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4 of the Biggest Challenges Nonprofit Clinics Face After COVID

It’s fair to say that few businesses have been spared the ill effects of the COVID-19 economic shutdown. Some have suffered more severe financial hits than others, including dental practices. However, imagine if the financial success of your dental practice or small business relied mostly on the benevolence of people who will never benefit from your services and the low reimbursement rates of Medicaid. Would your business be open if that were the case?

While the measures taken to prevent the spread of the coronavirus have taken their toll on businesses across the board, nonprofit dental clinics have been much more extensively impacted–and will continue to be for the foreseeable future. Here are four ways members of our Dental Resource Program (DRP) have been disproportionately burdened by the pandemic:

1. The steep costs of reopening.

(Several have not reopened due to costs.)

At the dawn of the pandemic many of our DRP members stepped up to help by donating the PPE they had on hand to local hospitals, only to discover months later that the extra PPE they need to reopen safely is in short supply.

Dr. Romina from Kids Community Dental Clinic in Burbank, California donates PPE to their local hospital in March.

Safety-net clinics that offer treatment to patients at free or reduced cost are accustomed to operating on a shoestring budget. But the additional supply costs and reduced capacity are pushing those tight budgets to the point of snapping. “PPE costs to reopen are staggering as well as the time and resources needed to clean the clinic and operatories after every patient,” one of our members from Missouri reported. For-profit dental offices may simply pass those costs along to the patient, but this is not an option for clinics serving low-income patients who are either uninsured or count on state-funded programs to pay for care. 

“Our expenses have increased due to COVID-19 and will continue to increase. We have had to purchase personal protective equipment at triple our normal rate. Additionally, we expect to spend at least $285,000 on implementing temporary telehealth. As we plan to re-open services, we anticipate additional costs as well.”

– One of our DRP member clinics based in California

What we’re doing to help: We are striving to provide relief to operating budgets by procuring donated products for our members. Before the shutdown our generous donors had provided more than one million dollars in donated dental products and equipment, greatly impacting the number of children who receive care through our DRP members. Since July, America’s ToothFairy has distributed more than $140,000 worth of products, but more is required to help kids who’ve been waiting months for treatment they desperately need. (Get more information about donating product here.)

2. An increase in emergency (and more expensive) treatment.

With many clinics shut down for months or only accepting urgent patients to keep them out of emergency rooms, the condition of patients in need of care worsened. “What were two surface cavities in February turned into pulpotomies or root canals and crowns by June,” another clinic told us. To make matters worse, Medicaid often only provides coverage for extraction in such cases, resulting in sub-par care for kids from low-income families.

What we’re doing to help: With support from donors, we can offer financial support to help clinics provide care for children whose treatment costs more than their families can afford. To sponsor the care of a child, click here to make a donation.

3. Reduction in staff and changes in operations.

At a time when more families are facing financial hardship and need the help of human service organizations, experts are estimating that as many as one-third of charities may not survive the next year. In order to save their programs and remain available to children in need in the years to come, many of our member clinics are making painful cuts to their operational budgets and staff. One of our members told us they had to lay off 19 employees, while others have reduced their hours of operation.

How you can help: Volunteer at a clinic in your community. Dental professionals are especially needed, but front office, clerical and custodial workers could also be a big help to stretch operational budgets. Our Dental Resource Program members are listed by city and state here, but any safety-net clinic, whether they are a member of our program or not, could benefit from extra help.

4. Community outreach is nearly impossible.

The children who need dental services the most often face transportation barriers, shortages in care providers, and lack the oral health literacy needed to seek routine dental care. Before COVID our DRP members overcome those challenges through mobile and school-based services, and community outreach at events like health fairs. Unfortunately, the restrictions imposed in most areas make services like these nearly impossible to provide. As a result, children miss out on essential preventive services and clinics lose another revenue stream.

“As a school-based clinic, all services stopped as schools closed. Dental pain did not stop, however as dental offices closed.”

– One of our DRP member clinics based in California

What we’re doing to help: Our mission is dual-focused: increasing access to dental care, and providing education about the importance of prevention. Since the onset of the pandemic we have intensified our focus on education in an effort to prevent the pain and suffering that often accompanies tooth decay:

• In April we launched a new Resources Page on our website, which makes all of our educational materials free to download for health educators and parents alike.

• Since July we’ve distributed more than 58,000 toothbrushes to organizations that can reach kids in need so that, even if they can’t get in to see the dentist, at least they have the basic tools they need for preventive care. (Our Smile Drive campaign is in full swing, but volunteers are needed to keep that momentum going. Visit SmileDrive.org to learn how you can help.)

• With support from DentaQuest, we’ve invited kids to learn about proper dental hygiene habits and win rewards through our Oral Health Action HERO Challenge. This campaign will run at various times throughout the year and doubles as a public service awareness campaign as participants share what they’ve learned through online videos.

• We’ve hosted online workshops to train non-dental volunteers on how to use our ToothFairy 101® Community Education Kit in order to provide oral health education to families in their area.


The pandemic has not made life easier for anyone, but we all must look for ways to help those who’ve been more profoundly impacted and provide support for organizations that can truly help those in need. We encourage everyone who believes in our mission to ensure that every child can have a healthy smile to make a donation to support our work, or visit our Get Involved page to find the best way for you to make a difference for kids in need!

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