title: Analysis of a payments database reveals trends in dental treatment provision.
abstract: Use of fluoride has led to dramatic improvements in oral health; however, the impact of these improvements on the volume and mix of treatment provided in dental systems is largely unknown. The use of administrative data to analyze trends in treatment provision gives 'real-life' insight into the impact of changing levels of oral health on oral health services. The first aim of this study was to determine the extent to which useful data on temporal treatment patterns could be extracted from a public insurance database. The second aim, contingent on the first, was to investigate whether increased tooth retention and decreases in caries were reflected in the volume and types of treatment provided to adults within a public social insurance scheme between 1997 and 2008. Data were retrieved from the Dental Treatment Benefit Scheme databases, and new datasets were generated to analyze the distribution of treatments and mean treatments provided to 1,271,937 adults over the 12-year period. Provision of restorations, extractions, and dentures decreased, and the ratio of preventive/diagnostic to invasive treatments per dentist increased, which supports reported improvements in oral health. In conclusion, this paper illustrates the decline in invasive treatments, and increase in preventive treatments that accompanied improvements in oral health.
authors.affiliation: Oral Health Services Research Centre, University College Cork, Cork, Ireland. h.guiney@ucc.ie
authors.forename: H
authors.initials: H
authors.lastname: Guiney
authors.forename: P
authors.initials: P
authors.lastname: Felicia
authors.forename: H
authors.initials: H
authors.lastname: Whelton
authors.forename: N
authors.initials: N
authors.lastname: Woods
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D003731:Dental Caries / Q000453:epidemiology*; D003752:Dental Health Services / Q000706:statistics & numerical data*; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D003778:Dentures / Q000706:statistics & numerical data; D003945:Diagnosis, Oral / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D011313:Preventive Dentistry / Q000706:statistics & numerical data; D012943:Social Security / Q000191:economics; D014081:Tooth Extraction / Q000706:statistics & numerical data; D016388:Tooth Loss / Q000453:epidemiology*; D055815:Young Adult
keywords: data mining; dentures; health services research; oral examination; permanent dental restoration; tooth extraction