Dental Tribune International

Is PPE the new gold and who is paying for it?

More than half of U.S. dentists are absorbing added PPE costs during the SARS-CoV-2 pandemic and the higher overheads are affecting wages and salaries, new hiring and investment in dental equipment. (Image: Ronnachai Palas/Shutterstock)
By Jeremy Booth, DTI
July 14, 2020

HOLLY RIDGE, N.C., U.S.: Recent comparisons between the value of personal protective equipment (PPE) and the value of gold have raised some interesting questions, such as whether the SARS-CoV-2 pandemic has caused consumers to value their health more than they value rare minerals or status symbols. The monetary value of PPE is still nowhere near that of gold, but the provision of essential services, such as oral care, now hinges on its supply. Many dentists are absorbing added PPE costs in order to keep patient numbers up, but at whose expense?

Demand for PPE has risen exponentially since March and continues to rise as cases of COVID-19 surge in the Americas. The price of the raw materials that are used to make it has also increased. In some instances, such as in the manufacture of gowns, manufacturers are reporting difficulties even in sourcing the required raw materials. The principles of market economics dictate that PPE prices could have only gone one way in the pandemic—up.

Many U.K. dentists, who have only recently begun returning to work, are reportedly passing the bill for PPE on to patients. According to a June 28 story in The Telegraph, national U.K. dental chain mydentist is charging patients an additional £35 (€39) for dental treatments that require aerosol-generating procedures. For more routine dental work, a fee of £7 is being charged. For patients who are covered by the country’s National Health Service, the government is picking up the bill. Some dentists who are absorbing the additional costs themselves are said to be operating at a loss.

Half of U.S. dental clinics expect to absorb higher PPE costs

A number of dental practices in Onslow County in North Carolina are passing added PPE costs on to patients, some of whom have expressed bewilderment at the extra charge. According to NewsChannel 12, the extra fee covers more than just masks and gloves.

“The reality is, there’s a lot of extra things we have to do because of COVID” – Dr. Michael Riccobene, dental practice owner

Local dental practice owner Dr. Michael Riccobene told the television station in July that a $10.00 (€8.83) fee was being charged to patients at White Dental in Holly Ridge. The fee is aimed at covering the heightened cost of $5 per N95 mask and additional expenditure related to preventing the spread of the virus in dental settings. “The reality is, there’s a lot of extra things we have to do because of COVID […] We’re worried about aerosols throughout the office, so we’ve installed air scrubbers which literally recycle the air five times an hour throughout the office,” Riccobene explained.

On average, U.S. dentists are spending $11.10 more per patient on PPE than they were before the pandemic. This was the finding of a June 25 survey by Baird Equity Research, which asked dentists around the country about their PPE costs and supplies. The highest additional PPE cost of $26 per patient was reported by 4% of practices, and 14% reported that they were spending an additional sum of between $16–$20. A quarter of practices said that they were spending between $11 and $15 more per patient, and 36% were spending between $6 and $10 more.

More than half (54%) of the dentists surveyed said that they expected to absorb the higher PPE costs themselves, 18% said that they would consider insurance to cover them, and 26% said that they would pass the costs on to patients.

Analysts at Baird commented that PPE costs appeared to be beginning to stabilize, but they expressed concern about the added costs. “We’ve not heard too many examples of the former (higher insurance reimbursement for added PPE costs) working, and we’ve heard some patients have complained about the latter (directly billing the patient for added PPE costs), leading us to believe most practices will likely end up absorbing much of these added costs.”

Most U.S. dentists switching to lower-priced PPE amid pandemic

Reading between the lines, what the analysts seem to be hinting at is that half of U.S. dentists are opting to absorb the extra costs, and that the other half may have little choice.

So how will absorbing these extra costs affect dental practices? In the survey, 52% of dentists said that it would cause them to switch to lower-priced PPE suppliers, and more than half (55%) said that they would reduce their spending on dental equipment; 43% said that they would switch to lower-priced consumables and almost one in ten (9%) indicated that higher PPE costs would lead to a reduction in wages or salaries. New hiring at their clinics would be slowed or stopped for 28% of the respondents as a result of the higher PPE costs, and 37% said that they would postpone plans to expand or remodel their dental offices.

Even if patients are not directly charged for the PPE that is required for their dental treatment, they may be paying in other ways, such as by receiving oral care of a lower quality owing to the restraints that the added costs are putting on dental clinics.

Editorial note: Ninety-one dentists from across the U.S. participated in the Baird survey; 93% of them were general dentists and the remaining 7% were specialists. Of the respondents, 54% worked in a single-dentist practice and 46% in a multidentist practice.

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