 4

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - highlights
• May 12 Webinar Recording: An Early Look at the “Reopening” of Dentistry: What the Economic Data Tell Us?
• May 12 webinar slides (PDF) 
• Additional questions of the week:
  • Pay status and unemployment benefits of associates, employees and independent contractors
  • How many day's worth of the following PPE does your practice have at this time: N95/KN95 masks, surgical masks, face shields, and gowns?
  • On a scale of 1 to 5, please describe your level of concern regarding the risk of transmission of COVID-19 in your practice to patients, the dental team and yourself.

Wave 3, Week of April 20 

• Full report including breakdowns by state, practice size, and DSO affiliation
• Special report with breakdowns by specialty 
• ADA News - highlights
• April 29 Webinar Recording: Economic Impact of COVID-19 on Dentistry - Where Are We Heading?
• Additional questions this week: Respondents were asked whether they were able to apply and received funds from an SBA 7(a) Paycheck Protection Program (PPP) loan and/or an Economic Injury Disaster Loan (EIDL). They were also asked if their practice is currently using virtual technology/telecommunications to conduct remote problem-focused evaluations (CDT Code D0140).

Wave 2, Week of April 6

• Full report including breakdowns by state, practice size, and DSO affiliation        
• ADA News - highlights    
• April 16 Webinar Recording: How is COVID-19 Impacting the Dental Care Sector?
• Additional question of the week: Current CDC guidelines recommend dentists delay non-urgent procedures through April 30. The situation is highly uncertain, but which of the following options would you consider to ensure the sustainability of your practice if the current restrictions on dental practices were to continue through the end of April, end of June, and end of August.

Wave 1, Week of March 23

• Full report including breakdowns by state, practice size, and DSO affiliation
• ADA News - highlights