Dentists' perceptions of under-privileged patients and clinical practices

Introduction: In Quebec (Canada), welfare recipients benefit from public insurance that covers their basic dental care. In spite of this coverage and major needs for care, these individuals rarely visit the dentist. To justify this low level of recourse to dental care, welfare recipients explain that they often have negative experiences at the dentist's office and that they sometimes feel stigmatized by oral health care providers. Objectives: The objective of this research was to determine how dentists' perceptions of their under-privileged patients impact clinical practices in terms of socio-organizational accessibility, dentist-patient communication and fee adjustment. Methods: This quantitative research used data already collected in the framework of the Dental Practice in Quebec 2006 study under the direction of the Ordre des dentistes du Québec in October 2006. Descriptive as well as logistic regression analyses of the data were carried out. Results: The sample consisted of 1,007 general practitioner dentists in private practice (response rate of 29.1%). 52.5% of the dentists have negative perceptions about the personality of their under-privileged patients and 58.2% about their behaviors. 34.6% frequently restrict socio-organizational accessibility, 14.1% never offer to adjust their fees and 90.5% frequently explain the treatment plans in detail to them. The younger the dentist, the more frequent clinical practice of exclusion is. Conclusion: It would be useful to include the issue of poverty and access to care in the dental curriculum in order to modify Dentists' clinical practices towards under-privileged patients and to improve access to the dental services.