LAUSR

Background: American adults delay dental care more than any other healthcare service. Unfortunately, the COVID-19 pandemic may have stalled efforts to address dental service delays. Early evidence has suggested substantial declines in dental service visits in the early phase of the pandemic, however our study is among the first to measure within-person changes from 2019 to 2020 and conduct subgroup analyses to examine if changing dental patterns were mediated by exposure to the pandemic, risk of adverse COVID-19 outcomes, or dental insurance. Methods: We analyzed a National Health Interview Survey panel of individuals initially surveyed in 2019, with subsequent follow up in 2020. The outcomes included dental service access measures and the interval of a most recent dental visit. By constructing a probability weighted linear regression model with fixed-effects, we estimated the average within-person change from 2019 to 2020. Robust standard errors were clustered within each respondent. Results: Overall, adults in 2020 were 4.6%-points less likely to visit the dentist compared to 2019 (p < 0.001). Significantly higher declines were found in Northeast/West regions compared to Midwest/South. We find no evidence that declining dental services in 2020 were associated with more chronic diseases, older age, or lack of dental insurance coverage. Adults did not report more financial or non-financial access barriers to dental care in 2020 compared to 2019. Conclusions: The long-term effects of the COVID-19 pandemic on delayed dental care warrants continued monitoring as policymakers aim to mitigate the pandemic's negative consequences on oral health equity.