The Disproportionate Impact of the COVID-19 Pandemic on Preventive Dental Care and Treatment for Children Who Are American Indian: Public Health Surveillance Utilizing School-Based Sealant Program Data

Objectives

School-based dental sealant programs are important in expanding the reach of oral health care to underserved populations. However, data collection during these visits is also valuable for public health surveillance and program planning. This study aimed to utilize these data to identify groups disproportionately impacted by pandemic closures.

Methods

SEAL!ND is a program in North Dakota that serves schools, where 45% or more of students are enrolled in the free and reduced-fee school lunch program. SEAL!ND provides dental screening, application of fluoride varnish and dental sealants, and oral health surveillance. Data are collected for evaluation and to track pediatric oral health. In the spring of 2020, the COVID-19 pandemic and subsequent public health emergency stalled the program and left these children without access to preventive dental services. We examined previous dental visits, untreated decay, treated decay, and early and urgent care need during the 2019–2020, 2020–2021, and 2021–2022 school years. Binomial and multinomial logistic regressions were conducted to examine the odds ratios of the oral health outcomes by race.

Results

The proportion of poor outcomes had noticeably increased for American Indian students compared to White students. There was also increased odds of untreated decay, treated decay, and early and urgent care need for American Indian students compared to White students.

Conclusions

These findings aid in identifying groups of students whose oral health was disproportionately impacted by the disruption in community-based, preventive dental care services during the pandemic for the purpose of future intervention.