Objective: Previous studies have identified disparities in medical care delivered to African American and Caucasian patients.  The Direct Observation Study allows the comparison of dental procedures provided for African American (AA) and Caucasian (C) patients in the Ohio Practice Based Research Network. 

Methods:  Trained research hygienists visited 120 dental practices and observed dentists and hygienists. This preliminary report includes 2083 patient self-reports of racial background collected from 73 practices.  The procedures were collected as part of an immediate post visit checklist.  AA patients were compared to C patients in both AA and C dentist practices.  Demographic, socioeconomic, insurance status and educational level were also compared.

Results: There were no differences in age or educational attainment between AA and C patients, but a greater proportion of C patients were in a higher income category. Twice as many C patients (35%) as AA (15%) patients were uninsured.  Among AA and C provider dental visits, services provided to AA and C patients were similar except that AA patients received more preventive services and C patients tended to receive more composite restorations. (See table).

Percent of Patients Receiving Procedures by Race

	Caucasian (n=1098) %	African American (n=146) %
Prevention	12.8	19.2
Endo tx	5.7	5.5
Extraction	5.3	5.5
Crown or  Bridge	20.2	15.8
Amalgam Rest	6.7	7.5
Composite Rest	24.4	15.8

 

 

 

 

 

 

 

 

 

Conclusions: Differences in the delivery of routine dental services were slight.  Surprisingly, the trend was for AA patients to receive more preventive services than C patients. Since clinically important disparities seem not to be present in the private practice situation, studies of disparities in dental care are probably best carried out in other venues. Supported by NIH/NIDCR 1R01DE015171