title: Providing care for underserved patients: periodontists' and periodontal residents' educational experiences, attitudes, and behaviors.
abstract: BACKGROUND
  Patients with special health care needs (SHCNs) and patients from underrepresented minority and/or low socioeconomic backgrounds are more likely to have problems accessing oral health care services. The objectives of this study are: 1) to explore how well the dental education of periodontists prepared them to treat these underserved patients, 2) to assess related professional attitudes and confidence when treating these patients as well as professional behaviors, and 3) whether educational experiences are related with attitudes, confidence, and behaviors in this context.
  
  
  METHODS
  Survey data were collected from a randomly selected sample of 291 members of the American Academy of Periodontology (AAP) and 64 periodontal residents.
  
  
  RESULTS
  Overall, large percentages of residents agreed that their predoctoral and graduate dental educations had prepared them well to treat patients with special needs (predoctoral education: 58%; clinical graduate education: 45%; and classroom-based graduate education: 37%), from different ethnic/racial backgrounds (predoctoral education: 74%; clinical graduate education: 74%; and classroom-based graduate education: 60%), and on Medicaid (predoctoral education: 60%; clinical graduate education: 61%; and classroom-based graduate education: 42%). Practicing clinicians were least positive about their educations. Students were more positive about treating patients on Medicaid and pro bono cases than practicing clinicians. However, the two groups did not differ in their confidence when treating underserved patients. The quality of predoctoral and graduate educations regarding underserved patients correlates with the attitudes, confidence, and behaviors of providers concerning providing care for these patients.
  
  
  CONCLUSIONS
  The findings of this study stress the importance of preparing future periodontists in their predoctoral and graduate programs for providing care for underserved patients such as patients with SHCNs. The better that dental education prepares future periodontists to provide care for underserved patients, the more confident periodontists will be when encountering these patients in their own practices and the more likely they will be to contribute to reducing disparities in oral health care access in the United States by treating these patients.
authors.affiliation: Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Garfinkle
authors.forename: Philip S
authors.initials: PS
authors.lastname: Richards
authors.forename: Marita R
authors.initials: MR
authors.lastname: Inglehart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003729:Dental Care; D003730:Dental Care for Persons with Disabilities; D003812:Dentist-Patient Relations; D004499:Education, Dental, Graduate / Q000592:standards; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D008297:Male; D008484:Medicaid; D008507:Medically Underserved Area; D008875:Middle Aged; D008913:Minority Groups; D010517:Periodontics / Q000193:education*; D011203:Poverty; D011231:Preceptorship / Q000592:standards; D012649:Self Concept; D017664:Uncompensated Care; D014481:United States; D035862:Vulnerable Populations; D055815:Young Adult