Non-Hispanic Black (NHB) and Hispanic and low-income US children have a higher prevalence of untreated caries than their higher-income and non-Hispanic White (NHW) counterparts. Due to the COVID-19 pandemic, many dental offices and school sealant programs closed beginning March 2020. We examine the effect of reduced access to restorative care and sealants on the oral health of children from low-income households overall and by race/ethnicity and how increased sealant delivery in September 2022 could mitigate these effects. We used Markov chain Monte Carlo simulation to model COVID-19’s impact on first permanent molar (1M) caries incidence and loss in quality of life (disability-adjusted life years [DALYs]) due to time lived with 1M untreated caries. Our model followed a cohort of children aged 7 y in March 2020 until February 2024. Model inputs were primarily obtained from published studies and nationally representative data. Excess DALYs per 1,000 children attributable to reduced access to care during the pandemic were 1.48 overall and greater for Hispanic (2.07) and NHB (1.75) children than for NHW children (0.94). Excess incidence of 1M caries over 4 y was 2.28 percentage points overall and greater for Hispanic (2.63) and NHB (2.40) children than for NHW (1.96) children. Delivering sealants to 50% of eligible 1Ms in September 2022 would not completely mitigate COVID-19’s health access impact: overall excess DALYs would decrease to 1.05, and absolute disparities in excess DALYs between NHW children and Hispanic and NHB children would remain but decrease by 0.38 and 0.33, respectively. Sealing 40% of eligible 1Ms, however, would bring overall 4-y caries incidence down to pre–COVID-19 levels and eliminate the differential effect of the pandemic on children from minority groups. The pandemic’s negative impact on the oral health of children from low-income households and increased disparities could be partially mitigated with increased sealant delivery.

非西班牙裔黑人 (NHB) 以及西班牙裔和低收入美国儿童患龋齿的患病率高于高收入和非西班牙裔白人 (NHW) 儿童。由于 COVID-19 大流行，许多牙科诊所和学校封闭剂计划从 2020 年 3 月开始关闭。我们研究了减少获得修复性护理和封闭剂对低收入家庭儿童口腔健康的影响，并按种族/族裔和2022 年 9 月增加的密封胶交付量如何减轻这些影响。我们使用马尔可夫链蒙特卡罗模拟来模拟 COVID-19 对第一恒磨牙 (1M) 龋齿发病率和生活质量损失（残疾调整生命年 [DALYs]）的影响，这是由于 1M 未经治疗的龋齿的生存时间。我们的模型在 2020 年 3 月至 2024 年 2 月期间跟踪了一组 7 岁的儿童。模型输入主要来自已发表的研究和具有全国代表性的数据。由于在大流行期间获得护理的机会减少，每 1,000 名儿童的额外 DALYs 总体为 1.48，西班牙裔 (2.07) 和 NHB (1.75) 儿童高于 NHW 儿童 (0.94)。4 年内 1M 龋齿的超额发生率为 2.28 个百分点，西班牙裔 (2.63) 和 NHB (2.40) 儿童高于 NHW (1.96) 儿童。在 2022 年 9 月向 50% 符合条件的 1Ms 提供密封剂不会完全减轻 COVID-19 的健康访问影响：总体超额 DALYs 将降至 1.05，NHW 儿童与西班牙裔和 NHB 儿童之间超额 DALYs 的绝对差异将保持不变，但会减少 0.38和 0.33，分别。然而，密封 40% 的符合条件的 1Ms，将使总体 4 岁龋齿发病率降至 COVID-19 之前的水平，并消除大流行对少数群体儿童的不同影响。大流行病对低收入家庭儿童口腔健康的负面影响和差距的扩大可以通过增加封闭剂的输送来部分缓解。