Deep Caries Treatment in the PEARL Network

Objective:  

To examine the association of treatment setting (CHC vs GP) with baseline patient and practice characteristics among patients and practices participating in a Practitioners Engaged in Applied Research and Learning (PEARL) network study of treatment for deep caries.

 Method:  

667 patients were enrolled in a prospective deep caries study in PEARL. Dentists reported on dentin caries activity and remaining dentin ranking, as well as on their practice-related characteristics. Patients were enrolled from November 14, 2006 thru February 5, 2009. Practice type was divided into community health centers (CHCs) and general practice. 

Result:  

CHCs (n=11 sites) contributed 37% of the enrolled patients; half enrolled by CHCs were self-reported as Hispanic vs 21% enrolled by GPs (n=22 sites).  Almost all CHCs (95%) were comprised of 2-4 dentists whereas 27% of the GPs were single practitioners.  Dentist in private practices were more experienced (27 years vs 7 years, p<0.0001). CHC patients were younger (mean=18-years vs 30-years for GPs)(p<0.0001). No difference was found in the prevalence of oral health impacts between general practice and CHCs (32% vs. 28%). However, the severity of oral impacts was higher among those in general practices than those in CHCs (p=.01). The proportion of the dentin caries activity and the remaining dentin caries were different between practice type (p<.0001). No differences were observed in use of partial caries removal. 

Conclusion:

These findings show that the PEARL network is increasing the diversity of their patient population and in doing so closing the health disparities gap in dental care. CHCs provide health care to uninsured people and in collaboration with PEARL, an integrated service to caries treatment is under way in several CHCs. Caries treatment characteristics remains an area of main concern particularly among uninsured populations, this study shows the value of PBRNs reaching out to CHCs. Support:NICDR U01-DE016755.