Practical Belief Scales Among Private General Dental Practitioners

BACKGROUND: Practice beliefs have been related to service rate variation. The aims of this study were to replicate practice belief scales in Australia and investigate associations with dentist and practice characteristics and services. METHODS: A random sample of Australian dentists completed mailed questionnaires (response rate 60.3 per cent). RESULTS: Private general practitioners (n = 345) provided service data from a typical day. Eight practice belief items were recorded on a five-point Likert scale, yielding four factor-based scales. Approximately 85 per cent of responses were on the agreement side of the midpoint for the scales of Information giving and Patient influence, 45 per cent for Preventive orientation and approximately 10 per cent for Controlling active disease rather than developing better preventive advice. Capital city dentists had higher agreement with the Preventive orientation scale, while males and older dentists showed less disagreement with the Controlling active disease item (Mann-Whitney, Kruskal-Wallis P < 0.05). Those agreeing with the scales (that is scores < or = the median) showed (Poisson regression P < 0.05): a higher rate of crown and bridge, a rate ratio (RR) of 1.31, but lower rates of extraction (RR = 0.76) and prosthodontic services (RR = 0.64) for the Information giving scale; a higher rate of restorative (RR = 1.22) and total services per visit (RR = 1.06) for the Preventive orientation scale; a higher rate of preventive services (RR = 1.14), but a lower rate of crown and bridge services (0.78) for the Patient influence scale; and higher rates of crown and bridge (RR = 1.40) and prosthodontic (RR = 1.59) but lower rates of periodontic (RR = 0.60) and extraction services (RR = 0.62) for the Controlling active disease item. CONCLUSIONS: These findings confirm the factor structure of practice beliefs and demonstrate small to moderate associations with variation in service rates.     

Trends in service provision among Australian private general dental practitioners over a 20-year period

AIM: To-investigate time trends in service provision. DESIGN: Five cross-sectional surveys across a 20-year period. SETTING: Australian private general practice PARTICIPANTS: A random sample of dentists. METHODS: Mailed questionnaires were collected in 1983, 1988, 1993, 1998 and 2003 (response rates 71%-76%). MAIN OUTCOME MEASURES: Services per visit, annual services per dentist; annual services per patient. RESULTS: Total services per visit increased over the study period from 1.78 to 2.37 (Poisson regression; P<0.05). However the annual number of services provided per dentist did not vary significantly, reflecting a trend among dentists to supply fewer patient visits per year. The annual number of services provided per patient increased from 3.47 to 5.50 (OLS regression; P<0.05), reflecting both increased service rates per visit and increased numbers of visits by patients. Dentists provided less restorative, prosthodontic and extraction services per year, but more diagnostic, preventive, endodontic and crown and bridge services. The annual care received per patient also included more diagnostic, preventive, endodontic and crown and bridge services but differed from the dentist pattern through increased rates of restorative services over the study period. CONCLUSIONS: The content of dentist workloads has changed to include less emphasis on removal and replacement of teeth and more effort on diagnosis and prevention aimed at retention of natural dentitions.     

Service provision trends among Australian private general dental practitioners: 1983/84 to 1998/99

AIM: To investigate time trends in service provision. DESIGN: Four cross-sectional surveys across a 15-year period. SETTING: Australian private general practice. PARTICIPANTS: A random sample of dentists. METHODS: Dentists were surveyed by mailed questionnaire in 1983, 1988, 1993 and 1998 (response rates 71%-75%). Data were weighted to provide representative estimates for the age by sex distribution of private general practitioners in 1983, 1988, 1993 and 1998. MAIN OUTCOME MEASURES: Services per visit, annual services per dentist, annual services per patient. RESULTS: Total services per visit increased over the study period from 1.78 to 2.14 (Poisson regression; p < 0.05). However the annual number of services provided per dentist did not vary significantly, reflecting a trend among dentists to supply fewer patient visits per year. The annual number of services provided per patient increased over the period from 3.47 to 5.22 (OLS regression; p < 0.05), reflecting both the increased service rate per visit and increased numbers of visits by patients. Dentists provided less restorative, prosthodontic and extraction services per year, but more endodontic and crown and bridge services. The pattern of annual care received per patient also included more endodontic and crown and bridge services but differed from the dentist pattern through increased service rates over the study period in areas such as restorative, diagnostic and preventive. CONCLUSIONS: While dentists are providing a similar number of services annually, the content of their workload has changed to include less emphasis on removal and replacement of teeth and more effort on maintenance and retention of natural dentitions.     

Development and testing of revised practice belief scales among private general dental practitioners

BACKGROUND: Practice beliefs have been related to service rate variation and appropriateness of care. The aim of this paper was to further develop practice belief scales by adding new items to an existing set and testing associations with dentist and practice characteristics, and services provided. METHODS: Practice belief items were recorded on a five-point Likert scale using mailed questionnaires from a random sample of dentists in 2004 (response rate = 76.8 per cent). RESULTS: Factor analysis yielded five factor-based scales, with three having adequate or near adequate internal consistency: Professional Autonomy (alpha = 0.72), Patient Focus (alpha = 0.71) and Preventive Orientation (alpha = 0.59). Responses were skewed towards strongly agree (scores 1-<2) for Professional Autonomy (60.6 per cent), Patient Focus (71.7 per cent) and Preventive Orientation (46.3 per cent). Higher percentages of dentists with strong agreement on Patient Focus were aged 30-39 and 60+ years, while lower percentages of dentists with strong agreement on Preventive Orientation were male (Chi-square, P < 0.05). Those strongly agreeing with the scales (scores 1-<2) had (Poisson regression; P < 0.05): lower rates of restorative, a rate ratio (RR) of 0.93, dentures (RR = 0.72) and extractions (RR = 0.63) for Professional Autonomy; higher rates of dentures (RR = 1.32), crowns (RR = 1.46) and extractions (RR = 1.47) for Patient Focus; and lower rates of restorative (RR = 0.88), dentures (RR = 0.78), crowns (RR = 0.72), extractions (RR = 0.50), endodontics (RR = 0.80), but a higher rate of scaling (RR = 1.13) for Preventive Orientation. CONCLUSIONS: The findings confirmed some of an earlier factor structure of practice beliefs, extended the potential practice belief domains, and demonstrated associations with service rates.     

Service-mix provided to patients in Australian private practice

Service-mix can reflect changes in demographic factors, oral health, patient demand and treatment philosophies. The aim of this study was to compare service-mix by patient age in 1988 with baseline data from 1983. A weighted, stratified random sample of dentists in Australia was surveyed by mailed questionnaire in 1983 and again in 1988. Service-mix was dominated by restorative, diagnostic and preventive areas. Comparing 1988 with 1983, there were significant increases for diagnostic, preventive, advanced restorative, orthodontic and general areas. Patterns across patient age groups and between years indicated younger patients were being provided with increased preventive services (patients aged 5–11, 25–44 years) and decreased restorative services (patients aged 5–11, 12–17 years), while older patients were being provided with reduced prosthodontic services (patients aged 25–44, 45–64 years), but increased restorative services (patients aged 45–64, 65+ years) and advanced restorative services (patients aged 25–44, 45–64 years).These patterns of service-mix have implications for dental education, research and service delivery.     

Service patterns associated with coronal caries in private general dental practice

OBJECTIVES: To describe the pattern of dental services associated with dental caries by level of carious lesion severity. METHODS: Data were collected by a mailed survey from a random sample of dentists from each State/Territory in Australia in 2003-2004. Dentists provided service data on patients treated on a typical clinical day for patients attending with a diagnosis of dental caries. RESULTS: Restorative rates were higher for insured patients, radiograph rates were higher for emergency visits, prophylaxis and topical fluoride rates were higher for non-emergency visits and at capital city locations with topical fluoride also higher for patients from higher socio-economic status areas, endodontic rates were higher for emergency visits and at non-capital city locations, while extraction rates were higher for males, uninsured patients and for emergency visits. Poisson regression models compared the rates of services from different service areas for initial and cavitated carious lesions with gross carious lesions, controlling for patient demographics, visit type, location and socio-economic status. Restorative services were provided at higher rates (P<0.05) for cavitated carious lesions (RR=2.38), radiographs were provided at lower rates for both initial (RR=0.28) and cavitated carious lesions (RR=0.31), both prophylaxis and topical fluoride services were provided at higher rates for initial carious lesions (RR=2.33 and 3.00, respectively), endodontic services were provided at lower rates for both initial (RR=0.03) and cavitated carious lesions (RR=0.07), and extractions were provided at lower rates for both initial (RR=0.23) and cavitated carious lesions (RR=0.16) compared to the reference category of gross caries. CONCLUSION: Service patterns varied by level of carious lesion severity with initial carious lesions managed by more preventive services, cavitated carious lesions with more restorative services, gross carious lesions with more radiographic, endodontic and extraction services. However, initial carious lesions tend to be managed with restorative rather than preventive service, suggesting scope for increased management by minimum intervention approaches.     

Insurance status and provision of dental services in Australian private general practice

Abstract Annual expenditure on dental care in Australia amounts to ADD 1.9 billion. Approximately one-third of this expenditure involves private dental insurance, yet little is known about the impact of insurance on the provision of services. The aim of this analysis was to examine differences in dental service provision between insured and non-insured patients. Data collected from a random sample of dentists from a survey conducted in 1993-94 were used, providing 817 responses (response rate 74%). Logistic regression analysis controlling for patient age and sex and reason for visit indicated that in private general practice insured patients were more likely to receive preventive (OR=1.37), crown and bridge (OR = 2.25), and endodontic services (OR=1.27), but less likely to receive extraction services (OR=0.52). However, no significant differences by insurance status were found for diagnostic, restorative, or prosthodontic services in the multivariate models. These differences in service provision by insurance status indicate a more favourable pattern of services for insured patients, and point to equity issues in the provision of services.     

Stability of practice beliefs and preferences for patients among private general dentists: a comparison of 1997 and 2007

Background:  Practice beliefs and dentist preferences for patients have been related to service rates and appropriateness of care. If practice beliefs and preferences for patients are stable then they could restrain long-term changes in practice styles and service rates. The aim of this paper was to assess the stability of practice beliefs and preferences for patients between 1997 and 2007.
Methods:  Practice beliefs and dentist preferences for patients were recorded on a five-point Likert scale using mailed questionnaires from a random sample of dentists in 1997 (response rate = 60 per cent) and 2007 (response rate = 77 per cent).
Results:  In both 1997 and 2007, n = 215 dentists provided data. For practice beliefs, 1 out of 8 items were significantly different (p < 0.05; McNemar's test) between the two observations (12.5 per cent of practice belief items) while 5 out of 37 dentist preferences for patient characteristics items were significantly different (13.5 per cent of items).
Conclusions:  The majority of items were not significantly different over time. This demonstrates a generally high degree of stability over time in the level of agreement with dentist practice beliefs and preferences for patients. Given that it may be difficult for clinicians to change practice beliefs and behaviours that have become established, it is important for policy makers to understand the relationship between provider characteristics and service patterns and for educators to positively shape beliefs and behaviours through undergraduate and continuing education.     

Preventive services in Australia by patient and visit characteristics

Objectives: Growth in rates of preventive services has been linked to trends in retention of teeth and the emergence of minimal intervention approaches. In this study, we examined associations between patient-level characteristics and rates of the preventive services dental/prophylaxis and application of remineralisation agents. Methods: A random sample of dentists in Australia was posted a self-administered questionnaire in 2009–2010. A service log was used to collect data on preventive services and patient characteristics. Results: Responses were obtained from 1,148 dentists (response rate = 67%). Preventive service rate models, adjusted according to the age and gender of patients, indicated that insured patients had higher rates of prophylaxis [rate ratio (RR) = 1.39; 95% confidence interval (95% CI): 1.21–1.59) and remineralisation services (RR = 1.85; 95% CI: 1.46–2.33), and that emergency visits had lower rates for prophylaxis (RR = 0.26; 95% CI: 0.20–0.35) and remineralisation services (RR = 0.23; 95% CI: 0.14–0.38). Those who had 20 teeth or more demonstrated higher rates of prophylaxis (RR = 1.41; 95% CI: 1.13–1.75) and remineralisation services (RR = 1.45; 95% CI: 1.02–2.08). Those with decayed teeth had lower rates of prophylaxis (RR = 0.54; 95% CI: 0.46–0.63) and remineralisation services (RR = 0.66; 95% CI: 0.53–0.82). Conclusions: Preventive services were associated with patient age, characteristics of visits and oral health. Patients who were worse off, in terms of attending an emergency visit for the relief of pain and having decayed teeth, had lower rates of preventive care. The findings indicate that patients most in need are missing out on the benefits of preventive dental services.Key words: Dental services, preventive services, dental prophylaxis, remineralisation services, private general practice     

Service-mix in general dental practice in Australia

An understanding of the current service-mix in private general practice in Australia and the factors that may influence its distribution is important in the anticipation of the future practice of dentistry. The present study aimed to describe service-mix, to investigate the association of service-mix with characteristics of presenting patients, and to identify and discuss a number of factors which may be influencing change in service-mix. Service-mix was dominated by restorative, diagnostic and preventive services and a limited number of services accounted for most service provision or dentist time. Both the broad areas of service and more frequently provided services were related to age of presenting patients. Service-mix appears to be changing over time. Changing needs and expectations of patients and philosophies and technologies available to dentists are among factors that push or pull service-mix in new directions. However, changing service-mix and practitioner variation require considerably more exploration.     

Longitudinal comparison of factors influencing choice of dental treatment by private general practitioners

BACKGROUND: Service rate variations and appropriateness of care issues have focused attention on factors that influence treatment decisions. The aims of this study were to examine what factors dentists consider in choosing alternative treatments, the stability of these factors over time and whether stability of treatment choice was related to age of dentist. METHODS: Baseline data were collected by mailed self-complete questionnaires from a random sample of Australian dentists (response rate = 60.3 per cent, n = 345 private general practitioners provided service data from a typical day) in 1997-1998 and follow-up data were collected in 2004 (response rate = 76.8 per cent, n = 177 matched longitudinal cases). RESULTS: The most frequent factors considered important across six alternative treatment pair choice scenarios were caries rate for 'exam v. x-ray', age of patient for 'preventive v. restorative intervention', cost of treatment for 'crown v. build-up', 'root canal v. extraction' and 'bridge v. denture', and calculus for 'prophylaxis v. scaling'. The only differences over time were (t-test, P < 0.05): higher proportions of responses in the mouth status group at follow-up for 'exam v. x-ray'; higher proportions of responses in the visit history group at follow-up for 'preventive v. restorative intervention'; a lower proportion of responses in the caries group at follow-up for 'crown v. build-up'; and a higher proportion of responses in the treatment constraints group at follow-up for 'prophylaxis v. scaling'. CONCLUSIONS: While a wide range of responses were offered as factors influencing the choice of alternative treatments, cost of treatment was a major consideration in situations where significantly cheaper alternatives existed, while patient preference was commonly included as a secondary consideration across a wide range of treatment choice scenarios. The treatment choice responses showed a high degree of stability over time across all age groups of dentists, suggesting that if routines are developed these are established before or soon after graduation as a dentist.     

Caries management decision: Influence of dentist and patient factors in the provision of dental services

Objectives

Little is known about how dentists implement caries management and provide restorative dental services in everyday practice. This study explored whether or not recent concepts in caries management were implemented in practice by private practitioners. The influence of patient and practitioner characteristics on the provision of restorative dental services was also investigated through multidimensional analyses.

Methods

A sample of French general private dental practitioners was asked to record the characteristics of 35 preventive or restorative treatments made on vital permanent teeth. The data collection form was designed to explore dentists’ attitudes towards caries management and their use of minimally invasive therapies.

Results

Twenty-six practitioners recorded the characteristics of 921 treatments performed on 457 patients. Results indicate that participants rarely performed non-invasive treatments. They used an inappropriate detection tool, as most of decisions to treat were based on visual inspection frequently associated with probing. Multidimensional analysis showed that dentists provided different restorative treatments depending on patient characteristics, with minimally invasive, esthetic restorations preferentially performed for healthy, young and well-insured patients. Restorative treatments and detection tools also varied markedly among practitioners. These variations in service patterns were not related to a specific patient profile in each dental practice.

Conclusions

Results indicate that recent concepts in caries management have not yet been adopted in everyday practice. Patient and dentist characteristics influence the provision of restorative dental services. Decision-making in caries management not only depends on pathophysiology but also seems to be influenced by many other factors.     

Procedures provided to Medicaid recipients by pediatric, general and public health dentists in the commonwealth of Virginia: fiscal years 1994 and 1995.

PURPOSE: The purpose of this study was to report any differences found among the mean percentages of procedures performed by three types of dental providers for each type of service performed. The study focused on the types of services provided by dentists to Medicaid children in Virginia. METHODS: Medicaid claims field for dental patients younger than age 21 were obtained and analyzed for fiscal years 1994 and 1995. Dental providers were categorized according to their practice: general practice (GP), pediatric dentist (PD) and public health dentist (PH). Each type of practitioner (GP, PD, and PH) was evaluated for percentages of diagnostic, preventive, and corrective services provided to their Medicaid patients. The preventive category was subdivided into preventive services (scaling, prophy, fluoride and oral hygiene instruction) and sealant services. RESULTS: For each type of service, the mean percentages of procedures performed were compared among the three types of dental providers. The evaluation of the diagnostic procedure variable resulted in the finding that GP practitioners performed a significantly greater percentage of diagnostic procedures to their Medicaid patients than do PD and PH dentists (p < 0.0001). The percentage of preventive procedures performed by PD and GP dentists was not significantly different but was significantly lower than those performed by PH dentists (p < 0.0001). Finally, PD dentists performed a significantly greater percentage of corrective procedures than both GP and PH dentists (p > 0.0037). CONCLUSION: Differences were found among the mean percentages of procedures performed by the three types of dental providers for each type of service performed.     

Factors affecting the amount of long-term restorative dental treatment provided to 100 patients by 20 dentists in 3 Adelaide private practices

Apart from the effects of the frequency of patient attendance for dental examination, and of a change of dentist, little is known of those factors which may influence the amount of treatment provided in dental practice. The present study investigated during 1992 the effects of seven factors on the amount of treatment provided for 100 adult patients treated by 20 male dentists over many years in three selected Adelaide private practices. The amounts of particular types of restorative treatments provided were significantly related to patient age, gender and frequency of attendance, and to practice location, change of dentist and number of changes of dentist, and to the experience or time since graduation of the dentist. These factors were of special significance for the number of crowns provided, most of which were placed in older patients by more experienced dentists. But, there was no evidence of increased numbers of direct placement restorations being received by patients who attended more frequently or who changed their dentists.     

Service provision trends between 1983–84 and 1993–94 in Australian private general practice

Patterns of service provision are expected to change over time, reflecting the dynamics of factors such as oral health status and trends in population demographics. The aim of this study was to identify trends in service provision over time. Data were collected from a random sample of Australian dentists in 1983–84, 1988–89, and 1993–94. Changes observed between 1983–84 and 1993–94 included a trend towards increased proportions of patients in older age groups, restorative care (from 40.2 per cent to 37.7 per cent) and prosthodontic care (9.3 per cent to 8.0 per cent) and increases in diagnostic (from 38.7 per cent to 46.0 per cent), preventive (20.9 per cent to 7.1 per cent), and crown and bridge services (3.1 per cent to 4.7 per cent) per visit. Other services such as orthodontic and general/miscellaneous services showed increases over the first half of the study period, but these did not continue between 1988–89 and 1993–94. The total number of services per visit increased over the study period for adult patients. These findings indicate changing patterns of practice over time, consistent with an increasing orientation towards prevention of disease and maintenance of a natural dentition.     

Practitioner, patient and carious lesion characteristics associated with type of restorative material: findings from The Dental Practice-Based Research Network

BackgroundThe authors conducted a study to identify factors associated with the materials that dentists in The Dental Practice-Based Research Network (DPBRN) use when placing the first restoration on permanent posterior tooth surfaces.MethodsA total of 182 DPBRN practitioner-investigators provided data regarding 5,599 posterior teeth with caries. Practitioner-investigators completed an enrollment questionnaire that included the dentist’s age, sex, practice workload, practice type and number of years since graduation. When patients who had provided informed consent to participate in the investigation sought treatment for a previously unrestored carious surface, the practitioner-investigator recorded patient and tooth characteristics.ResultsPractitioner-investigators used amalgam more often than they used direct resin-based composite (RBC) for posterior carious lesions. Practitioner and practice characteristics (years since graduation and type of practice); patient characteristics (sex, race, age and dental insurance status); and lesion characteristics (tooth location and surface, preoperative and postoperative lesion depth) were associated with the type of restorative material used.ConclusionsSeveral practitioner and practice, patient and lesion characteristics were associated significantly with use of amalgam and RBC: geographical region, years since dentist’s graduation, patient’s dental insurance status, tooth location and surface, and preoperative and postoperative lesion depth.Clinical ImplicationsDespite advances in esthetic dentistry, U.S. dentists still are placing amalgam on posterior teeth with carious lesions. Amalgam was used more often than RBC in older patients, who may have had deeper carious lesions.     

Practice activity trends among Australian private general dental practitioners: 1983-84 to 1998-99

AIM: To investigate time trends in practice activity. DESIGN: Four cross-sectional surveys across a 15 year period. SETTING: Australian private general practice. PARTICIPANTS: A random sample of dentists. METHODS: Dentists were surveyed by mailed questionnaire in 1983, 1988, 1993 and 1998 (response rates 71%-75%). Data were weighted to provide representative estimates for the age by sex distribution of private general practitioners in 1983, 1988, 1993 and 1998. MAIN OUTCOME MEASURES: Hours per year worked, patient visits per hour and patient visits per year. RESULTS: The number of patient visits per year declined across the period, related to parallel decreases in the number of patient visits per hour (ANOVA; P<0.05), while there was no significant difference during the period in the number of hours per year devoted to work. The interaction of dentist sex by time of survey indicated that while numbers of patient visits per year had remained stable for female dentists, there was a trend for the higher number of patient visits per year among male dentists at the beginning of the survey period to decline over time. CONCLUSIONS: Male dentists had higher levels of practice activity compared with female dentists, but a decline in the number of patient visits per year reflected a convergence of male practice patterns towards that of female dentists.     

Rural and urban differences in prosthodontic care provided by Virginia general dentists

Virginia dentists were surveyed to reveal how changes in practice activities affected rural and urban practices in terms of prosthodontics and to assess the impact these changes may have on dentists, continuing education courses, and school curricula. Six hundred licensed dentists were selected at random and were mailed a survey containing questions about their demographics and the types of prosthodontic treatment they performed. Of the 333 respondents, 195 were considered eligible to represent general dentists. Based on this study, rural dentists devote slightly more practice time to providing removable prosthodontic treatment and oral surgery than urban dentists and slightly less time to providing implant restorative treatment. Rural dentists provide significantly more patients with removable partial dentures, complete dentures with no implants, and complete dentures of any type. Most prosthodontic fees were significantly lower for rural dentists.     

Service provision trends between 1983–84 and 1993–94 in Australian private general practice

Patterns of service provision are expected to change over time, reflecting the dynamics of factors such as oral health status and trends in population demographics. The aim of this study was to identify trends in service provision over time. Data were collected from a random sample of Australian dentists in 1983–84, 1988–89, and 1993–94. Changes observed between 1983–84 and 1993–94 included a trend towards increased proportions of patients in older age groups, restorative care (from 40.2 per cent to 37.7 per cent) and prosthodontic care (9.3 per cent to 8.0 per cent) and increases in diagnostic (from 38.7 per cent to 46.0 per cent), preventive (20.9 per cent to 7.1 per cent), and crown and bridge services (3.1 per cent to 4.7 per cent) per visit. Other services such as orthodontic and general/miscellaneous services showed increases over the first half of the study period, but these did not continue between 1988–89 and 1993–94. The total number of services per visit increased over the study period for adult patients. These findings indicate changing patterns of practice over time, consistent with an increasing orientation towards prevention of disease and maintenance of a natural dentition.     

Secular trends in dental services provided by dental therapists and dentists in Southwest Alaska

BackgroundThe goal of the study was to identify secular trends in dental service delivery between dental therapists and dentists in the Yukon-Kuskokwim Delta region of Southwest Alaska, the first area of the United States to authorize dental therapy practice.MethodsElectronic health record transactions from the Yukon-Kuskokwim Health Corporation from 2006 through 2015 (n = 27,459) were analyzed. Five types of dental services were identified using Current Dental Terminology procedure codes: diagnostic, preventive, restorative, endodontic, and oral surgery. Main outcomes were percentages of services provided by dental therapists compared with dentists and population-level preventive oral health care.ResultsThe overall number of diagnostic, preventive, and restorative services in the Yukon-Kuskokwim Delta increased. For diagnostic services, there was a 3.5% annual decrease observed for dentists and a 4.1% annual increase for dental therapists (P < .001). Similar trends were observed for restorative services. For preventive services, there was no change for dentists (P = .89) and a 4.8% annual increase for dental therapists (P < .001). Dental therapists were more likely than dentists to provide preventive care at the population level.ConclusionsDental therapists have made substantial contributions to the delivery of dental services in Alaska Native communities, particularly for population-based preventive care.Practical ImplicationsThe study’s findings indicate that there is a role for dental therapy practice in addressing poor access to oral health care in underserved communities.