title: Clinical Teaching of Prosthodontics in Undergraduate Courses in a German Dental School: Patients, Visits, Efforts, and Incentives.
abstract: It is unknown what disadvantages are faced by patients deciding for a prosthodontic treatment by inexperienced students. Commonly, the related extra effort and time are compensated by cost reduction of treatment fees. Thereby, the dental schools subsidize treatments to teach clinical prosthodontics. The aim of this study was to clarify the benefits to patients as well as the efforts of the dental school. Data collected from three courses in a dental school in Germany were patient gender, age, occupation, zip code, number of visits, scope of treatment including costs, financial discount, and remaining copayment. Travel costs were calculated based on zip code. Balance of travel costs and treatment discount was defined as financial benefit. The results showed that 185 patients (95 male) aged 32 to 82 years (median=58) were treated with fixed restorations (FR, n=110), telescopic dentures (TD, n=87), complete dentures (CD, n=17), or other (RD, n=3). The mean number of visits was 11 for FR, 12 for TD, and 9 for CD. Single distance to the clinic ranged from 0.6 to 65 miles (median=12). Total costs of prosthodontics were reduced by 19% on average. The mean financial benefit was 429 USD (median=298, min=-482, max=4025). The financial benefits were found to differ widely, including additional expenditures of patients. Participation, travel burden, and copayment did not depend on age, gender, or occupation. The financial benefit was relativized because students needed at least twice the sessions of a dentist. As a result, the financial efforts of dental schools are significant and compromise a cost-covering education.
authors.affiliation: Dr. Huettig is Assistant Medical Director, Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Tübingen, Germany; Mr. Behrend is a doctoral candidate, Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Tübingen, Germany. fabian.huettig@med.uni-tuebingen.de.
authors.forename: Fabian
authors.initials: F
authors.lastname: Huettig
authors.affiliation: Dr. Huettig is Assistant Medical Director, Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Tübingen, Germany; Mr. Behrend is a doctoral candidate, Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Tübingen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Behrend
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003824:Denture, Complete / Q000191:economics; D003828:Denture, Overlay / Q000191:economics; D003830:Denture, Partial, Fixed / Q000191:economics; D004497:Education, Dental; D005260:Female; D005382:Financing, Personal; D005858:Germany; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009790:Occupations; D010361:Patients; D011476:Prosthodontics / Q000193:education*; D012111:Residence Characteristics; D012189:Retrospective Studies; D012575:Schools, Dental / Q000458:organization & administration; D013663:Teaching / Q000379:methods*; D014186:Transportation / Q000191:economics
keywords: cost analysis; dental education; dental school clinics; patient-centered care; personal financing; prosthodontics