CU Anschutz School of Dental Medicine research underscores the ongoing importance of consistent periodontal maintenance for oral and overall health
The COVID-19 pandemic disrupted routine health care in unprecedented ways, forcing providers and patients alike to delay or forgo preventive services. At the University of Colorado Anschutz School of Dental Medicine, those disruptions allowed a team of oral health and informatics researchers to better understand what happens when routine periodontal maintenance is paused, and what those findings mean moving forward.
In a retrospective study, researchers Sangeetha Chandrasekaran, BDS, MS, MS; Neel Shimpi, PhD, BDS, MS; Tonia Carter, PhD, MS, MPhil; Pirin Becker, and Karo Parsegian, DMD, MDSc, PhD; examined the oral health outcomes of 279 patients whose periodontal maintenance therapy (PMT) schedules were interrupted during the pandemic. Their findings offer a clear takeaway: Even temporary gaps in preventive care can lead to measurable declines in oral health.
The takeaway: New research shows that dental appointment interruptions brought on by the COVID-19 pandemic bring a quick decline in oral and overall health. Periodontal disease - affecting half the country in those over 30 - can start slowly with plaque buildup and gingivitis, but can quickly become more serious and cause irreversible damage.
"The longer the patients went without maintenance care, the more their teeth and gums were affected, from increased buildup of bacteria to tooth loss," said Chandrasekaran, professor and chair of the Division of Periodontics at CU Anschutz Dental.
While the pandemic itself has receded, its lessons remain highly relevant, particularly as providers and patients work to reinforce consistent, prevention-focused care habits.
Why Periodontal Maintenance Matters
Periodontal disease affects nearly half of U.S. adults over age 30 and becomes more common with age. It often begins as gingivitis - marked by redness, swelling and bleeding gums - before progressing to periodontitis, a more serious condition that can destroy bone and lead to tooth loss.
"If gum disease isn't treated, it can slowly damage the parts of your tooth and bone that hold your teeth in place, eventually leading to tooth loss," Chandrasekaran said. "This doesn't just affect how your mouth looks, it can also make it harder to chew and speak."
She emphasized, "Gum disease isn't only an oral problem - it is a long-term inflammatory burden in the body. The bacteria and inflammation in your gums can spread and affect other areas."
The connection to systemic health is increasingly well understood. Chronic inflammation linked to periodontal disease may contribute to broader health issues, particularly for individuals with conditions such as diabetes or cardiovascular disease.
For patients with a history of periodontitis, routine maintenance visits - at least every six months, but sometimes every three, as recommended by your dental provider - are essential. These appointments help control bacterial buildup, monitor disease progression, and prevent recurrence.
"The best approach is prevention," Chandrasekaran said. "Regular cleanings and good oral hygiene practices help keep harmful bacteria under control and prevent problems from starting in the first place."
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What the Research Revealed
The study provides real-world evidence of how interruptions affect oral health outcomes. Patients were grouped based on the length of time between pre- and post-pandemic maintenance visits, ranging from one to three years or more.
The most notable finding: longer gaps between visits were significantly associated with increased plaque accumulation - an early but important indicator of declining oral health. However, the study did not find statistically significant short-term changes in clinical attachment loss (CAL) or bleeding on probing (BOP), suggesting that some markers of disease progression may take longer to manifest.
The research also identified patterns in tooth loss during the disruption period. Male patients and current smokers were more likely to lose teeth, while those who had adhered to more frequent maintenance visits before the pandemic experienced a protective effect.
Together, these findings highlight a critical point: Preventive care gaps may first appear in early warning signs like plaque buildup before progressing to more severe, irreversible damage.
Closing the Gap in Preventive Care
Although pandemic-related closures are no longer the primary barrier to care, the study underscores ongoing challenges that continue to affect patient compliance. Busy schedules, cost concerns, lack of insurance and the absence of pain or immediate symptoms often cause patients to delay or skip maintenance visits.
"Since gum disease usually doesn't cause pain until it becomes severe, many people don't feel an urgent need to go to the dentist," Chandrasekaran said.
The pandemic amplified these behaviors, but it also clarified the stakes. Interruptions in care, even when temporary, can set patients back in ways that are both measurable and preventable.
For dental professionals, the findings reinforce the need to prioritize patient education, strengthen recall systems and emphasize the connection between oral health and overall well-being.
For patients, the message is straightforward: maintaining scheduled dental care is not optional - it is essential.
"Regular and uninterrupted visits have an impact on oral health but can also have meaningful impact on overall health," Chandrasekaran said. "The mouth is connected to the rest of the body, and conditions there often affect overall health."
As CU Anschutz Dental continues to advance evidence-based research and clinical care, the study stands as a clear reminder and a call to action. The most effective way to protect long-term oral and overall health is also one of the simplest: show up, consistently, for preventive care.
Key points:
A study showed that interruptions to dental care, brought by the COVID-19 pandemic, had impacts to oral health, especially among smokers and male patients.
Even small interruptions to dental care can increase the risk of complications from periodontal disease.
Periodontal disease affects half of Americans over 30, and increases with age. Good oral hygiene and regular dental visits can help protect both oral and overall health.
