Going to the dentist may drill a hole in your pocketbook as well as your teeth. A growing number of dental practices across the nation are adding a $10 to $20 surcharge to cover the extra costs of personal protection equipment and air purifiers for their offices. As dentists resume services put on hold during the pandemic, they face new infection control requirements that could lead to higher costs — and perhaps less access — for patients.

According to NBC News, dentists said they are financially struggling after most states shut down their practices for any service except emergency care during March and April. They added that the pandemic also forced them to see fewer patients to keep waiting rooms uncrowded.

The American Dental Association agreed to the extra infection control fee as long as dentists informed their patients upfront about the charge. The ADA said, at this time, it’s easier to implement a set fee than have insurance companies increase their reimbursement rate.

However, the ADA has asked insurance companies and other third-party payers to adjust their reimbursement fees to accommodate “the increasing cost of personal protective equipment that dentists are using to protect themselves, their staff and patients.”