Service mix in general dental practices employing and not employing dental hygienists.
Service mix studies conducted in Australia have indicated a low provision of periodontal services. The service mix in Australian general dental practices employing dental hygienists has not been studied. This study compares the service mix between 18 practices employing hygienists and 29 practices not employing hygienists in Adelaide. Practices employing hygienists tended to be larger group practices, with younger dentists seeing a younger set of patients. Practices employing dental hygienists provided a mean of 97.9 services to 57.2 patients over 2 days, significantly higher than the mean of 68.8 procedures to 39.1 patients in practices not employing dental hygienists. Comparing the % of procedures provided in treatment categories as a ratio of total procedures, practices employing dental hygienists provided significantly more periodontal procedures and less oral surgery, prosthetic and restorative procedures. Periodontally-related services accounted for an average of 37.7% of procedures in practices employing dental hygienists compared with 18.9% in practices not employing dental hygienists (p < 0.05). Periodontal and preventive treatment of 50.7% of patients in practices employing hygienists was delegated to a hygienist, and the level of delegation of periodontally-related procedures was 77.2%. Over 90% of procedures performed by hygienists were periodontally-related, with the removal of subgingival calculus accounting for 57.7% of all procedures provided by dental hygienists. In conclusion, practices employing hygienists had a more periodontally-orientated service mix, with hygienists acting to complement the services of dentists in the provision of periodontal services, rather than as a substitute for the dentist.
School of Dental Science, University of Melbourne, Australia.
L F
LF
Brown
A J
AJ
Spencer
P A
PA
Keily
D000328:Adult; D001315:Australia / Q000453:epidemiology; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003728:Dental Calculus / Q000628:therapy; D003729:Dental Care / Q000706:statistics & numerical data; D003756:Dental Hygienists / Q000706:statistics & numerical data*; D003777:Dental Prophylaxis / Q000706:statistics & numerical data; D017266:Dental Prosthesis / Q000706:statistics & numerical data; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data; D005792:General Practice, Dental / Q000706:statistics & numerical data*; D006123:Group Practice / Q000706:statistics & numerical data; D006801:Humans; D007400:Interprofessional Relations; D009055:Mouth / Q000601:surgery; D010348:Patient Care Team / Q000706:statistics & numerical data; D010510:Periodontal Diseases / Q000517:prevention & control / Q000628:therapy; D011313:Preventive Dentistry / Q000706:statistics & numerical data