Study finds dentists in research network do not discriminate

Case examines preventive dental practices

Regardless of race, private practice dentists do not discriminate in services they provide their patients, according to a new study from Case Western Reserve University's School of Dental Medicine.

The report is among findings from nine research projects and one public policy statement that Case's dental faculty and students will present during the annual meeting of the American Association of Dental Research and the American Dental Education Association in Orlando, Fla., March 8-11 based on research being done with practicing dentists of the Ohio Dental Practice Based Research Network.

The findings are from the first analyses of observational data from a major study, funded by the National Institute of Health and the National Institute of Dental and Craniofacial Research, to discover what happens in dental practices and how private practice dentists and dental hygienists counsel patients in ways to prevent dental diseases.

Other dental schools working with similar networks are New York University, the University of Washington (Seattle) and the University of Alabama at Birmingham.

Dentists, who primarily work in isolation from each other, receive little or no feedback from their peers.

One aspect of this study provides information to help dentists see how their individual practices compare to other dental professionals in the study.

Examining information gathered through observations, patient charts and insurance billings, Case researchers confirm that the people visiting private dentists are generally middle class and have attained some higher education.

In the study, more African Americans have dental insurance, but all dental patients end up paying "out of the pocket" for approximately 50 percent of the dental costs, according to Dr. Stephen Wotman, Case professor of dentistry and the lead investigator on $2.5 million study. Approximately 8% of the patients from Ohio Dental Practice Research Network study are African American.

The Case researchers visited and collected data from 120 practices in a dental research network established by the Case dental school in 1998 to have access to what dentists actually do in their practices. Researchers reviewed the practices of 124 dentists and 128 hygienists during 3,400 patient visits. The data was collected between June 2004 and September 2005.

"Preventive counseling is the major method by which people learn self care and self care can prevent the majority of dental disease," said Wotman.

According to a 2000 U.S. Surgeon General Report, some 70 percent of dental disease can be prevented through an individual's efforts to brush, floss, conduct self examinations for oral cancers and stop using tobacco products.

How this information reaches the patient is a concern for the profession.

"We believe that at the high end of preventive counseling there is a 'champion' in the office," said Wotman.

He added that from observations it usually is the hygienist, but when the hygienist and dentist battle dental disease together, the patient wins.

One of the nine studies found that a prevention procedure was performed in 78.1% of the hygienist visits compared to 14.4% of the dentist visits and prevention counseling was done in 87.7% of hygiene visits compared to 28.7% of dentists' visits.

Many people find visiting the dentist stressful, with 65% of the patients feeling some level of anxiety.

One study examined how dentists and hygienists make their patients comfortable. Some of those strategies include distractions in the office environment, verbal reassurances and relaxation techniques. The researchers reported that all dentists use some form of comfort-giving with their patients.

In April, Case will host two educational sessions where every dentist and hygienist in the study will receive a written report about their preventive practices and see how they compare to the average of all professionals in the study.

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Case Western Reserve University is among the nation's leading research institutions. Founded in 1826 and shaped by the unique merger of the Case Institute of Technology and Western Reserve University, Case is distinguished by its strengths in education, research, service, and experiential learning. Located in Cleveland, Case offers nationally recognized programs in the Arts and Sciences, Dental Medicine, Engineering, Law, Management, Medicine, Nursing, and Social Work. http://www.case.edu.


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