Dental Insurance and Treatment Patterns at a Not-For-Profit Community Dental Clinic.

ABSTRACT

OBJECTIVES: To examine patient demographics, distance traveled and dental-related treatment provided according to type of dental insurance at a large, not-for-profit community dental clinic (CDC) in Vancouver, Canada. METHODS: Using electronic dental records, we assessed the use of private and government-sponsored (public) dental insurance at the CDC in 2014 and 2015 at the appointment and procedure levels. Study variables included patient demographics, distance traveled, type of treatment provided, type of dental insurance and cost of treatment. RESULTS: Examination of records from 9524 appointments involving 16 639 procedures revealed that 44% (4190 appointments) were made by patients with private insurance and 31.4% (2995) by those with public insurance. Patients with private dental insurance were 1.27 times more likely (p < 0.001) to have restorative treatment than those with public-sponsored dental insurance. Procedures involving tooth extraction were 14.2 times more likely (p < 0.001) to be performed in patients with public insurance than those with private insurance. CONCLUSIONS: Access does not equal equity; although the CDC enables access by various populations, its ability to provide equitable treatment is compromised by external factors. CDCs may have a vital role in oral health equity; however, dental treatment continues to be dictated by financial reimbursement.