RESUMEN
BACKGROUND: The Affordable Care Act of 2010 increased dental coverage for children in the United States, (U.S.) but not for adults. Few studies in current scholarship make use of up-to-date, nationally representative data to examine oral health disparities in the U.S. POPULATION: The purpose of this study is to use nationally representative data to determine the prevalence of untreated caries among children and adults of different socioeconomic and racial/ethnic groups and to examine the factors associated with untreated caries among children and adults. METHODS: This study used the 2011-2014 National Health and Nutrition Examination Survey (NHANES) demographic, oral health questionnaire, and oral health dentition examination data (n = 7008 for children; n = 9673 for adults). Participants that had a standardized oral health examination and at least one natural primary or permanent tooth considering 28 tooth spaces were included in this study. Our main outcome measure was untreated coronal caries defined as decay on the crown or enamel surface of a tooth that had not been treated or filled. Population estimates were calculated to determine the prevalence of untreated caries among children and adults in the United States. Frequencies and Pearson's chi-square tests were used to compare those with and without untreated caries. Multivariate logistic regression models were used to evaluate the factors associated with untreated caries. We conducted analyses among children and adults separately. RESULTS: From 2011 to 2014, 12.4 million children and 57.6 million adults in the United States had untreated caries. Age, family income level, recent dental visit, and financial and non-financial barriers were significantly associated with untreated caries in both children and adults. Race/ethnicity, gender and education level were also significantly associated with untreated caries among adults. The odds of untreated caries associated with financial barriers were 2.06 for children and 2.84 for adults while the odds of untreated caries associated with non-financial barriers were 2.86 for children and 1.67 for adults. CONCLUSIONS: Demographic and socio-economic disparities in untreated caries exist among children and adults.
Asunto(s)
Caries Dental/epidemiología , Disparidades en Atención de Salud/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Distribución de Chi-Cuadrado , Niño , Preescolar , Atención Odontológica/estadística & datos numéricos , Caries Dental/terapia , Femenino , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Grupos Raciales/estadística & datos numéricos , Factores Socioeconómicos , Estados Unidos , Adulto JovenRESUMEN
OBJECTIVE: To estimate premium and out-of-pocket costs for child dental care services under various dental coverage options offered within the federally facilitated marketplace. STUDY DESIGN: We estimated premium and out-of-pocket costs for child dental care services for 12 patient profiles, which vary by dental care use and spending. We did this for 1039 medical plans that include child dental coverage, 2703 medical plans that do not include child dental coverage, and 583 stand-alone dental plans for the 2015 plan year. Our analysis is based on plan data from the Center for Consumer Information and Insurance Oversight and Data.HealthCare.Gov. RESULTS: On average, expected total financial outlays for child dental care services were lower when dental coverage was embedded within a medical plan compared with the alternative of a stand-alone dental plan. The difference, however, in average expected out-of-pocket spending varied significantly for our 12 patient profiles. Older children who are very high users of dental care, for example, have lower expected out-of-pocket costs under a stand-alone dental plan. For the vast majority of other age groups and dental care use profiles, the reverse holds. CONCLUSIONS: Our results show that embedding dental coverage within medical plans, on average, results in lower total financial outlays for child beneficiaries. Although our results are specific to the federally facilitated marketplace, they hold lessons for both state-based marketplaces and the general private health insurance and dental benefits market, as well.
Asunto(s)
Atención Odontológica/economía , Gastos en Salud/estadística & datos numéricos , Cobertura del Seguro/economía , Seguro Odontológico/economía , Niño , Atención Odontológica Integral/economía , Bases de Datos Factuales , Femenino , Humanos , Seguro/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Seguro Odontológico/tendencias , Seguro de Salud/organización & administración , Masculino , Evaluación de Necesidades , Patient Protection and Affordable Care Act/economía , Muestreo , Estados UnidosRESUMEN
Periodontal disease has been linked to poor glycemic control among individuals with type 2 diabetes. Using integrated dental, medical, and pharmacy commercial claims from Truven MarketScan® Research Databases, we implement inverse probability weighting and doubly robust methods to estimate a relationship between a periodontal intervention and healthcare costs and utilization. Among individuals newly diagnosed with type 2 diabetes, we find that a periodontal intervention is associated with lower total healthcare costs (-$1799), lower total medical costs excluding pharmacy costs (-$1577), and lower total type 2 diabetes-related healthcare costs (-$408). © 2016 The Authors. Health Economics Published by John Wiley & Sons Ltd.
Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Revisión de Utilización de Seguros/estadística & datos numéricos , Enfermedades Periodontales/complicaciones , Bases de Datos Factuales , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Costos de la Atención en Salud , Humanos , Hipoglucemiantes/economía , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
BACKGROUND: Dental care is extremely costly and beyond most people means in developing countries. The primary aim of this study was to determine the impact of out-of-pocket payments for dental care on household finances in 40 low and middle income countries. A second aim was to compare the burden of payments for dental care with that for other health services. METHODS: We used data from 174,257 adults, aged 18 years and above, who reported their total and itemized household expenditure in the past four weeks as part of the World Health Surveys. The financial burden on households was measured using the catastrophic health expenditure (CHE) and impoverishment approaches. A household was classified as facing CHE if it spent 40% or more of its capacity to pay, and as facing impoverishment if it fell below the country-specific poverty line after spending on health care was subtracted from household expenditure. The odds of experiencing CHE and impoverishment due to expenditure on dental care were estimated from two-level logistic regression models, controlling for various individual- and country-level covariates. RESULTS: Households that paid for dental care had 1.88 (95% Confidence Interval: 1.78-1.99) greater odds of incurring CHE and 1.65 (95% CI: 1.52-1.80) greater odds of facing impoverishment, after adjustment for covariates. Furthermore, the impact of paying for dental care was lower than that for medications or drugs, inpatient care, outpatient care and laboratory tests but similar to that of health care products, traditional medicine and other health services. CONCLUSION: Households with recent dental care spending were more likely to use a large portion of their disposable income and fall below the poverty line. Policy makers ought to consider including dental care as part of universal health care and advocate for the inclusion of dental care coverage in health insurance packages.
Asunto(s)
Atención Odontológica/economía , Países en Desarrollo/estadística & datos numéricos , Financiación Personal/economía , Gastos en Salud/estadística & datos numéricos , Pobreza/economía , Adulto , Composición Familiar , Femenino , Salud Global/economía , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana EdadRESUMEN
If trends continue, the majority of U.S. dental students will soon be women. However, there is little empirical analysis examining gender differences in the labor supply of dentists and the potential effects on the dental care sector. We help fill this data void by examining differences in dentists' hours worked by gender, how this has changed over time and the potential implications for the current and future aggregate labor supply of dentists in California.
Asunto(s)
Odontología/tendencias , Odontólogas/provisión & distribución , Admisión y Programación de Personal/estadística & datos numéricos , Adulto , California , Selección de Profesión , Femenino , Predicción , Humanos , Persona de Mediana Edad , Carga de TrabajoRESUMEN
BACKGROUND: The Affordable Care Act included a dependent coverage policy that extends parents' or guardians' health insurance to adults aged 19-25. This policy does not apply directly to private dental benefits. However, for various reasons it could still have an indirect "spillover" effect if employers voluntarily expand dental coverage in conjunction with medical coverage. OBJECTIVE: To assess the effect of the Affordable Care Act's dependent coverage policy on private dental benefits coverage, utilization, and financial barriers to dental care. RESEARCH DESIGN: Difference-in-differences models were used to measure the association between the dependent coverage policy and private dental benefits coverage, utilization, and financial barriers to dental care. We analyze 2008-2012 National Health Interview Survey data, comparing results in 2011 and 2012 with results from 2008 to 2010 (prereform period). SUBJECTS: Adults aged 19-25 were compared with adults aged 26-34. MEASURES: Private dental benefits coverage, dental care utilization, and financial barriers to obtaining needed dental care. RESULTS: Relative to the prereform period, private dental benefits coverage among adults aged 19-25 increased by 5.6 percentage points in 2011 (P<0.001) and 6.9 percentage points in 2012 (P<0.001) compared with adults aged 26-34. Dental care utilization among adults aged 19-25 increased by 2.8 percentage points in 2011 (P=0.062) and 3.3 percentage points in 2012 (P=0.038) compared with adults aged 26-34. Adults aged 19-25 experienced a 2.1 percentage point decrease in 2011 (P=0.068) and a 2.0 percentage point decrease in 2012 (P=0.087) in financial barriers to dental care compared with adults aged 26-34. CONCLUSIONS: The dependent coverage policy was associated with an increase in private dental benefits coverage and dental care utilization, and a decrease in financial barriers to dental care among young adults aged 19-25.
Asunto(s)
Atención Odontológica/estadística & datos numéricos , Seguro Odontológico/estadística & datos numéricos , Patient Protection and Affordable Care Act/legislación & jurisprudencia , Adulto , Femenino , Investigación sobre Servicios de Salud , Humanos , Seguro Odontológico/legislación & jurisprudencia , Masculino , Adulto JovenRESUMEN
OBJECTIVES: We estimated short-term health care cost savings that would result from oral health professionals performing chronic disease screenings. METHODS: We used population data, estimates of chronic disease prevalence, and rates of medication adherence from the literature to estimate cost savings that would result from screening individuals aged 40 years and older who have seen a dentist but not a physician in the last 12 months. We estimated 1-year savings if patients identified during screening in a dental setting were referred to a physician, completed their referral, and started pharmacological treatment. RESULTS: We estimated that medical screenings for diabetes, hypertension, and hypercholesterolemia in dental offices could save the health care system from $42.4 million ($13.51 per person screened) to $102.6 million ($32.72 per person screened) over 1 year, dependent on the rate of referral completion from the dental clinic to the physician's office. CONCLUSIONS: Oral health professionals can potentially play a bigger role in detecting chronic disease in the US population. Additional prevention and monitoring activities over the long term could achieve even greater savings and health benefits.
Asunto(s)
Enfermedad Crónica/economía , Odontólogos , Costos de la Atención en Salud/estadística & datos numéricos , Adulto , Enfermedad Crónica/epidemiología , Enfermedad Crónica/prevención & control , Enfermedad Crónica/terapia , Ahorro de Costo/economía , Ahorro de Costo/estadística & datos numéricos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/economía , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/tratamiento farmacológico , Hipercolesterolemia/economía , Hipercolesterolemia/epidemiología , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Hipertensión/economía , Hipertensión/epidemiología , Masculino , Tamizaje Masivo/economía , Tamizaje Masivo/métodos , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , Derivación y ConsultaRESUMEN
Over the course of the past twenty years, private equity (PE) has played a role in acquiring medical practices, hospitals, and nursing homes. More recently, PE has taken a greater interest in acquiring dental practices, but few data exist about the scope of PE activity within dentistry. We analyzed dentist provider data for the period 2015-21 to examine trends in PE acquisition of dental practices. The percentage of dentists affiliated with PE increased from 6.6 percent in 2015 to 12.8 percent in 2021. During this period, PE affiliation increased particularly among larger dental practices and among dental specialists such as endodontists, oral surgeons, and pediatric dentists. PE-affiliated dental practices were more likely to participate in Medicaid than practices not affiliated with PE. Future research should investigate whether PE's role in dentistry affects the affordability and quality of dental services.
Asunto(s)
Odontólogos , Humanos , Estados Unidos , Odontólogos/estadística & datos numéricos , Medicaid/estadística & datos numéricos , Sector Privado , Práctica Privada/estadística & datos numéricosRESUMEN
BACKGROUND: While international literature on rural retention is expanding, there is a lack of research on relevant strategies from pluralistic healthcare environments such as India, where alternate medicine is an integral component of primary care. In such contexts, there is a constant tug of war in national policy on "Which health worker is needed in rural areas?" and "Who can, realistically, be got there?" In this article, we try to inform this debate by juxtaposing perspectives of three cadres involved in primary care in India-allopathic, ayurvedic and nursing-on rural service. We also identify key incentives for improved rural retention of these cadres. METHODS: We present qualitative evidence from two states, Uttarakhand and Andhra Pradesh. Eighty-eight in-depth interviews with students and in-service personnel were conducted between January and July 2010. Generic thematic analysis techniques were employed, and the data were organized in a framework that clustered factors linked to rural service as organizational (salary, infrastructure, career) and contextual (housing, children's development, safety). RESULTS: Similar to other studies, we found that both pecuniary and non-pecuniary factors (salary, working conditions, children's education, living conditions and safety) affect career preferences of health workers. For the allopathic cadre, rural primary care jobs commanded little respect; respondents from this cadre aimed to specialize and preferred private sector jobs. Offering preferential admission to specialist courses in exchange for a rural stint appears to be a powerful incentive for this cadre. In contrast, respondents from the Ayurvedic and nursing cadres favored public sector jobs even if this meant rural postings. For these two cadres, better salary, working and rural living conditions can increase recruitment. CONCLUSIONS: Rural retention strategies in India have predominantly concentrated on the allopathic cadre. Our study suggests incentivizing rural service for the nursing and Ayurvedic cadres is less challenging in comparison to the allopathic cadre. Hence, there is merit in strengthening rural incentive strategies for these two cadres also. In our study, we have developed a detailed framework of rural retention factors and used this for delineating India-specific recommendations. This framework can be adapted to other similar contexts to facilitate international cross-cadre comparisons.
Asunto(s)
Actitud del Personal de Salud , Selección de Profesión , Terapias Complementarias , Personal de Salud/psicología , Servicios de Salud Rural , Estudiantes de Medicina/psicología , Adulto , Femenino , Humanos , India , Masculino , Persona de Mediana Edad , Política Organizacional , Sector Privado , Sector Público , Investigación Cualitativa , Servicios de Salud Rural/organización & administración , Salarios y Beneficios , Encuestas y Cuestionarios , Recursos Humanos , Adulto JovenRESUMEN
Low utilization of dental services among low-income individuals and racial minorities reflects pervasive inequities in U.S. health care. There is limited research determining common characteristics among dentists who participate in Medicaid or the Children's Health Insurance Program. Using detailed Medicaid claims data and a provider database, we estimate that among dentists with 100 or more pediatric Medicaid patients, 48% practice in high-poverty areas, 10% practice in rural areas, and 29% work in large practices (11 or more dentists). Among those with zero Medicaid patients, 18% practice in high-poverty areas, 4% practice in rural areas, and 11% work in large practices. We found that dentist race/ethnicity has an independent effect on Medicaid participation even when adjusting for community characteristics, meaning non-White dentists are more likely to treat Medicaid patients, regardless of the median income or racial/ethnic profile of the community.
Asunto(s)
Accesibilidad a los Servicios de Salud , Medicaid , Estados Unidos , Niño , Humanos , Etnicidad , Renta , OdontólogosRESUMEN
OBJECTIVE: To examine the factors that account for differences in dentist earnings between White and minoritized dentists. DATA SOURCES: We used data from the American Dental Association's Survey of dental practice, which includes information on 2001-2018 dentist net income, practice ZIP code, patient mix between private and public insurance, and dentist gender, age, and year of dental school graduation. We merged the data on dentist race and ethnicity and school of graduation from the American Dental Association masterfile. Based on practice ZIP code, we also merged the data on local area racial and ethnic composition from the American Community Survey. STUDY DESIGN: We used a linear Blinder-Oaxaca decomposition to assess observable characteristics that explain the gap in earnings between White and minoritized dentists. To assess differences in earnings between White and minoritized dentists at different points of the income distribution, we used a re-centered influence function and estimated an unconditional quantile Blinder-Oaxaca decomposition. DATA EXTRACTION METHODS: We extracted data for 22,086 dentists ages 25-85 who worked at least 8 weeks per year and 20 hours per week. PRINCIPAL FINDINGS: Observable characteristics accounted for 58% of the earnings gap between White and Asian dentists, 55% of the gap between White and Hispanic dentists, and 31% of the gap between White and Black dentists. The gap in earnings between White and Asian dentists narrowed at higher quantiles of the income distribution. CONCLUSIONS: Compared to other minoritized dentists, Black dentists have the largest earnings disparities relative to White dentists. While the level of the explained component of the disparity for Black dentists is comparable to the explained part of the disparities for other minoritized dentists, the excess percentage of the unexplained component for Black dentists accounts for the additional amount of disparity that Black dentists experienced. Persistent income disparities could discourage minoritized dentists from entering the profession.
Asunto(s)
Odontólogos , Renta , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Odontólogos/economía , Etnicidad , Hispánicos o Latinos/estadística & datos numéricos , Renta/estadística & datos numéricos , Estados Unidos/epidemiología , Blanco/estadística & datos numéricos , Grupos Minoritarios/estadística & datos numéricos , Asiático/estadística & datos numéricos , Negro o Afroamericano/estadística & datos numéricos , Economía en Odontología/estadística & datos numéricos , Factores Económicos , Minorías Étnicas y Raciales/estadística & datos numéricosRESUMEN
Training, service delivery, and financing are done separately in dentistry and general health care, which has influenced reimbursement structures, access to services, and outcomes. This article considers how medical and dental separation exacerbates health inequity and canvasses data demonstrating that oral health and dental services are the least affordable health services. This article also proposes how dental and general medical care coverage can be meaningfully integrated through better health policy to motivate health equity.
Asunto(s)
Política de Salud , Accesibilidad a los Servicios de Salud , Atención Odontológica , Servicios de Salud , Humanos , Salud BucalRESUMEN
BACKGROUND: There is little published research on whether public and private dental benefits plans affect the types of oral health care procedures patients receive. This study compares the dental procedure mix by age group (children, working-age adults, older adults), dental benefits type (Medicaid and Children's Health Insurance Program, private), and level of Medicaid dental benefits by state (emergency only, limited, extensive). METHODS: The authors extracted public dental benefits claims data from the 2018 Transformed Medicaid Statistical Information System. To compare procedure mix with beneficiaries who had private dental benefits, the authors used claims data from the 2018 IBM MarketScan dental database. The authors categorized dental procedures into specific service categories and calculated the share of procedures performed within each category. They analyzed procedure mix by age, plan type (fee-for-service, managed care), and adult Medicaid benefit level. RESULTS: Aside from orthodontic services, the dental procedure mix among children with public and private benefits is similar. Among adults with public benefits, surgical interventions make up a higher share of dental procedures than routine preventive services. CONCLUSIONS: Children with public benefits have a procedure mix comparable with those with private benefits. There are substantial differences in procedure mix between publicly and privately insured adults. Even in states that provide extensive dental benefits in Medicaid, those programs primarily finance invasive surgical treatment as opposed to preventive treatment. PRACTICAL IMPLICATIONS: There is a need to assess best practices in publicly funded programs for children and translate those attributes to programs for adults for more equitable benefit design and care delivery across public and private insurers.
Asunto(s)
Planes de Aranceles por Servicios , Medicaid , Anciano , Niño , Atención Odontológica , Accesibilidad a los Servicios de Salud , Humanos , Salud Bucal , Estados UnidosRESUMEN
OBJECTIVE: Postgraduate dental (PGD) primary care training has grown significantly. This study examines the individual, educational, community, and policy factors that predict practice patterns of PGD-trained dentists. STUDY DESIGN: Individual dentist records from the 2017 American Dental Association Masterfile, with indicators of Medicaid participation and practice in a Federally Qualified Health Center (FQHC), were linked to postdoctoral training, community/practice location, and state policy factors. Generalized logistic models, adjusted for these factors, were used to predict PGD-trained dentists: (1a) serving Medicaid children, (1b) accepting new Medicaid patients, and (2) working in an FQHC. RESULTS: Individual attributes that predicted serving Medicaid children included all race/gender combinations (vs. White females), and foreign-trained dentists and contractors/employees/associates (vs. practice owners). Black women are most likely to work in an FQHC. Residency attributes that predicted serving Medicaid children and working in an FQHC were Health Resources and Services Administration postdoctoral funding and being community based. Dentists practicing in rural or high-poverty communities were more likely to serve Medicaid children and work at FQHCs. States with higher levels of graduate medical education investment, higher Medicaid rates, and more generous adult dental Medicaid benefits increased the likelihood of serving Medicaid children, while states with more expansive adult dental Medicaid benefits increased the likelihood of working in an FQHC. CONCLUSION: Federal training investment in PGD education combined with Medicaid payment and coverage policies can strongly impact access to dental care for vulnerable populations. Yet, oral health equity cannot be achieved without increasing dentist workforce diversity.
Asunto(s)
Selección de Profesión , Odontólogos , Educación de Posgrado en Odontología , Pautas de la Práctica en Odontología , Competencia Cultural , Diversidad Cultural , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Estados UnidosRESUMEN
OBJECTIVE: This study examines the individual, educational, and policy factors that predict dentists pursuing postgraduate dental (PGD) training. METHODS: Individual dentist records from the 2017 American Dental Association Masterfile were linked with pre-doctoral training attributes and state-level dental policy factors. Generalized logistic models, adjusted for individual, educational, and policy factors, were used to predict: (1) attending any PGD program, and (2) primary (i.e., advanced general practice, pediatrics, or dental public health, per the Health Resources and Services Administration [HRSA]) versus specialty care. RESULTS: The majority of new PGD residency slots (77%) were in primary care. Women held 56% of primary care slots; men held 62% of specialty slots. Individual characteristics that predicted PGD primary care training included being Black, Hispanic, Asian, or other race; being male or older age reduced the odds. Pre-doctoral school characteristics that predicted PGD primary care training included having a pre-doctoral HRSA grant, affiliation with an academic medical center, and being a historically Black college/university; being a private school or in a small metro area lowered the odds. At the policy level, the strongest predictors of attending PGD primary care training are a residency requirement in the state you currently practice in and federal graduate medical education (GME) investment per residency slot. CONCLUSION: Pursuing PGD training is variable based on the race/ethnicity/gender of the dentist. Federal investments in pre-doctoral dental education and GME can drive equity, as they significantly increase the odds that dentists will go on to PGD training, as do state licensure requirements.
Asunto(s)
Educación de Posgrado en Odontología , Internado y Residencia , Educación de Posgrado en Odontología/tendencias , Femenino , Humanos , Masculino , Estados Unidos , United States Health Resources and Services AdministrationRESUMEN
In the two decades between Oral Health in America: A Report of the Surgeon General and Oral Health in America: Advances and Challenges much good happened but intractable challenges persist. Inequity in oral health status, utilization, and access to care continue to negatively affect the health and economic wellbeing of Americans and their families, local, state, and federal health care systems, and American society overall. To move the nation forward, we argue that: more emphasis is needed in prevention; access to care must be improved to mitigate inequity; newer understandings of oral disease must be leveraged in the service of health and health care; the value that oral health brings to economic wellbeing must be elucidated; better policy choices must be made in all of the above; and more effective oral health care leaders in driving policy change must be trained.
Asunto(s)
Enfermedades de la Boca , Salud Bucal , Atención a la Salud , Predicción , Política de Salud , Accesibilidad a los Servicios de Salud , Humanos , Salud Pública , Estados UnidosRESUMEN
Purpose: The SARS-CoV-2 virus continues to mutate, and the COVID-19 pandemic remains a global health crisis. The purpose of this longitudinal study was to continue to analyze the use of infection prevention and control practices (IPC) and personal protective equipment (PPE) by dental hygienists in the United States (US) during the COVID-19 pandemic.Methods: Web-based surveys on COVID-19 related health, IPC, and PPE were administered monthly to a panel of US licensed dental hygienists (n=6,976) from September 2020 to August 2021. Trends over time and predictors of IPC and PPE use were estimated using Stata 17.0 xt commands and multilevel multivariable logistic regression. Linear regression modeling for trends in time and tests for changes in trends were conducted (Joinpoint Regression Program, Version 4.9.0.0).Results: Almost all practicing dental hygienists (99.9%, 14,926 observations) reported COVID-19 specific IPC in place at their primary dental practice. Consistently >96% of dental hygienists reported operatory disinfection and staff masking over the study period. Patient face masking and physical protections such as barriers or air filtration increased in use over time, then declined in spring 2021. Screening or interviewing patients before appointments, checking patient temperatures before treatment, checking staff temperatures at shift start, disinfecting frequently touched surfaces, and encouraging distance between patients were reported by >85% of respondents until March 2021, at which point significant decreases were observed. Wearing a mask or respirator and eye protection during patient care consistently rose over time from September 2020 (77.1%) to August 2021 (81.4%). Always wearing a N95 or equivalently protective respirators during aerosol generating procedures peaked in 2/2021 and declined thereafter. Dental practice setting, supply of respirators, COVID-19 vaccination, and COVID-19 community transmission level were significantly associated with IPC and PPE use.Conclusion: Most US dental hygienists reported always wearing masks and eye protection during patient care and a variety of IPC types have been instituted to reduce the risk of COVID-19 transmission in dental practice settings. However, the use of N95 or equivalent respirators and some additional IPC methods declined during 2021.