Racial and ethnic variation in the provision of dental procedures

Objectives: Most of the available information on racial/ethnic disparities in oral health is based on differences in sociodemographic variables related to dental disease burden, dental visits, and access to care. However, very little is known regarding racial/ethnic variation in the provision of dental procedures. This study examined trends in the provision of dental procedures and sought to determine whether there are racial/ethnic differences in the provision of dental procedures. Methods: This is a retrospective observational study of patients treated at a dental training institution. Data for all patients 18 to 60 years of age in axiUm (electronic database) for 2001 to 2003 were analyzed. Data include demographic information, poverty status, insurance coverage, dental procedure, and race/ethnicity. Separate logistic regression models (by dental procedure category and year) were fitted while considering race/ethnicity, insurance coverage, poverty status, marital status, and age as possible covariates. Results: The total number of dental procedures completed by providers increased by 14,000 between 2001 and 2003. African-Americans were significantly less likely to have restorative procedures [odds ratio (OR): 0.60, 95 percent confidence interval (CI): 0.42 to 0.86], (OR: 0.52, 95 percent CI: 0.38 to 0.73), (OR: 0.46, 95 percent CI: 0.36 to 0.58) in 2001, 2002, and 2003, respectively, than the White population. Significant differences in the use of other dental procedures (prosthodontics - removable) and oral surgery procedures by race/ethnicity were observed. Conclusions: Substantial racial/ethnic variation in the provision of dental procedures exists. This study presents findings beyond anecdotal information on racial/ethnic variation in the provision of dental procedures and requires further research to compile more detailed data.