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西南阿拉斯加的牙科治疗师和牙医提供的牙科服务的世俗趋势。

Secular trends in dental services provided by dental therapists and dentists in Southwest Alaska.

出版信息

J Am Dent Assoc. 2022 Dec;153(12):1145-1153. doi: 10.1016/j.adaj.2022.08.012. Epub 2022 Oct 12.

Abstract

BACKGROUND

The goal of the study was to identify secular trends in dental service delivery between dental therapists and dentists in the Yukon-Kuskokwim Delta region of Southwest Alaska, the first area of the United States to authorize dental therapy practice.

METHODS

Electronic health record transactions from the Yukon-Kuskokwim Health Corporation from 2006 through 2015 (n = 27,459) were analyzed. Five types of dental services were identified using Current Dental Terminology procedure codes: diagnostic, preventive, restorative, endodontic, and oral surgery. Main outcomes were percentages of services provided by dental therapists compared with dentists and population-level preventive oral health care.

RESULTS

The overall number of diagnostic, preventive, and restorative services in the Yukon-Kuskokwim Delta increased. For diagnostic services, there was a 3.5% annual decrease observed for dentists and a 4.1% annual increase for dental therapists (P < .001). Similar trends were observed for restorative services. For preventive services, there was no change for dentists (P = .89) and a 4.8% annual increase for dental therapists (P < .001). Dental therapists were more likely than dentists to provide preventive care at the population level.

CONCLUSIONS

Dental therapists have made substantial contributions to the delivery of dental services in Alaska Native communities, particularly for population-based preventive care.

PRACTICAL IMPLICATIONS

The study's findings indicate that there is a role for dental therapy practice in addressing poor access to oral health care in underserved communities.

摘要

背景

本研究的目的是确定在阿拉斯加西南部的育空-科尤库克三角洲地区,牙科治疗师和牙医之间的牙科服务提供的长期趋势,该地区是美国第一个授权牙科治疗实践的地区。

方法

分析育空-科尤库克卫生公司 2006 年至 2015 年(n=27459)的电子健康记录交易。使用当前牙科术语程序代码确定了五种类型的牙科服务:诊断、预防、修复、牙髓和口腔手术。主要结果是与牙医相比,由牙科治疗师提供的服务百分比和人群水平的预防性口腔保健。

结果

育空-科尤库克三角洲的总体诊断、预防和修复服务数量有所增加。对于诊断服务,牙医的年增长率为 3.5%,而牙科治疗师的年增长率为 4.1%(P<.001)。修复服务也观察到类似的趋势。对于预防服务,牙医没有变化(P=0.89),而牙科治疗师的年增长率为 4.8%(P<.001)。牙科治疗师比牙医更有可能在人群水平上提供预防保健。

结论

牙科治疗师在为阿拉斯加原住民社区提供牙科服务方面做出了重大贡献,特别是在人群为基础的预防保健方面。

实践意义

研究结果表明,在服务不足的社区中,牙科治疗实践在解决口腔卫生服务获取不足方面发挥了作用。

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