There’s one certainty about 2020: It did not go according to plan.

Whether the topic is health, the economy or racial justice, nothing about the last 12 months followed a script we’ve seen before. And the oral health system was an important player in the story, serving as an example of innovation, a casualty of economic pain and a glimpse into the racial gaps that continue to grow in our society.

Change, as the saying goes, was the only constant. And change won’t stop anytime soon, with an uncertain winter and the glimmer of COVID-19 vaccine hope on the horizon.

Before we get to 2021, though, let’s look back at four lessons we learned about oral health in 2020:

1. Access to Oral Health Is an Issue of Racial Justice

• One of the most important lessons from the pandemic is that systemic racism has a very real public health impact. As Dr. Myechia Minter-Jordan, president and CEO for the DentaQuest Partnership for Oral Health Advancement and Catalyst Institute, wrote: “The COVID-19 crisis has laid bare the inequities in health care that existed well before the pandemic. We know this not only from the powerful experiences of Black and Brown people, we know it because we can see it in the data.”
• Racial disparities persist when it comes to access to oral health. Data shows that Black adults are 68% more likely to suffer unmet dental needs and 22% less likely to have had a routine dental visit than white adults. Not only are people of color suffering disproportionately high mortality rates from the coronavirus, a report on ventilator-associated pneumonia by the DentaQuest Partnership showed that people of color and those with poor dental health are more likely to develop this deadly infection if placed on a ventilator.

2. Teledentistry Is a Tool for the Future — Beyond the Pandemic

• Teledentistry has been a growing trend for years, but the pandemic thrust it into the spotlight this year. And it performed well on center stage. Survey data from Oregon, released in June 2020, showed that 86% of patients said they would recommend teledentistry services to others. Another survey in November showed that 75% of dentists who were already using the technology anticipate steady or increased telehealth in the coming months.
• The DentaQuest Partnership released its Three Domain Framework this year, creating a new model in dentistry that features teledentistry as Domain One. Providers have been testing strategies and offered tangible tips and takeaways on how they are using the tools going forward.

3. Providers Have Stepped Up to Care for the Underserved

• Providers also worked hard to maintain access to care for children when school closures cut a critical line to dental care for poor students. It’s a problem that once again highlighted the serious gap in access to care for low-income students and families and the need to do better to meet patients where they are. Tiffany Foy, a hygienist at Advantage Dental in Oregon, is just one example of how providers are finding creative ways to get kids in a dental chair.
• We celebrated several Health Equity Heroes, individuals who are going above and beyond to expand access to equitable oral care and health care — especially in underserved communities. One example, Dr. Ritika Chandra, moved to quickly incorporate teledentistry into her practice to increase access to care in Seattle at the start of the pandemic. She continues to develop new programs to engage with patients and is training other providers on how to incorporate teledentistry going forward.

4. Value-Based, Integrated Care Is the Path Forward

• Long before the coronavirus pandemic, many parts of the U.S. health care industry have been moving — some faster than others — toward value-based care delivery and value-based payment models. The pandemic has forced many dentists and oral health providers to seriously consider the short- and longer-term benefits of making this shift, as COVID-19 has taught us a lot about value-based care.
• Medical-dental integration has been an important strategy for increasing access to care for vulnerable populations for many years, especially as research continues to show the many direct links between oral health and overall health. COVID-19 has emphasized the need for integrating oral health into other health disciplines more than ever before, and it’s given dentists an opportunity to redefine their role.

If there is one thing that was made abundantly clear this year, it is that the time is now to fundamentally transform the oral health system so that it works better for everyone.

We can’t afford to wait any longer.