Identifying children who will experience high caries increments.

An 18-month longitudinal study of 197 5 to 18-yr-old children was conducted to assess the performance of multiple baseline variables in predicting which children would experience high increments of caries. Nine predictors were assessed; DMFS and defs scores, number of permanent teeth, indices of fissure retentiveness and occlusal morphology, S. mutans and lactobacilli levels, and sex and race. Discriminant analyses were applied to data for children in five age groups to identify the 30% who would have the largest 18-month DMFS increments. Prediction performance was assessed by comparisons with the actual high increment group, defined as those children with increments in the upper quartiles of the DMFS distributions within age groups. The analyses predicted between 56% and 91% of actual high increment children depending on age group. The children identified in the analyses experienced between 59% and 91% of the disease experienced by the actual high increment groups.

Patient response to participation in a quality review program conducted in private dental offices.

A sample of largely well-educated affluent, and youthful dental patients drawn from 11 private dental offices participated in a quality assurance project that included clinical review examinations conducted at a special appointment. More than 90% of patients were willing to participate at no cost to them, and examinations were conducted on 225 patients. Attitudinal measurements were taken on all the patients both before and after their involvement. Patients responded well to this mechanism. Patients responded well to this mechanism of quality assurance and expressed increased trust and confidence in their dentists' care after experiencing reviews. Issues concerning the confidentiality of dental records were addressed. Of the participants, approximately 75% believed clinical examinations by visiting dentist/examiners would increase the quality of American dentistry. Generally, patients were willing to have the examinations repeated periodically, although few were willing to pay for this review. The potential for quality assurance to increase patient confidence in dental care was verified.