Dental safety net providers’ experiences with COVID-19 year one service delivery should inform dental pandemic preparedness

Abstract Background COVID-19 disrupted dental service delivery and revealed gaps in dental pandemic emergency preparedness and response (PHEPR). Emerging dental PHEPR frameworks can be strengthened by understanding the experiences of the discipline’s frontline workers—dental safety net providers—during the initial phase of the COVID-19 pandemic. Methods Experienced qualitative researchers interviewed safety net dental directors and clinicians (n=21) in six states to understand their experiences delivering services between March 2020 and February 2021. Interview transcriptions were analyzed using iterative codes to identify major and minor themes. Conventional qualitative validity checks were continuously utilized to ensure impartiality and rigor. Results Three major themes were identified. (1) Unpredictability caused concerns among staff and patients, while also deepening fulfilling collaborations. (2) Service delivery was guided by various resources that balanced safety, flexibility, & respect for autonomy. (3) Pandemic-driven changes to oral health service delivery are timely, long-lasting, and can be somewhat fraught. Conclusions The human, material, and policy resources that providers used to control infections, serve vulnerable patients, maintain clinic solvency, and address provider burnout during COVID-19 pandemic year one can improve dental PHEPR. Practical Implications Dental PHEPR should address concerns beyond infection control within and between practice models, governmental agencies, and professional organizations. Examples of such concerns include, but are not limited to guideline synchronization, materials exigencies, task-shifting, and provider resilience.