After a two-month closure in March, dentists are still seeing the economic impact on their businesses and health impact on their patients. During the most current surge of COVID-19 cases, they don’t plan on closing their doors again.
When the first wave of COVID-19 spread through the country, about 80% of practices in New Hampshire voluntarily closed their doors to everyone but emergency patients. For two months, many practices lost their incomes entirely — about half of practices in the state said they stopped paying staff in a recent study. Several dentists, already on the cusp of retirement, decided to close their practices early.
The stability of dental practices in the state has slowly improved since they reopened in May, but Michael Auerbach, the executive director of the New Hampshire Dental Society, cautioned it will be a long road to full recovery. Personal protective equipment, which many practices pay for out of pocket, is still a large expenditure for many dentists. Furthermore, the pandemic created a new shortage of dental hygienists, many of whom have stayed home to care for their kids while child care remains in flux.
Dental practices aren’t unique in their financial strain — hospitals in the state have already lost hundreds of millions of dollars due to COVID-19 – but Auerbach said dentists, many of whom own their own small businesses, are especially vulnerable.
“I know it negatively impacted every practice in the state really, really dramatically,” he said. “Dental offices are small businesses and they pay for these supplies out of pocket. That is challenging, especially when recovering from a two to three-month hiatus.”
Early in the pandemic, Auerbach had urged officials to help keep dentist offices open, not just to keep practices financially afloat but to avoid an oral health crisis. Even though New Hampshire dental practices opened sooner than much of the rest of the country, they had already seen the oral consequences.
Joshua Osofsky, the president of the New Hampshire Dental Society, said at his practice several patients have had compounded dental problems because they waited to come in for care – what should have been a simple filling turned into a root canal, a patient with a cracked tooth that could have easily been mended with a crown showed up with half their tooth missing.
“Time is a factor in everything in medicine,” Osofsky said.
Despite new cases surging past the numbers from March – the two-week average for new cases is higher than it has ever been in the state – Auerbach doesn’t expect dental practices to close again. He said since March, scientists have learned enough about the best safety precautions in clinical settings to continue safely accepting clients into their offices.
Patients haven’t been deterred by the peaking numbers, either, he said. While the number of patient visits isn’t entirely back to where they were pre-pandemic, most facilities in New Hampshire are operating between 85 and 95% of their normal capacity, according to a report from the American Dental Association.
“The biggest concern right now is catching up,” he said. “Patients are complaining they have to wait for an appointment. Dentists are working 10 to 12 hour days sometimes just to manage the volume.”
Other practices, like Concord Family Dentistry, are still struggling to get their usual amount of patients. Nowadays, the dentists see about three patients an hour, down from an average of five an hour pre-pandemic.
Shannon Anderson, a receptionist at the practice, attributes it to two factors; fear of the virus and financial hardship.
“A lot of patients don’t have money right now,” she said. “They’re neglecting dental work to put money elsewhere.”