Children's oral health care use and oral health in the United States after the COVID-19 pandemic

Abstract

Background: The COVID-19 pandemic adversely affected children's access to and use of oral health care services and their oral health status. The authors compared these outcomes after the pandemic through 2023 with prepandemic levels. Methods: Data from the annual National Survey of Children's Health from 2019 through 2023 were analyzed. The authors used a multivariable regression model to compare children's unmet oral health care needs, oral health care use (ie, any visits, any preventive visits, and specific preventive dental services), and parent or caregiver ratings of the child's oral health each year from 2020 through 2023 with 2019. Additional analyses were stratified according to sociodemographic characteristics and state-level dentist supply. Results: In the total sample, all outcomes had rebounded to prepandemic levels by 2023, or earlier in some cases, except for poor oral health ratings, which were still higher in 2023 than the prepandemic level by 0.3 percentage points (pp) (95% CI, 0.06 to 0.5 pp). Moreover, states with low dentist supply had lower dental examination and sealant rates in 2023 than 2019 by 2.5 pp (95% CI, –4.7 to –0.3 pp) and 1.9 pp (95% CI, –3.5 to –0.3 pp), respectively. Hispanic and publicly insured children also had lagging sealant rates in 2023 compared with prepandemic levels. Conclusions: Oral health care access and usage rebounded to prepandemic levels by 2023 for most children. However, poor oral health rates were still higher in 2023. In addition, dental examination and sealant rates remained lower in states with low dentist supply. Practical Implications: More efforts are needed to address persistent oral health issues for children most vulnerable to poor oral health and those related to low dentist supply.