Provision of Specific Dental Procedures By General Dentists
The field of dentistry is undergoing substantial changes that are relevant to the range of services that general dentists (GDs) provide. These include the changing picture of dental economics and dental care utilization, demography of patient populations, the scope of practice, changing delivery models, access to care, and an increased interest in the relationship between oral health and general health. One vision for the future of general dentistry is that it serves as a segue into the health care system at large, offering an opportunity to monitor, refer, or treat both oral health and general medical conditions. In that vision, GDs function in a primary care role, and the comprehensiveness of the procedures that GDs provide takes on additional significance.
GDs assume a dual role as providers of primary oral health care and as gatekeepers who refer patients to specialists. In 1996, about 81% of all dental visits in the United States were provided by GDs. Nonetheless, a study of Michigan children's Medicaid claims data found that about 20% of dentists only provided diagnostic and preventive services for their Medicaid patients, meaning that for these children Medicaid coverage was not a segue into comprehensive primary dental care that included restorative care. Most dental extractions are provided by GDs, especially among lower-income patients. Most non-surgical periodontal care is provided in GDs' offices, and increases in demand for periodontal services are being met mainly by GDs, not periodontists. As long as they are capable of providing the service to the standard of care, GDs substitute for a specialist's care, instead of complementing it, which has economic and delivery system implications.
Decisions made to treat or refer may be a means for GDs to adapt to changing economic demand and the needs of their patient population. It is known that characteristics of the patient population that the GD serves can substantially influence the specific types of services provided. An Australian study led to the conclusion that dental service rates are influenced by a large number of small effects from a wide range of dentist, practice, and patient factors. A few studies have identified certain dentist characteristics as being associated with provision of endodontic, periodontal, and oral surgical services. However, little is known about how commonly GDs provide directly a comprehensive range of procedures, or about factors associated with this provision. Therefore, our objectives were to: (1) determine whether and how often GDs provide specific dental procedures; and (2) test the hypothesis that provision is significantly associated with key dentist, practice, and patient population characteristics.
Background
The field of dentistry is undergoing substantial changes that are relevant to the range of services that general dentists (GDs) provide. These include the changing picture of dental economics and dental care utilization, demography of patient populations, the scope of practice, changing delivery models, access to care, and an increased interest in the relationship between oral health and general health. One vision for the future of general dentistry is that it serves as a segue into the health care system at large, offering an opportunity to monitor, refer, or treat both oral health and general medical conditions. In that vision, GDs function in a primary care role, and the comprehensiveness of the procedures that GDs provide takes on additional significance.
GDs assume a dual role as providers of primary oral health care and as gatekeepers who refer patients to specialists. In 1996, about 81% of all dental visits in the United States were provided by GDs. Nonetheless, a study of Michigan children's Medicaid claims data found that about 20% of dentists only provided diagnostic and preventive services for their Medicaid patients, meaning that for these children Medicaid coverage was not a segue into comprehensive primary dental care that included restorative care. Most dental extractions are provided by GDs, especially among lower-income patients. Most non-surgical periodontal care is provided in GDs' offices, and increases in demand for periodontal services are being met mainly by GDs, not periodontists. As long as they are capable of providing the service to the standard of care, GDs substitute for a specialist's care, instead of complementing it, which has economic and delivery system implications.
Decisions made to treat or refer may be a means for GDs to adapt to changing economic demand and the needs of their patient population. It is known that characteristics of the patient population that the GD serves can substantially influence the specific types of services provided. An Australian study led to the conclusion that dental service rates are influenced by a large number of small effects from a wide range of dentist, practice, and patient factors. A few studies have identified certain dentist characteristics as being associated with provision of endodontic, periodontal, and oral surgical services. However, little is known about how commonly GDs provide directly a comprehensive range of procedures, or about factors associated with this provision. Therefore, our objectives were to: (1) determine whether and how often GDs provide specific dental procedures; and (2) test the hypothesis that provision is significantly associated with key dentist, practice, and patient population characteristics.
SHARE
