The Impact of COVID-19 on African American Dental Students’ Self-Confidence in Implementing Specific Clinical Treatments

Background/Objectives: Few studies have examined the effects of the COVID-19 pandemic on the clinical readiness of dental students in the provision of care. This study examined whether dental students who graduated during the pre-pandemic period (2019 and before) would have higher self-reported clinical skills confidence than those who graduated during the post-pandemic period (2025 and after) at the only two Historically Black Colleges and Universities (HBCUs) in the United States that teach dentistry. The study hypothesized that the change in educational methods that resulted from the pandemic would result in a reduction in self-reported confidence during the senior year. Methods: A cross-sectional online survey was sent to dental graduates from two Historically Black Colleges and Universities in the United States. The questionnaire included a validated 40-item instrument to measure self-reported confidence during senior year in clinical procedures and questions about relevant demographic variables. Results: In fixed prosthodontics, confidence decreased significantly for tooth preparation, impressions, try-in of ceramic-fused-to-metal restorations, and cementation of fixed prostheses (p < 0.05). Confidence also declined for diagnostic and periodontal procedures, including mucogingival anomaly diagnosis, surgical elimination of periodontal pockets, and management of traumatic dental contacts (p < 0.05). The largest decline was seen in the diagnosis and conservative treatment of oroantral communications and fistulas. Of particular clinical and statistical importance, there were significant reductions in self-confidence in the ability to perform tooth extractions and minor oral surgery in medically compromised patients, tooth extractions with separation of roots, and diagnosis and therapy of acute and chronic dental infections (p < 0.05). Conclusions: The findings provide further evidence of the adverse effect of the COVID-19 pandemic on the African American dental workforce. Given the limited access to care that patients traditionally treated by HBCU dentists have, this study provides evidence that the underserved community may be more adversely affected by the pandemic than previously described.