Impact of the COVID-19 Pandemic on the Provision of Dental Care by the Public Dental Services of Cyprus

Background: During 2020 dentists were included in the group of health professionals that were directly affected by the pandemic. This study aimed to capture the impact of the pandemic in the provision of dental care through the Public Dental Services (PDS) of Cyprus in 2020 and 2021 (during pandemic) compared to 2019 (pre pandemic). More specifically, it examined the consequences in the number of visits, the average number of patients per day, the proportion of new patients to the total number of visits, and the type of services provided.

Methodology: Statistical data from the PDS were analyzed with the help of SPSS2.

Results: Cyprus PDS statistics show a national decline in the number of visits of 41.3% in 2020 compared to 2019 (p < 0.01) and a further decline of 9.6% in 2021 (compared to 2020). The decline in the average number of patients per day (37.6%) in 2019-21 was less than the decline in the average number of visits (47.0%). Similarly, there was a 34.7% decrease in work volume (p < 0.01) between 2019 and 2020 and a further 2.8% decrease in 2021. These decreases were not consistent both between different types of centres and between different districts.

In terms of treatments offered nationwide, the largest decrease in 2020 was in dental scaling (53.5%), followed by dental examinations (47.9%), composite fillings (47.5%) and amalgam (45.4%). The share of the most affected dental treatment (scaling, examination, composite and amalgam) in the total workload has decreased from 51% in 2019 to 40% in 2020 (p < 0.01). The least affected dental work in 2020 was temporary fillings, which increased by 6.6%. In 2021, the profile of care provision changed as there was an increase in composite fillings, up 45.7% compared to 2020 (p<0.01), while all other types of dental work continued to decline. The share of the most affected dental treatments (scaling, examination, composite and amalgam) in the total workload increased (from 40% in 2020 to 43.9% in 2021), but still significantly lower than in 2019 (pre-pandemic - 51%). Interestingly, the share of extractions in total workload increased from 16.6% in 2019 to 21.5% in 2021.

Conclusion: The COVID-19 pandemic and the subsequent restrictive measures imposed had a negative impact on the provision and seeking of dental care by the PDS. The decline in the frequency of dental visits, if sustained over a longer period of time and not reversed, will have a negative impact on the level of oral health of people living in Cyprus and will increase the unmet need for dental care. The increase in extractions is expected to have a negative impact on the level of oral health, as it is the most radical dental treatment and the need for prosthetic rehabilitation will also increase. In addition, the economic impact of COVID-19 and the global economic instability, which has reduced family incomes, is expected to drive more patients to the public sector, where fees are quite low, adding to already burdened waiting lists. People with lower socio-economic status are expected to bear the highest burden, which will increase oral health inequalities.