Estimating the Within-Person Change in Dental Service Access Measures during the COVID-19 Pandemic in the United States.

Background: American adults delay dental care more than any other healthcare service. Unfortunately, the COVID-19 pandemic may have stalled efforts to address dental service delays. Early evidence has suggested substantial declines in dental service visits in the early phase of the pandemic; however, our study is among the first to measure within-person changes from 2019 to 2020 and conduct subgroup analyses to examine if changing dental patterns were mediated by exposure to the pandemic, risk of adverse COVID-19 outcomes, or dental insurance. Methods: We analyzed a National Health Interview Survey panel of individuals initially surveyed in 2019, with subsequent follow-up in 2020. The outcomes included dental service access measures and the interval of a most recent dental visit. By constructing a probability-weighted linear regression model with fixed-effects, we estimated the average within-person change from 2019 to 2020. Robust standard errors were clustered within each respondent. Results: From 2019 to 2020, adults reported a 4.6%-point reduction in the probability of visiting the dentist ( Conclusions: The long-term effects of the COVID-19 pandemic on delayed dental care warrant continued monitoring as policymakers aim to mitigate the pandemic's negative consequences on oral health equity.