History Can Provide Some Clues to the Future of Dentistry

Naren Arulrajah


COVID-19 is a pandemic unlike anything we have experienced in modern times, creating almost surreal chaos in the dental community. It feels like we are in uncharted waters. And, in many ways, we are.

However, it is not entirely unprecedented. We have faced health and financial crises before. Society, the economy, and the dental industry have proved resilient. In truth, we often come out of a crisis stronger, wiser, and better equipped to face the next challenge.

This Is Not the First Health Crisis to Transform Dentistry

Three decades ago, the discovery and rapid spread of a disease sparked widespread panic. Early in the HIV/AIDS epidemic, much like the COVID-19 pandemic, misinformation and lack of data created fear and confusion. There was a great deal of uncertainty about the best way to protect clinicians and patients. Dentists wondered if they were taking unnecessary steps or if they were doing too little.

Gradually, scientific research and accumulated data provided answers. Effective, reliable precautions were incorporated into standard operating procedures. Those precautions remain in effect to this day, offering protection not only from HIV/AIDS, but also from hepatis and other bloodborne pathogens.

While the method of transmission for COVID-19 is quite different, the atmosphere of uncertainty is similar. Furthermore, we are already seeing a familiar pattern. As early research accumulates, we have a much better understanding of the disease.

With more time and scientific advances, we will almost certainly reach a similar point where the disease is understood well enough that we can feel confident in the effectiveness of our precautions. For now, though, we can learn to:

  • Have patience: The paranoia and the danger will decrease as scientific knowledge increases.
  • Be flexible: Data is rapidly accumulating, and an astonishing amount of research is currently being conducted. Keep yourself and your team informed and ready to implement the most recent best practices.
  • Prepare for lasting changes: Many newly introduced safety precautions are likely to become permanent. They are also likely to reduce the spread of not only coronavirus but also many other contagious respiratory diseases. Consider this the silver lining in the very, very dark cloud that is this pandemic.

Recessions End, But Dentistry Conitnues

COVID-19 presents a dual crisis. Not only is it a pandemic, but it also has devastated the economy. However, economic devastation is certainly not new.

Historians acknowledge as many as 47 recessions in the United States, beginning in the late 1700s when the Articles of Confederation were signed, and there have been well over a dozen significant recessions. Volatility is the nature of a free economy, or any economy for that matter. According to the World Bank Group, there have been four global recessions.

Past recessions have been attributed to factors ranging from war to oil prices and even to  unsustainable growth. But they all have one thing in common—the economy bounced back. Many businesses recovered, new businesses opened, and good times returned. Moreover, essential industries such as healthcare survived.

The most recent major recession, also known as the Great Recession of 2008 and 2009, saw a decrease and subsequent increase in dental collections co-related with similar changes in per capita disposable income, with a slight delay.

The changes in gross production did not follow the same pattern, though. Hygiene production performed better than doctor production during difficult years. Furthermore, the number of patient visits continued declining for several years, while gross production per visit increased.

How can we interpret these trends? During the recession, and in the early stage of recovery, people were far more willing to spend on low-cost hygiene treatments while delaying major procedures.

As you well know, though, delaying treatment of a major oral health problem makes it worse and more costly. It seems that procrastination was a costly choice for patients, leading to more major cases, even while the overall number of dental visits declined.

In the current situation, most people are avoiding dental visits due to fear and necessity. Yet the economic implications are likely to last much longer than the pandemic. Moreover, there is a good chance that we will see similar patient trends following this recession. How can history help you prepare?

  • Promote early treatment: Patients understand the value, both economic and health, of avoiding problems. This is an important selling point during difficult economic times. Remind patients that filling a cavity now is far more cost-effective than root canal therapy and a crown in a couple of years.
  • Ramp up your hygiene program: People with toothaches, chipped teeth, cavities, or bleeding gums might be afraid of the diagnosis and attached price tag. The “I don’t want to know” factor will keep some of them away. But if there is not a problem yet, then avoiding one can be powerful incentive. Hygiene appointments can be one of your most reliable revenue streams in hard times.
  • Offer financing options: Avoidance only works for just so long before the severity of symptoms drives people back to the dental chair. They likely still will have limited incomes, yet they will be facing pricey treatments. Many of them will opt for the dentist who makes it most affordable. Consider in-house membership plans, working with third-party financing, accepting payments, and similar measures.

Final Thoughts

There are few guarantees in life, but we can be certain of a few things. Virtually every human being has teeth. Those teeth require care for comfort, cosmetic, and medical reasons. In other words, the demand for dentistry may evolve and fluctuate, but it will not disappear. With a flexible approach and careful planning, neither will your practice.

Mr. Arulrajah, president and CEO of Ekwa Marketing, has been a leader in medical marketing for more than a decade. Ekwa provides comprehensive marketing solutions for busy dentists, with a team of more than 180 full-time professionals, providing web design, hosting, content creation, social media, reputation management, SEO, and more. If you’re looking for ways to boost your marketing results, call (855) 598-3320 for a free strategy session with him.

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