Variations in Self-Reported Provision of Services by General Dentists in Private Practice

Despite a focus on preventive care, dentists still spend more time filling cavities than preventing them, according to this article by Center Director of Research Nadereh Pourat in the Journal of the American Dental Association. Pourat and co-author Marvin Marcus used a 2003 survey of general dentists in private practice in California to assess the amount of time dentists spent providing different services and found that preventive care was the third most frequently performed activity by primary care dentists after operative (fillings, etc.) and prosthodontic (bridges, dentures) care. After accounting for multiple differences in practice, including employment of hygienists, those most likely to spend more time on preventive care include female dentists, those dentists with fewer publicly insured patients, as well as dentists practicing in Northern California. The authors note that some of these differences may be because patients don't ask for preventive care or have more complex needs. Yet, the state (and nation's) continued economic doldrums may lead dentists to gravitate away from low-cost preventive care and towards more lucrative procedures. Health care reform's emphasis on prevention may prove an opportunity to expand the availability of preventive care by mid-level providers and in settings other than the dental practice, including schools. It is also time to rethink financial and quality-related incentives to promote delivery of such care. ​