Comparison of Restorations versus Extractions between Patients with and without Access to Oral Care

Objective: The purpose of this study was to assess differences in treatment choice between two patient cohorts in Southern Nevada; one with access to oral care and one without access.

Methods: The study included adult cases (n=1716) treated between June and December 2007 at a dental school clinic and adult cases (n=722) treated during this same time at Southern Nevada Veterans Administration Dental Clinic (VA). Comparisons were made between two treatment options selected by these subjects: simple extractions versus one surface and two surface composite/amalgam restorations. Number and type of procedures were analyzed using descriptive statistics.

Results: Forty five percent of the patients treated at the VA selected to have extractions in comparison to the majority (71.8%) of the cohort treated in the dental training center. Of those treated at the dental clinic, 89% (n=1492) were not insured and 3.7% (n=64) were Medicaid patients. Of those treated at the VA, 54.7% (n=395) chose to have restorations. All the patients treated at the VA receive subsidized oral care and chose more costly restorative care with 69.37% (n=274) selecting colored fillings versus 30.63% (n=121) choosing silver fillings.

Conclusion: Long term access to oral care for Southern Nevada's Veteran population enables them to retain their natural teeth and elect restorative procedures over extractions more often than uninsured citizens living residing in Southern Nevada. Further research is required to access oral disease disparities, patient education, disease prevention and treatment.