Evaluations of effectiveness and quality of care.

Although technical competency continues to be viewed as an essential prerequisite for practicing dentistry, it is no longer felt to be a sufficient indicator of the effectiveness or quality of care that will be or is provided by a practitioner. Consistent with a broader definition of quality that includes timeliness and appropriateness of treatment, continuity of care, emphasis on prevention, and adequate documentation of services provided, initiatives are being mounted to develop improved methods for evaluating the effectiveness of treatment approaches and quality of care provided for patients. Fundamental to these evaluations are hypotheses relating aspects of the structure, process, and outcome dimensions of dental practice. Evidence for interrelationships among elements of these dimensions generally is weak or lacking entirely. If dentistry is to keep apace with other segments of the health care community, efficient methods must be developed to collect valid and reliable data from practice settings that will facilitate the evaluation of the impact of treatments, providers, and organizational arrangements on the oral health status and general welfare of patients.