IADR Abstract Archives
The Influence of Dentist-Density on Dentists’ Clinical Decision-Making
Objectives: To investigate the association between dentist-density, defined as the number of dental clinics within a 1-km radius of a dental practice, and dentists’ clinical decisions, as determined through a series of case scenarios.
Methods: This was a cross-sectional study using a self-administered mail survey, collecting demographic and practice information from a random sample of general dentists in Ontario, Canada (n=3,201). The outcome (clinical-decision-making) was quantified using case scenarios of common clinical situations. Dentists’ responses were categorized into conservative and aggressive treatment decisions. ArcGIS was used to measure dentist-density by counting the number of dental clinics within a 1-km radius buffer around each respondent. The analyses were performed by stratifying dentists into low and high dentist densities, adjusting for population size. Associations were assessed using bivariate analysis and binary logistic regression.
Results: One thousand and seventy-five dentists responded (33.6% response rate). Overall, dentists practicing in high-dentist density areas adopt more aggressive treatment decisions compared to those in low-dentist density areas. In stratified analysis, American graduates were 2.12 (95% CI: 1.11, 4.05) and 2.79 (95% CI: 1.29, 6.01) as likely to adopt aggressive treatments compared to Canadian graduates in low-and high-density areas, respectively. In addition, dentists who perceived large pressure from other dental clinics in low- and high-density strata were 1.32 (95% CI: 0.72, 2.41) and 1.77 (95% CI: 0.99, 3.20) as likely to adopt aggressive treatments compared to those who perceived no pressure in both groups, respectively.
Conclusions: This is the first Canadian study to explore the association between dentist-density and clinical decisions. The findings from this study suggest that dentist density is a modifier in dentists’ decision-making that might accentuate or mask the effect of the other predictors.
Methods: This was a cross-sectional study using a self-administered mail survey, collecting demographic and practice information from a random sample of general dentists in Ontario, Canada (n=3,201). The outcome (clinical-decision-making) was quantified using case scenarios of common clinical situations. Dentists’ responses were categorized into conservative and aggressive treatment decisions. ArcGIS was used to measure dentist-density by counting the number of dental clinics within a 1-km radius buffer around each respondent. The analyses were performed by stratifying dentists into low and high dentist densities, adjusting for population size. Associations were assessed using bivariate analysis and binary logistic regression.
Results: One thousand and seventy-five dentists responded (33.6% response rate). Overall, dentists practicing in high-dentist density areas adopt more aggressive treatment decisions compared to those in low-dentist density areas. In stratified analysis, American graduates were 2.12 (95% CI: 1.11, 4.05) and 2.79 (95% CI: 1.29, 6.01) as likely to adopt aggressive treatments compared to Canadian graduates in low-and high-density areas, respectively. In addition, dentists who perceived large pressure from other dental clinics in low- and high-density strata were 1.32 (95% CI: 0.72, 2.41) and 1.77 (95% CI: 0.99, 3.20) as likely to adopt aggressive treatments compared to those who perceived no pressure in both groups, respectively.
Conclusions: This is the first Canadian study to explore the association between dentist-density and clinical decisions. The findings from this study suggest that dentist density is a modifier in dentists’ decision-making that might accentuate or mask the effect of the other predictors.