Darling Brian G, Kanellis Michael J, McKernan Susan C, Damiano Peter C
College of Dentistry, University of Iowa, Iowa City, IA, USA.
Pediatric Dentistry, University of Iowa, Iowa City, IA, USA.
J Public Health Dent. 2015 Spring;75(2):163-8. doi: 10.1111/jphd.12089. Epub 2015 Mar 10.
The Affordable Care Act is predicted to increase dental benefits coverage for millions of Americans. Utilization of expanded function dental auxiliaries (EFDAs) can contribute to increased workforce capacity. Iowa currently allows EFDAs to perform certain nonrestorative procedures. This study investigated dentists' willingness to use auxiliaries for restorative procedures in order inform recent discussions about expanding scope of practice for EFDAs to include such procedures.
This study examined responses from 677 primary care dentists who responded to the 2013 Survey of Iowa Dentists (response rate = 59 percent). The authors performed univariate and bivariate analyses (χ(2) and t-tests) to examine characteristics of dentists who indicated willingness to utilize an auxiliary for newly proposed restorative functions.
Thirty-seven percent of respondents indicated they would delegate at least one of the newly proposed restorative functions to an auxiliary. Pediatric dentists were significantly more likely to be willing to delegate (P = 0.042). Placing stainless steel crowns was most acceptable (31.9 percent of respondents), followed by amalgam restorations (22.3 percent), and composites (18.6 percent).
Many dentists are willing to delegate reversible restorative procedures. Increasing scope of practice for auxiliaries may increase capacity of the existing dental workforce and improve access for newly insured populations. Expanding scope of practice for dental auxiliaries offers a viable mechanism to rapidly increase states' dental capacity in response to rising demands for dental care, including newly insured Medicaid populations.
预计《平价医疗法案》将增加数百万美国人的牙科福利覆盖范围。扩大功能牙科辅助人员（EFDA）的使用有助于提高劳动力能力。爱荷华州目前允许EFDA执行某些非修复性程序。本研究调查了牙医在修复性程序中使用辅助人员的意愿，以便为最近关于扩大EFDA执业范围以包括此类程序的讨论提供参考。
本研究调查了677名对2013年爱荷华州牙医调查做出回应的初级保健牙医的回答（回应率 = 59%）。作者进行了单变量和双变量分析（χ²和t检验），以检查表示愿意在新提议的修复功能中使用辅助人员的牙医的特征。
37%的受访者表示他们会将至少一项新提议的修复功能委托给辅助人员。儿科牙医更有可能愿意委托（P = 0.042）。放置不锈钢冠最容易被接受（31.9%的受访者），其次是汞合金修复（22.3%）和复合材料修复（18.6%）。
许多牙医愿意委托进行可逆性修复程序。扩大辅助人员的执业范围可能会增加现有牙科劳动力的能力，并改善新参保人群的就医机会。扩大牙科辅助人员的执业范围提供了一种可行的机制，以迅速提高各州的牙科服务能力，以应对包括新参保的医疗补助人群在内的对牙科护理不断增长的需求。
