Treatment Disparities among Patients Attending a Dental School Clinic in Nevada

Objective: The purpose of this study was to assess differences in a patient cohort according to dental treatments associated with social determinants of health.

Methods: Adult cases (n=425) treated in December, 2006 at a dental school clinic were reviewed. Comparisons were made between two treatment groups: simple extractions versus composites/amalgam restorations. Descriptive variables included gender, race/ethnicity, dental insurance status, self-reported tobacco use, and socioeconomic status (SES), calculated using median household income by zip code (High = > $60,000; Moderate = $33,000 - $60,000; Low = <$3,000). Number and type of procedures were analyzed using ANOVA statistical methods.

Results: The majority of the sample [(44% males (N=187), 56% females (N=238)] were moderate to low SES (96%; N=408), with 56% Caucasian (N=238), 21% African American (N=89), and 16% Hispanic (N=68). Most were not insured (87%; N=368), and used tobacco products (N=249). Sixty percent of the sample received extractions and 40% restorations, with a combined mean of 3.60+4.76 total procedures performed. Significant differences existed between race/ethnicity on number (F=5.897, p<0.05) and type (F=3.846, p<0.05) of procedures, with extractions being prevalent in African Americans and Hispanics. Statistical differences in SES were found only in the type of procedure (F=16.453, p<0.05), with the lower SES group receiving more extractions.

Conclusion: Results indicate health disparities exist in the number and type of procedures when comparing extractions to amalgam/composite restorations. Lower SES Non-Caucasian patients were not given alternatives to less expensive simple extractions when treated. Oral health equity should be of utmost importance to dental professionals.