There are many concerns globally as it relates to the impact on the business of the dental practice. This is also being driven by the patient’s ability to pay, be reimbursed or service provided by municipal /government contract. It may also drive treatment planning decisions by the patient in collaboration with the dental professional.
With continued hotspots globally the dental practice business may continue to face or see higher infection risk for patients and staff(1). To help mitigate the risk the practice of dentistry may need to be modified(2). Results could lead to complications with long term impact(3). However there seems to be reason that Covid-19 can be tamed by vaccination or become less pathogenic and virulent in future(4). The impact on dental treatment approaches makes Teleorthodontics(5), Telemedicine(6) and Teledentistry(7) viable. This includes conducting triage by phone(8,9) or other communication apps(10). Sixty One percent of all treatment plans/protocols appear to be revised/amended(11). In Germany treatment utilization has been reduced by the following: 80% preventive, 76% periodontics, and 70% prothetics(12). Revisions to treatment not only involves aerosol reduction techniques but also infection control practices and procedures to mitigate aerosols(13,14,15,16,17). In addition, immunocompromised patients may not be allowed to receive what would be considered elective dental treatment18). Preventive oral health care is to be postponed for Covid 19 patients for 28 days from onset of symptoms(18). Children should be treated as if they were carriers(19). The short-term impact of a decline in dental care spending by 66% in 2020 and possibly 32% in 2021 is projected in the USA by the American Dental Association’s Health Policy Institute(20). Most dentists in the USA are reporting a decline in volume of their collections by 5%(20,21). The economic impact have been seen and most likely will increase(22).
 Lo Giudice R. The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) in Dentistry. Management of Biological Risk in Dental Practice. Int J Environ Res Public Health. 2020 Apr 28;17(9). pii: E3067. doi: 10.3390/ijerph17093067.
 Ather A, Patel B, Ruparel NB, Diogenes A, Hargreaves KM. Coronavirus Disease 19 (COVID-19): Implications for Clinical Dental Care. J Endod. 2020 May;46(5):584-595. doi: 10.1016/j.joen.2020.03.008.
 Maspero, C.; Abate, A.; Cavagnetto, D.; El Morsi, M.; Fama, A.; Farronato, M. Available Technologies, Applications and Benefits of Teleorthodontics. A Literature Review and Possible Applications during the COVID-19 Pandemic. J Clin Med 2020; 9: 1891.
 Giudice A, Barone S, Muraca D, Averta F, Diodati F, Antonelli A, Fortunato L. Can Teledentistry Improve the Monitoring of Patients during the Covid-19 Dissemination? A Descriptive Pilot Study. Int J Environ Res Public Health. 2020 May 13;17(10). pii: E3399. doi: 10.3390/ijerph17103399.
 Ahmed MA, Jouhar R, Ahmed N, Adnan S, Aftab M, Zafar MS, Khurshid Z. Fear and Practice Modifications among Dentists to Combat Novel Coronavirus Disease (COVID-19) Outbreak. Int J Environ Res Public Health. 2020 Apr 19;17(8). pii: E2821.
 Ge ZY, Yang LM, Xia JJ, Fu XH, Zhang YZ. Possible aerosol transmission of COVID-19 and special precautions in dentistry. J Zhejiang Univ Sci B. 2020 May;21(5):361-368. doi: 10.1631/jzus.B2010010.
PMID: 32425001; PubMed Central PMCID: PMC7089481.