Effect of continuing education on physicians’ provision of dental procedures

Medical offices potentially may be an efficient setting to deliver preventive dental services to low-income children who seldom attend dental offices. Objectives: To evaluate the effect of three methods of continuing medical education (CME) on provision of preventive dental services among pediatricians and family physicians in North Carolina. Methods: In this prospective, randomized controlled trial, 118 medical practices were assigned to one of three CME methods: Group A had a 1.5 hour CME lecture and received course materials; Group B had the same as A with additional conference-calls providing technical support; and Group C had the same as B with additional in-office visits providing technical support. Provision of dental procedures was measured during 13-25 months of follow-up using physicians’ claims for reimbursement that enumerated the number of visits at medical offices in which Medicaid-eligible children aged <3yrs received: screening for dental disease, parent counselling, application of fluoride varnish and (where necessary) referral to a dentist. Adoption was defined as the provision of one or more dental services while the rate of provision was measured as the number of dental services provided per month of follow-up after CME. Results: 11 practices withdrew from the study. Adoption probabilities did not differ among study groups: Group A=65%, Group B=56% and Group C=61% (P=0.74). Adoption was more likely in large practices that had 1000 or more pediatric patients (81%) than in small practices that had less than 500 patients (42%) – P=0.04. Provision rates were marginally higher in group B (16.1 visits/month, 95%CI=10.0-25.9) than in Groups A (12.5, 7.2-21.6) and C (13.4, 7.9-22.1). Conclusions: A majority of physicians adopted these preventive dental procedures although different CME methods did not affect adoption rates. Large medical practices were more likely than small practices to provide preventive dental services to Medicaid-eligible children in NC. Supported by: USDHHS/CDC/CMS.