ABSTRACT Background The degree to which children experience unmet need for dental care during the COVID-19 pandemic, and its association with pandemic-related household job or income loss, is unknown Methods The authors performed a cross-sectional household survey of 348 families in Pittsburgh, PA during the week June 25 to July 2, 2020 Unmet need for child dental care and pandemic-related household job or income loss were assessed using caregiver self-report Results Caregivers reported that the greatest unmet child health care need during the COVID-19 pandemic was dental care (16 %) followed by medical care for a well visit or vaccination (5 %) Approximately 40% of caregivers reported job loss or a decrease in household income due to the COVID-19 pandemic We found a significant association between the probability of unmet child dental care and pandemic-related household job or income loss (P= 022) Losing a job or experiencing a decrease in income due to the COVID-19 pandemic was associated with unmet child dental care (Relative Risk , 1 77; 95% confidence interval , 1 08 to 2 88) Conclusions In our sample, three times as many households reported unmet dental care for a child compared to unmet medical care Unmet child dental care was more common in households where pandemic-related job or income loss occurred Practical Implications If unmet dental care continues as a result of the COVID-19 pandemic, non-traditional strategies for delivering dental care can be considered to improve access to dental care for children, such as teledentistry and oral health prevention services in primary care settings