Care Delivery

The following resources will help to understand:

  • Immediate impact of closures on the dental delivery system across multiple sectors (private practice, dental service organization (DSO), safety net, community-based)
  • Strategies being used to reopen, and the short-term impact on dental providers, their practices, and patients
  • Longer term impacts on care delivery (eg, widespread use of telehealth, emphasis on minimally invasive dentistry)
  • Differential impacts on safety net services, access, and workforce

(February 2021) Employment Patterns of Dental Hygienists in the United States During the COVID-19 Pandemic
Published in the Journal of Dental Hygiene, this paper provides insights on dental hygienists’ employment patterns and their attitudes toward working as dental hygienists during the COVID-19 pandemic. Survey results from over 4,700 participating dental hygienists showed that the COVID-19 pandemic has led to an approximately 8% reduction in dental hygienist employment. The paper concluded that the reduction in the dental hygienist workforce is likely to continue until the pandemic passes.

(February 2021) COVID-19 Prevalence and Related Practices Among Dental Hygienists in the United States
This paper published in the Journal of Dental Hygiene, estimates the prevalence of COVID-19 among dental hygienists practicing in the United States, describes infection prevention and control practices, and discusses trends in mental health in the population under investigation. Of the study participants, 3.1% had ever tested positive or been diagnosed with COVID-19. Over 99% of the participants reported their primary dental practice had enhanced infection prevention or control efforts in response to the pandemic.

(2/23/2021) COVID-19: The Dentists’ Perceived Impact on the Dental Practice
This study published in the European Journal of Dentistry, assesses dentists’ knowledge of the risks from the COVID-19 infection, and how they perceive its impacts their practice. The majority of participating dentists were aware of the need for changes in their dental practice in reference to specific sterilization processes, testing patients, asking patients to not be accompanied, and reducing the number of visits per day.

(02/15/2021) Knowledge and Awareness on Novel Coronavirus Spread Among Dental Fraternities in Visakhapatnam, India: A Questionnaire-based Survey
As essential healthcare workers, dentists have a responsibility to stay abreast of the scientific knowledge and awareness on COVID-19 and related infection control measures. This study published in the Journal of Education and Health Promotion assesses the knowledge and awareness of COVID-19 disease and infection control practices among dentists in Visakhapatnam, India. Findings from this study showed the need to implement periodic educational interventions and training programs on infection control practices among dentists.

(02/11/2021) Prevalence and Risk Indicators of First-wave COVID-19 Among Oral Health-care Workers: A French Epidemiological Survey
This study published in PLOS One describes a study that aimed to assess the prevalence and risk indicators of first-wave COVID-19 in a population of oral health care workers representing approximately 10% of French oral health care workers. While oral health care professionals were not at a higher risk of COVID-19 than the general population, higher risk indicators are likely to exist among high aerosol-generating subspecialities in dentistry.

(02/11/2021) Impact of COVID-19 on the Work of Spanish Dentists: An Early Response to the Pandemic
Published in the Journal of Clinical and Experimental Dentistry, this paper describes a study that assesses the quality of information about COVID-19 that were provided to Spanish dentists, and if they felt the decisions taken by health institutions were appropriate during the early response to the pandemic.

(02/10/2021) Legal Liability Facing COVID-19 in Dentistry: Between Malpractice and Preventive Recommendations
This review published in the Journal of Forensic and Legal Medicine discusses the legal aspects of dental interventions during the COVID-19 pandemic. Dentists should be aware of legal implications of implementing safety measures to prevent contamination during dental sessions. The review concluded that dentists should follow all scientific procedures and document all steps taken during the COVID-19 pandemic.

(2/6/2021) Impact of COVID-19 Pandemic on Oral Health Procedures Provided by the Brazilian Public Health System: COVID-19 and Oral Health in Brazil
This original research published in Health Policy and Technology describes a study that aimed to assess the number of dental procedures performed in the Brazilian public health system during the first wave of the COVID-19 pandemic. Dental procedures decreased from 47 million in the first semester of 2019 to 15 million in 2020; approximately a 66% decrease. The paper concluded that the COVID-19 pandemic also reduced by half the number of oral health procedures provided in almost all Brazilian states, regardless of the incidence of COVID-19 in those states.

(2/4/2021) Dental Emergencies Management in COVID-19 Pandemic Peak: A Cohort Study
This paper describes a study, published in the Journal of Dental Research, to measure the ability of a triage-based management strategy to limit patient admissions and to evaluate the success of remote management over a 1-month period. Of the patients included in the triage-based management strategy, approximately 50% of patients were able to be managed without admission for emergency, and of those patients, the proportion of successful management was over 70% for remote management and over 90% for on-site management.

(02/04/2021) Impact of COVID-19 Pandemic on Healthcare Professionals and Oral Care Operational Services: A Systemic Review
Published in Risk Management and Healthcare Policy, this systematic review evaluates guidelines and strategies in providing dental care safely during the COVID-19 pandemic and reviews the efficacy of universal personal protective measures.

(01/31/2021) The Impact of SARS-CoV-2 Outbreak on the Polish Dental Community’s Standards of Care—A 6-month Retrospective Survey-based Study
In this study, researchers aimed to evaluate the impact of the COVID-19 pandemic on the Polish dental community, standards of care, health, and welfare. This research article published in the International Journal of Environmental Research and Public Health concluded that most Polish dentists followed the recommendations provided and restricted their practices to admitting only patients with pain or incomplete treatment.

(01/30/2021) The Role of Teledentistry in Oral Surgery During the COVID-19 Pandemic
While the COVID-19 pandemic has caused unprecedented challenges to care delivery, innovative approaches such as teledentistry have allowed dental care to be delivered remotely. This study published in Advances in Oral and Maxillofacial Surgery evaluated the patient experience and effectiveness when utilizing teledentistry for care delivery.

(01/28/2021) Dentistry’s Full Recovery Still Months Away
The COVID-19 pandemic has resulted in patient volume remaining well below pre-COVID-19 levels. This article discusses some of the factors that may influence dentistry’s full recovery, including vaccination distribution and availability and consumer sentiment to return to dental offices.

(01/28/2021) Pediatric Dental Care During and Post-COVID-19 Era: Changes and Challenges Ahead
Published in the Pediatric Dental Journal, this paper discusses the changes and challenges of pediatric dental care during the COVID-19 pandemic and in the post-COVID-19 era. Traditional approaches in the management and provision of pediatric oral health care will need to be adapted to the new era to be able to control the disease and maintain the oral health of the population.

(1/26/2021) COVID-19 Pandemic and Its Impact on Pediatric Dentistry in Austria: Knowledge, Perception and Attitude Among Pediatric Dentists in a Cross-Sectional Survey
Published in the Journal of Multidisciplinary Healthcare, this paper discusses a study that aimed to assess the knowledge, perception, and attitude regarding COVID-19 among pediatric dentists in Austria. Data suggests, of the pediatric dentists who had their practice open, most followed national and international recommendations during provision of care.

(01/25/2021) The Contrasting Short‐term Effects of COVID‐19 on Dental Care Practices in the United States
Published in Clinical and Experimental Dental Research, this article compares the short-term effects of the COVID-19 pandemic on dental practices. It also examines racial disparities in context of the effects of the pandemic on the ethnicity of dentists who participated in the study.

(01/22/2021) Psychological Distress and the Perceived Impact of the COVID-19 Pandemic on UK Dentists During a National Lockdown
This paper published in the British Dental Journal discusses a study that aimed to determine the level of psychological distress in UK dentists during the lockdown period. Data suggests that while levels of psychological distress was reduced (attributed to lessened day-to-day stressors of clinical dentistry), novel stressors were introduced during the lockdown period warranting monitoring of mental health and wellbeing of dentists.

(01/21/2021) Anxiety Among Dental Professionals and Its Association With Their Dependency on Social Media for Health Information: Insights From the COVID-19 Pandemic
Posts on the viral origin, pathogenesis, and transmission have flooded social media platforms resulting in a phenomenon known as ‘infodemic’ which has adversely impacted the psychological wellbeing of dental health care workers. Published in BMC Psychology, this paper discusses the impact of social media on the anxiety levels of dental health workers during the COVID-19 pandemic.

(1/15/2021) Geography Is Destiny: Dentists’ Access to COVID Shots Depends on Where They Live
This article published by Kaiser Heath News discusses how states are diverging from CDC guidelines in their COVID-19 vaccination plans, despite the CDC advisory board recommending dentists be prioritized for vaccinations as front-line health workers.

(1/15/2021) Oral Health Matters: The Ethics of Providing Oral Health During COVID-19
Published in the HEC Forum, this paper highlights the importance of recognizing oral health care as a part of primary health care, and the opportunity the COVID-19 pandemic has presented to reshape how oral health care is financed and delivered.

(1/13/2020) Using Dental Health Care Personnel During a Crisis: COVID-19 Pandemic in the Bronx, New York
This article published in Public Health Reports, describes efforts of Jacobi Medical Center and its use of nontraditional health care personnel to provide health care services during the initial few months of the COVID-19 pandemic. The article shows how dental staff members can be called upon as additional health personnel during times of need.

(1/7/2021) Assessment of SARS-CoV-2 Infection in Dentists and Supporting Staff at a University Dental Hospital in Argentina
The risk of infection by SARS-CoV-2 is higher in oral health care professionals. This paper published in the Journal of Oral Biology and Craniofacial Research, describes a study that aimed to evaluate the prevalence of COVID-19 in essential health care workers, who provided services at a dental care and educational institute in the Buenos Aires Metropolitan Area.

(01/07/2021) Dental Emergencies Presenting to Maxillofacial Units During the COVID-19 Pandemic: A 5-Centre UK Hospital Study
This paper from the British Dental Journal describes a study to monitor the presentation and management of dental emergencies at 5 hospital trusts in the UK. The burden of dental emergency presentation should be anticipated and planned for during lockdown periods and warrants a restructuring of emergency dental service provision.

(01/05/2021) Postponed Dental Visits During the COVID-19 Pandemic and Their Correlates. Evidence From the Nationally Representative COVID-19 Snapshot Monitoring in Germany (COSMO)
The initial few months of the COVID-19 pandemic resulted in decreased use of dental services in Germany. Results from this study published in Healthcare identified that more than one out of 5 individuals postponed a dental visit. Several correlates of these postponed visits were identified, which may inform dental care providers of individuals at risk for deterioration of oral health exacerbated by postponed dental visits.

(01/05/2021) SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges
Evidence suggests that patients diagnosed with COVID-19 experience several oral health symptoms. This scientific review, published in the Journal of Clinical Medicine, provides an updated source of information about SARS-CoV-2/COVID-19 and its effects on oral health care.

(01/03/2020) Pediatric Dental A&E Service During the COVID-19 Pandemic in the Greater London Area
This paper, published in the European Archives of Pediatric Dentistry, describes a Pediatric dental A&E service during the first lockdown that utilized a telephone triage system. While telephone consultations and digital photographs were useful for screening patients, this paper also discusses factors that limit provision of care utilizing tele-dentistry.

(12/29/2020) Trends in US Outpatient Antibiotic Prescriptions During the COVID-19 Pandemic
Published for the Infectious Diseases Society of America, this paper discusses trends in US outpatient antibiotic prescriptions during the COVID-19 pandemic. Data indicates antibiotic prescriptions decreased from January 2020 to May 2020, and included antibiotic agents used for dentistry.

(12/29/2020) Clinical Response to COVID-19 and Utilization of an Emergency Dental Clinic in an Academic Institution
This paper published in the Journal of Endodontics, describes the response of an emergency dental clinic at the Tufts University School of Dental Medicine (TUSDM) during the initial peak surge in COVID-19 cases in Massachusetts and the provision of emergency dental care during a pandemic.

(12/28/2020) Implementation of Photographic Triage in a Pediatric Dental, Orthodontic, and Maxillofacial Department During COVID‐19
Published in the International Journal of Pediatric Dentistry, this paper describes a photographic triage system that was initiated at Alder Hey Children’s Hospital to facilitate continued assessment of dental, orthodontic, and maxillofacial emergencies.

(12/18/2020) The Importance of COVID-19 Vaccination for Healthcare Personnel
Following the recommendations from the Advisory Committee on Immunizations Practices (ACIP), the CDC recommended healthcare personnel be among those offered the first doses of the COVID-19 vaccine which include dentists, dental hygienists, and assistants.

(12/11/2020) Beyond Re-emergence: Pediatric Dentistry Practice Checklist
This American Academy of Pediatric Dentistry (AAPD) resource is a continually updated page connecting users to the latest information on infection prevention and control practices to help pediatric dentists stay as safe as possible while caring for children during the pandemic. Presented in categories created for ease of use, the Beyond Re-emergence practice checklist offers information that is vital to safety in pediatric dentistry during COVID-19 and beyond with topics like operating room access, in-office testing, and vaccination.

(12/11/2020) School Dental Programs Still Face Challenges
School-based oral health programs (SBOHPs) provide a vital service to children who have limited access to health services outside the school. The COVID-19 pandemic has exacerbated this issue as a result of school closures. This report from the DentaQuest Partnership for Oral Health Advancement and Association of State and Territorial Dental Directors (ASTDD) discusses SBOHPs and challenges faced as a result of the COVID-19 pandemic.

(12/11/2020) The COVID-19 Pandemic and Dentistry: The Clinical, Legal and Economic Consequences – Part 1: Clinical
This paper published in the British Dental Journal discusses the clinical, legal, and economic consequences of the COVID-19 pandemic on dentistry. While the full effect of the disruption to dentistry is likely to be substantial, the paper discusses the immediate future, as well as longer-term permanent changes.

(12/3/2020) Dental Challenges and the Needs of the Population During the Covid-19 Pandemic Period. Real-Time Surveillance Using Google Trends
This paper published in the International Journal of Environmental Research and Public Health aims to understand the dental challenges and needs of the population during the COVID-19 pandemic. Data has identified greater dental needs in the population in the post-pandemic period and the importance of considering teledentistry programs in preparation for future pandemic outbreaks.

(11/25/2020) Pivoting Dental Practice Management During the COVID-19 Pandemic—A Systematic Review
This systematic review published in Medicina identifies additional infection control measures being implemented globally and evaluates the psychological impacts of the COVID-19 pandemic on dental professionals. The review highlights the importance of evidence-based safety practices required to help dental professionals make important and informed safety decisions.

(11/23/2020) Patients With Detectable SARS-CoV-2 IgG Antibody are Noninfectious
It is important for dentists to know patient’s infectivity status as it determines the provision of oral health care. This scientific paper, published in the British Dental Journal concludes that patients with a positive SARS-CoV-2 IgG antibody test are non-infectious (>99% certainty) and can be safely treated with good precautions.

(11/21/2020) Prosthodontic Principles in Dental Implantology: Adjustments in a Coronavirus Disease-19 Pandemic-Battered Economy
The COVID-19 pandemic has had an impact on dental care providers and dental offices. This publication discusses adjustments that may need to be met to encourage patients to invest in implant treatment.

(11/17/20) Incidence of COVID-19 Virus Transmission in 3 Dental Offices: A 6-Month Retrospective Study
This publication describes a study conducted over a 6-month period (March 15 to September 15, 2020) in 3 different dental offices in New York, that aimed to determine the incidence of COVID-19 virus transmission in those practices. By utilizing appropriate infection control guidance, the 3 dental offices were able to record no transmission of COVID-19 to healthcare workers or patients during the study period.

(11/15/2020) The Influence of 2020 Coronavirus Lockdown on Presentation of Oral and Maxillofacial Trauma to a Central London Hospital in Response to the COVID-19 Pandemic
This paper describes the effect the lockdown had on oral and maxillofacial surgical trauma presentations during the pandemic. Analyzing how the flow of emergency referrals for dental infection have been managed can inform and improve patient management pathways in the future.

(11/13/2020) How Did COVID-19 Impact on Dental Antibiotic Prescribing Across England?
Antibiotic resistance is the result of unnecessary antibiotic use. This paper describes how restricted access to dental care as a result of the COVID-19 pandemic resulted in higher antibiotic prescribing.

(11/19/2020) Re-emergence: A Report on Pediatric Dental Practice Re-entry Into Practice During the COVID-19 Pandemic
This report published by the American Academy of Pediatric Dentistry (AAPD) assesses the COVID-19 pandemic’s impact on pediatric dental care. The report is based on survey data during the first wave of the COVID-19 pandemic.

(11/12/2020) Who Is Caring for the Oral Health of Dependent Institutionalized Elderly During the COVID‐19 Pandemic?
The COVID-19 pandemic has exacerbated oral health challenges in care homes. This editorial in the British Journal of Gerodontology discusses the urgent need of re-establishing oral health care delivery for the dependent elderly.

(11/11/2020) Effect of COVID-19 Lockdown on Dental Care of Patients: A Survey Analysis
This scientific paper published in the International Journal of Research and Review describes the effects the COVID-19 lockdown had on routine dental care and evaluated patient willingness for teledentistry. The paper concludes that age and gender are not barriers to acceptance of teledentistry and can be used for facilitation of dental care.

(11/01/2020) Responding to a Pandemic: Development of the Carolina Dentistry Virtual Oral Health Care Helpline
This original contribution to the Journal of the American Dental Association describes the Carolina Dentistry Virtual Oral Health Care Helpline, established for consultation and triage for people with oral health questions and concerns, aimed at preventing unnecessary in-person care.

(10/30/2020) HPI Poll: Urban Dentists Reporting Lower Patient Volume Than Rural Dentists
Since March 23, 2020, ADA’s Health Policy Institute has been conducting a biweekly poll on economic conditions during the pandemic. According to data from the poll from October 19, dentists practicing in 20 of the largest US cities reported lower patient volume than those practicing in rural and/or smaller urban areas.

(10/21/2020) Patient Perceptions About Professional Dental Services During the COVID-19 Pandemic
This publication describes a study that aimed to identify patient perceptions of risk susceptibility and attitudes toward COVID-19 in a dental setting. As patients’ confidence to return to regular dental visits may be influenced by certain conditions and events, this study sought to identify that information, so consistent public health messaging can be used to target susceptible populations and work to address their fears of contracting the virus.

(10/16/2020) Infographics: National Findings on Health Centers’ Response to COVID-19
To determine health centers’ response to COVID-19, the Health Resources and Services Administration (HRSA) has been surveying health centers weekly. In addition to identifying if health centers are meeting testing needs in their communities, there is information on turn-around times for COVID-19 test results, and issues with personal protective equipment (PPE) access are identified.

(10/15/2020) ADA Study Finds COVID-19 Rate Among Dentists Less Than 1%
A survey conducted by the ADA in June 2020 determined that fewer than 1% of dentists nationwide were estimated to be COVID-19 positive. The sample size of 2,195 dentists included dentists from every state and Puerto Rico.

(10/14/2020) Dentists Are Facing Difficulties in Recruiting Dental Team Members During Recovery
A recent poll conducted by the ADA Health Policy Institute identified recruiting dental team members as a challenge. As of October 5, approximately 99% of dental offices in the US were open, however staffing was at approximately 93% of pre-COVID-19 levels.

(10/12/2020) New ADA Toolkit Offers Guidance for Providing COVID-19 Testing in Dental Practices
In response to expressed interests by dentists, the ADA released a toolkit to help dentists apply for federal certification required to offer their patients rapid response, point-of-care COVID-19 testing.

(10/02/2020) Vaccine Allocation Framework Identifies Dentists as Essential
This article describes the recommendation made at the National Academies panel (tasked with drafting the framework to inform decisions about how to allocate the initial supply of the vaccine through its Committee on Equitable Allocation of the Vaccine for the Novel Coronavirus), affirming that dentists should have early access to a vaccine.

(09/29/2020) Dentists’ Knowledge, Attitudes, and Professional Behavior Toward the COVID-19 Pandemic
This paper published in The Journal of the American Dental Association examines dentists’ knowledge, attitudes, and professional behavior toward COVID-19. There were 1,251 survey respondents from 49 countries, allowing for a broader analysis of dentists’ perspectives from around the world.

(09/28/2020) Managing the Oral Health of Cancer Patients During the COVID-19 Pandemic: Perspective of a Dental Clinic in a Cancer Center
Published in a special issue of the Journal of Clinical Medicine titled, ‘Impact of COVID-19 on the Dental Community’, this article describes how a dental clinic in a comprehensive cancer center, was able to continually provide medically necessary and urgent dental care, through the timely adaptation of clinical workflows and guidelines to ensure risk of transmission remained low.

(09/28/2020) Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic
This resource discusses a study conducted in May/June 2020, which describes the characteristics of US adults who delayed dental care due to the COVID-19 pandemic. The nationally representative survey sample identified that nearly half of the respondents reported delaying going to the dentist or seeking dental care as a result of the COVID-19 pandemic.

(09/14/20) Oral Health Value Based Care: The Federally Qualified Health Center (FQHC) Story
ADA informs about a new value-based model of care for federally qualified health centers (FQHCs). The National Association of Community Health Centers and DentaQuest partner to describe the role of FQHCs as part of the dental safety net in the US. Two critical questions are addressed: 1) Should FQHCs move toward value-based payments and care during a pandemic, and 2) How can FQHCs adapt toward valued oral health care delivery as a result of COVID-19.

(09/03/20) Fact Sheet: Service Use Among Medicaid & CHIP Beneficiaries Age 18 and Under During COVID-19
The Centers for Medicare and Medicaid Services releases data on the impact of COVID-19 on the service utilization for children age 18 and under enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). The data covers many key domains including dental services

(09/01/20) COVID-19 Forces New Approaches to Delivering Oral Health Care
This article published by the National Conference of State Legislatures discusses the importance of new approaches to delivering oral health care with a focus on coverage and access to teledentistry, reaching the underserved, and preventive care for children.

(08/31/20) Clarifying the WHO Guidance on Dental Care During COVID-19: An Interview With Dr. Julie Hawley
An interview with Dr. Julie Hawley, the director of analytics and evaluation at the DentaQuest Partnership for Oral Health Advancement, clarifies a misreading of the World Health Organization’s recent COVID-19 dental guidance.

Resource references WHO Interim Guidance published on 8/3/2020: Considerations for the Provision of Essential Oral Health Services in the Context of COVID-19

(08/26/20) COVID-19 Vaccine Prioritization: Work Group Considerations
A presentation on work group considerations for COVID-19 vaccine prioritization to ensure equity in vaccine allocation and distribution.

(08/25/20) Best Practices for Infection Control in Dental Clinics During the COVID-19 Pandemic
Prepared by the Organization for Safety, Asepsis, and Prevention (OSAP), this best practices resource guide was developed as a compilation of current regulations, guidance, and practice tips aimed at establishing an infection control plan.

(08/15/20) COVID-19 Is an Opportunity for Reform in Dentistry
A correspondence discussing the COVID-19 pandemic as an opportunity for reform in dentistry, including delineating the role of dental personnel in an integrated model of care and re-orienting dental care towards a less invasive and more preventive approach.

(08/14/20) Is There an Upside to COVID-19 for Dentistry?
This commentary guest editorial, published in the Journal of the American Dental Association, discusses opportunities for furthering dentistry. These include providing added layers of safety for patients and staff, technology-assisted patient interactions, and acknowledging dentistry’s essential role in overall health care.

(08/12/20) From the Factory to the Frontlines – The Operation Warp Speed Strategy for Distributing a COVID-19 Vaccine
This report to Congress discusses the Operation Warp Speed (OWS) strategy for quickly distributing a COVID-19 vaccine.

(08/12/20) American Dental Association Responds to World Health Organization Recommendation: Dentistry Is Essential Health Care
A statement by the American Dental Association disagreeing with the World Health Organization’s recommendation to delay ‘routine’ dental care in certain situations due to COVID-19.

Resource references WHO Interim Guidance published on 8/3/2020: Considerations for the Provision of Essential Oral Health Services in the Context of COVID-19

(08/10/20) ADA Board of Trustees: Dentistry Is Essential Health Care
This article describes an interim policy adopted by the American Dental Association Board of Trustees, stating that oral health is an integral component of systemic health, and dentistry is an essential health care service.

(08/07/20) COVID-19 and Dentistry: Challenges and Opportunities for Providing Safe Care
An article published on the Patient Safety Network (of the Agency for Healthcare Research and Quality), identifies the challenges and opportunities for providing safe care in dentistry.

(08/04/20) Guidance for Dental Settings
Published by the Centers for Disease Control and Prevention, this regularly updated “Guidance for Dental Settings” consists of infection prevention and control guidance for dental settings during the COVID-19 pandemic. This guidance consists of recommendations for routine care and recommendations for patients with suspected or confirmed cases of COVID-19.

(07/27/20) Dental and Doctors’ Offices Still Struggling with COVID Job Loss
A California Healthline article discussing dental office employment trends as affected by COVID-19. From February to April, the number of dental office employees in California decreased by approximately 60%, higher than the nation-wide decrease (of dental employment) of 56%.

(05/06/20) Recommendations for the Re-Opening of Dental Services: A Rapid Review of International Sources
Compiled recommendations for the reopening of dental services identified from 17 guidance documents from 16 countries produced March 11-18, 2020.