Document Type
Article
Original Publication Date
2022
Journal/Book/Conference Title
Journal of Dental Research
Volume
101
Issue
10
First Page
1147
Last Page
1154
DOI of Original Publication
https://doi.org/10.1177/00220345221090183
Date of Submission
March 2024
Abstract
Non-Hispanic Black (NHB) and Hispanic and low-income US children have a higher prevalence of untreated caries than their higher-income and non-Hispanic White (NHW) counterparts. Due to the COVID-19 pandemic, many dental offices and school sealant programs closed beginning March 2020. We examine the effect of reduced access to restorative care and sealants on the oral health of children from low-income households overall and by race/ethnicity and how increased sealant delivery in September 2022 could mitigate these effects. We used Markov chain Monte Carlo simulation to model COVID-19’s impact on first permanent molar (1M) caries incidence and loss in quality of life (disability-adjusted life years [DALYs]) due to time lived with 1M untreated caries. Our model followed a cohort of children aged 7 y in March 2020 until February 2024. Model inputs were primarily obtained from published studies and nationally representative data. Excess DALYs per 1,000 children attributable to reduced access to care during the pandemic were 1.48 overall and greater for Hispanic (2.07) and NHB (1.75) children than for NHW children (0.94). Excess incidence of 1M caries over 4 y was 2.28 percentage points overall and greater for Hispanic (2.63) and NHB (2.40) children than for NHW (1.96) children. Delivering sealants to 50% of eligible 1Ms in September 2022 would not completely mitigate COVID-19’s health access impact: overall excess DALYs would decrease to 1.05, and absolute disparities in excess DALYs between NHW children and Hispanic and NHB children would remain but decrease by 0.38 and 0.33, respectively. Sealing 40% of eligible 1Ms, however, would bring overall 4-y caries incidence down to pre–COVID-19 levels and eliminate the differential effect of the pandemic on children from minority groups. The pandemic’s negative impact on the oral health of children from low-income households and increased disparities could be partially mitigated with increased sealant delivery
Is Part Of
VCU Oral Health Promotion and Community Outreach Publication
Comments
This is the author manuscript version of the article published in final form as J Dent Res. 2022 September ; 101(10): 1147–1154. doi:10.1177/00220345221090183.