Pandemic-related stress and habits have contributed to a wide range of dental problems—from cracked teeth to an affliction called “mask mouth.” And after staring at themselves on screens for more than a year, more people are looking to straighten and brighten their smiles.
“Demand is up, but we can’t meet it because of the workforce shortage,” says Dr. Priya Tirumalasetty, who runs five-chair Setty Dental Group in the Loop.
A national hygienist shortage, coupled with the fact that Americans are requiring more dental care, puts added pressure on the industry. Some dentists, including Tirumalasetty, have even started doing routine cleanings themselves. The move aims to shorten patient wait times, but not without cutting into the time dentists can spend performing higher-acuity procedures.
With many dental hygienists citing general concerns about COVID-19 or child care responsibilities, nearly one in 12—about 8 percent—nationwide had left the industry since the pandemic started, according to a February report from the American Dental Hygienists’ Association and the American Dental Association.
As of June, about 5 percent of dental hygienists still had not returned to work, says Marko Vujicic, chief economist and vice president of the American Dental Association’s Health Policy Institute.
Dental assistants also are in short supply, says Dr. Clark Stanford, dean of the University of Illinois at Chicago College of Dentistry. “Even though we pay market rate, there’s not a lot of people applying,” Stanford says.
Meanwhile, some local dentists say wages for hygienists and dental assistants already are being driven up by the battle for talent.
Those costs are in addition to what dentists are spending on personal protective equipment and high-quality air filters that mitigate the potential for aerosols, or airborne particles, that could transmit a virus.
Between such mitigations and widespread availability of COVID vaccines, even patients who avoided dental care earlier in the pandemic are clamoring for appointments.
Compared with pre-pandemic levels, patient volumes are up nearly 40 percent across all four Chicago-area Compass Dental offices, says owner Dr. Brandon Prusa. To accommodate the influx of patients, which is partly due to acquiring patient charts from three practices during the pandemic, Prusa says he’s hired two additional dentists and extended office hours.
In addition to seeing more patients, practices are having to accommodate longer-than-average cleanings, taking care to remove excess plaque and tartar from the teeth of patients who missed preventive visits.
Cleanings that used to take 45 minutes are taking an hour or longer, says Brittany Brindza, a hygienist at Compass dental. And deep cleanings, which sometimes require an extra visit, are becoming more common.
Before the pandemic, patients typically could get an appointment with Tirumalasetty within two weeks. But now she’s booked up to six weeks in advance. And while Tirumalasetty says patient volumes have returned to pre-pandemic levels, her office is only at about 85 percent of capacity.
“Normally we have at least two hygienists—if not three—and at the moment we have one,” Tirumalasetty says. “If we had our second hygienist present, I could say we’d be at 100 percent.”
Even some staffing agencies are tapped out.
Brindza says she frequently gets calls from staffing agencies looking for workers to pick up shifts. “As of now I can’t temp, but if I could I would,” Brindza says. “We’re pretty busy right now, especially with patients who weren’t coming in and now they’re trying to get in fast.”
From June 2019 to June 2021, the total number of employees at dentists’ offices nationwide increased 4 percent, passing 1 million workers for the first time, according to the latest Bureau of Labor Statistics data. Even before COVID-19 started spreading, the total number of dental workers had been ticking up, with the aging population driving demand for dental services.
But demand is accelerating sooner than expected.
“It has been a difficult year for everyone, and we’ve seen that manifested in teeth,” Tirumalasetty says.
For example, while teeth typically wear down slowly over time, dentists say they’re seeing a faster rate of wear during the pandemic as many patients manage a higher-than-average level of stress.
“In a normal year, we see a certain group of patients that clench and grind and break (off) bits here and there,” Tirumalasetty says. But during the pandemic, “it was unprecedented how many (patients) came in with giant broken chunks of teeth.”
Another pandemic-related oral health affliction the industry is watching: “mask mouth,” a condition associated with dry mouth, bad breath and tooth decay.
“The body has been tricked into thinking you have a more humid environment, so our mouths are not producing the saliva they once did,” Prusa says. “I’ve seen people that are coming in with tons of decay and crowns and broken teeth. It’s just crazy.”
Cosmetic procedures also are on the rise. Dentists say they have video conferencing to thank, noting that large numbers of patients mention seeing their teeth on Zoom calls, which leads to inquiries about straightening or whitening.
“People are becoming more aware of how they come across and how they look in the various media platforms that we’ve been using the last two years,” Stanford says. “And as we start to return to work, people are also wanting to (get things done). It’s like coming back to high school from summer vacation. . . .Sometimes they want to get things fixed really fast—faster than we can do.”