Adult Dental Care Utilization and Tooth Loss Pre- and During COVID-19: A Cross-sectional Study

The COVID-19 pandemic significantly impacted healthcare utilization, including dental care services, among the adult population in the United States (U.S.). This study examines changes in dental care utilization and tooth loss among U.S. adults before and during the pandemic. Data were drawn from the Behavioral Risk Factor Surveillance System (BRFSS) for the years 2018 (n = 437436) and 2020 (n = 401958). The primary outcomes assessed were past-year dental visits and tooth loss, with analyses stratified by social and demographic characteristics, as well as geographic trends. Weighted estimates were employed for descriptive analyses, chi-square tests (p ≤ 0.05) for unadjusted associations, and multivariable logistic regression models for adjusted associations. Our findings indicate a modest but statistically significant decline in dental care utilization, from 67.9% in 2018 to 66.6% in 2020. Reductions in dental visits were observed across several subgroups, including adults under 65 years of age, those with more than a high school education, various income levels, and self-reported health statuses, except those with poor health. In contrast, an increase in dental visits was noted among Medicare and Medicaid beneficiaries. Additionally, a notable decrease in tooth loss was observed among individuals with higher educational and income levels, private insurance, and those who primarily speak English. The results suggest that the COVID-19 pandemic has led to significant changes in dental care utilization, with varying effects across different population subgroups. These findings highlight the need for targeted interventions to address disparities in oral health care access, particularly for vulnerable populations, in both current and future public health emergencies.