Use of and Attitudes Toward Non-Dentist Providers: from The Dental-PBRN

Objectives: To quantify: 1) the current utilization of non-dentist providers; 2) the association between provider and practice characteristics and delegation of tasks to non-dentist providers; 3) dentists’ attitudes toward a new non-dentist provider model (the dental therapist, DT).

Methods:  This study engaged Dental Practice-Based Network (DPBRN; www.DentalPBRN.org) practitioner-investigators in a single, cross-sectional administration of a questionnaire (n=991). Of these 991, 74% (n=729) responded.

Results:  Utilization of hygienists and assistants was found to be confined to procedures ascribed to conventional roles, e.g., oral health education, radiographs, impressions, scaling and root planing, etc. There was no significant difference in delegation of tasks to non-dentist providers by dentist practice type (solo, group, public health). However, the HealthPartners Dental Group (one type of group practice) reported a higher percentage of delegation (p<0.05). Dentists’ year of graduation was not significantly associated with utilization and delegation of non-conventional procedures (p<0.05). With regard to expanded functions, 21% of dentists reported that their dental hygienists provide local anesthesia; 4% and 6% utilize the restorative expanded functions of dental hygienists and dental assistants respectively. The majority of dentists felt that having a DT would disrupt relationships with patients (59%) and add an administrative burden (57%). However, 47% of respondents reported that having a DT would free up time for more complex and interesting procedures, that they would trust the quality of the DT’s work (33%) and that DTs would increase access to care in their state (36%). Forty-seven percent of Minnesota dentists would consider hiring a DT (n=81).

Conclusions:  Expanding the scopes of practice for dental hygienists and assistants has not translated to the maximal delegation allowed by law. This current state of affairs may provide insight into dentists’ acceptance of newer models of non-dentist providers.  Support: DE-16746, DE-16747.