Practice patterns among male and female general dentists in a Washington State population.

BACKGROUND: Women make up about 14 percent of general dentists in the United States, and the proportion is projected to exceed 29 percent by 2020. METHODS: The authors obtained dental benefits claims data from the Washington Dental Service (WDS), Seattle, and used them to examine the practice patterns of 265 women and 1,947 men engaged in general dentistry for at least 26 days in 2001. Practice variables of interest included age, days worked, procedures performed and total income from WDS reimbursements and patient copayments. The number, age and sex of patients treated also were obtained. Using productivity data, the authors also estimated the potential impact of an increase in the percentage of female dentists in the state. RESULTS: The authors found no differences between male and female dentists in the number of procedures per patient, income per patient or income per day of work. Frequency distributions of various services were highly similar for both groups. Multiple regression models showed no influence of dentist's sex on total income. However, the mean and median numbers of days worked were about 10 percent lower for female dentists than for male dentists. This difference was consistent with the finding that female dentists treated approximately 10 percent fewer patients, performed about 10 percent fewer procedures and had a combined income of about 10 percent less than that of male dentists. CONCLUSION: Practice patterns of male and female dentists generally were equivalent in this WDS population. CLINICAL IMPLICATIONS: Female and male dentists provided a similar range of services and earned an equal income per patient treated and per day worked. However, women worked fewer days per year than did men, irrespective of age. If the dental work force and practice patterns remain unchanged otherwise, the total number of patients treated per dentist will decrease slightly as women make up an increasing proportion of dentists.

Patterns of oral care in a Washington State dental service population.

BACKGROUND: The authors compare patterns of oral health care reported by the Washington Dental Service, or WDS, Seattle, in 1993 and 1999 to assess changes in patient populations, practice characteristics, procedures and treatment costs in the state. METHODS: Data were obtained from dental benefits claims from a population of about 1.25 million people. Variables of interest included patient age and other demographic information, character of dental practice, dental procedures and treatment costs that combined WDS payment and patient copayment. RESULTS: The results showed high agreement (97 percent) between the database and randomly surveyed patient records. For both 1993 and 1999, general dental offices were responsible for more than 80 percent of patient care. Single crowns (21 percent), restorative services (15 percent) and dental prophylaxis (13 percent) made up about half of the costs of dental care. Broad categories of service were similar in 1993 and 1999, and anticipated major declines in restorative procedures related to caries were not apparent. The mix of services varied considerably by patient age and between generalists and specialists in both years. CONCLUSIONS: Patterns of oral health care among this insured patient population largely remained unchanged from 1993 to 1999, with some shifts in specific procedures and specialty care. During this period, dentists saw more patients and performed fewer treatments per patient, while total treatment costs per patient increased. CLINICAL IMPLICATIONS: Patterns of oral health care in the United States are projected to undergo major changes linked to improved oral health, declining trends in caries and periodontal diseases, scientific advances in treatment approaches and a patient population that is living longer. Changes in care patterns during this six-year period may reflect patient and provider preferences, as well as the influence of reimbursement policies. Dental benefits databases can serve as a critical resource for monitoring such changes.

Patterns of oral care in dental school and general dental practice.

This study compared patterns of oral care provided by predoctoral dental students for patients seeking treatment at the University of Washington (UW) with patterns reported for general dental offices by the Washington Dental Service (WDS). Dental care included about 5 million services provided to 880,317 patients by 2,803 WDS general dentists and about 45,600 dental services provided to 9,488 patients by 155 UW dental students during 1999. There was high fidelity between databases and randomly surveyed patient records for treatment provided in both UW (95 percent) and WDS (97 percent) populations. While patient age patterns were generally similar, UW students completed more procedures for young children and for adults older than seventy-four years but completed fewer procedures for age groups of from thirteen to eighteen and from forty-five to fifty-four than general dental offices. The relative mix of all services completed by UW and WDS providers was similar (ANOVA, P=0.82). Within categories of service, the percentage of total services completed by students compared to those submitted by community dentists to WDS was about the same for examinations, radiographs, fluoride and sealants, amalgams, composites, single crowns, and endodontics. The percentage of total procedures completed showed a greater emphasis by UW students on inlays/onlays, dentures, extractions, and periodontal maintenance, and lesser experience with implants, orthodontics, sedation, and emergency procedures than general dental offices. We conclude that the relative distribution of clinical services provided by UW dental students is comparable to those procedures reported to WDS by dental offices in the adjacent community.