New research from Delta Dental finds a significant decrease in the provision of preventive oral health services resulting from the pandemic, raising concerns about long-term impacts

Study assessed effects the COVID-19 pandemic had on oral health care provided from July 2020 through December 2021

WASHINGTON, D.C. – Oct. 19, 2023 – New research from Delta Dental on oral health care during the COVID-19 pandemic, published recently by the Journal of the American Dental Association, reported a significant decrease in the provision of preventive oral health care services when compared to pre-pandemic levels.

The study, Impact of the COVID-19 pandemic on oral health care use in the United States through December 2021, showed that there were significant decreases in preventive dental services that persisted for more than a year, particularly across all age groups under 65. These could reflect, in part, anecdotal reports of loss of employer-sponsored dental benefits, reluctance to seek care due to concerns about COVID-19 exposure, or staff shortages at dental offices. Study authors also found a significant increase in the delivery of night guards to adult patients. This may indicate a rise in stress-related teeth grinding that can crack or fracture teeth.

“This data tells us that, while we’re through the pandemic, we’re just beginning to understand the long-term impacts it could have on the nation’s oral and overall health,” said Joseph Dill, DDS, MBA, Chief Dental Officer, Delta Dental Plans Association and Head of Dental Science, Delta Dental Institute. “The reduction in preventive procedures seen across age groups could lead to an increase in caries or deterioration of periodontal status, particularly for people who require regular preventive and maintenance care. This can exacerbate other health problems, like risk of stroke, high blood pressure, and diabetes.” 

Key takeaways from the study include:

The COVID-19 pandemic has had both direct and indirect effects on oral health care, including prevention, treatments, and procedures.

  • Direct effects on oral health care include the closure of dental practices and ensuing interruption of care. For those requiring regular preventive and maintenance care, these delays could lead to an increase in caries (cavities) or worsening of periodontal disease.

The decrease in preventive services from pre-pandemic levels raises concerns about long-term health impacts.

  • Reductions in preventive procedure volumes across age groups younger than 65 years may have longer-term effects on oral and overall health.

There was a significant increase in the number of occlusal night guards delivered to adult patients and an increase in crowns in patients 65 years and older.

  • This likely indicates an increase in stress-related bruxing (teeth grinding), which may also have led to an increase in cracked or fractured teeth in seniors. However, the claims data could not confirm anecdotal reports of an increase in cracked or fractured teeth.

The research assessed the effects of the COVID-19 pandemic on oral health care using national insurance claims data. The research team analyzed claims by quarter from 2017 to 2019 and from July 2020 to December 2021, including 600 million submitted procedure codes.

Delta Dental conducts important research using national dental care claims data to uncover trends in oral health care and to help instruct avenues for intervention. The study team intends to conduct follow-up research that will explore national oral health claims data from 2022. 

Read the study

About the Delta Dental Institute

The Delta Dental Institute is dedicated to advancing oral health for all Americans in partnership with Delta Dental companies and dedicated partners across the country. With expertise rooted in Delta Dental's rich history of oral health leadership, we engage in and support oral health research, community outreach, and advocacy, striving to ensure that everyone understands the importance of oral health to overall health and has access to the care they need. Visit for more information.

About Delta Dental Plans Association

Based in Chicago, Illinois, Delta Dental Plans Association is the not-for-profit national association of the 39 independent Delta Dental companies. Through these companies, Delta Dental is the nation's largest dental benefits provider, covering more than 89 million Americans and offering the country's largest dental network with approximately 152,000 participating dentists. Over the last decade, Delta Dental companies and their foundations invested over $1.9 billion to improve the oral and overall health of our communities.