Patterns of Oral Care in a Washington Dental Service Population

Objectives: We compared patterns of oral health care reported by the Washington Dental Service (WDS) in 1993 and 1999 to assess changes in patient populations, practice characteristics, relative proportion of procedures accomplished, and treatment costs in the state of Washington. Methods: Data was obtained from dental benefit claims from a population of about 1.25 million people, 3400 general and specialty dental offices, 10.1 million procedures, and $817.6 million allowed benefit and patient costs for both study years. Results: There was high agreement (>97%) between the database and randomly surveyed patient records. For both 1993 and 1999, general dental offices were responsible for more than 80% of patient care. Single crowns (21%), restorative services (15%) and dental prophylaxis (13%) comprised about half of the costs for dental care in this population. Broad categories of service were similar in 1993 and 1999, and anticipated major declines in restorative procedures related to caries were not apparent. Pattern changes that showed an increase between 1993 and 1999 included number of patients per dental office (23%), procedures per dental office (16%), and adjusted cost per patient (17%). Pattern changes that showed a decrease between 1993 and 1999 included number of procedures per patient (-6%). The mix of services varied considerably by patient age, and between generalists and specialists in both years. Conclusions: Patterns of oral health care among this insured patient population remain largely unchanged from 1993 to 1999 with some shifts in specific procedures and specialty care. During this period, dentists saw a greater number of patients, performed fewer treatments per patient seen, and total treatments costs per patient increased. Dental benefits databases provide a valuable resource for current and reliable information on evolving oral care patterns.