Quality of Care in Dental Practice; The Approach of the Indian Health Service*

Abstract

For any dentist interested in review by peers for maintaining the quality of services, reading of this paper is urged.For some dentists quality-control seems to evoke additional adrenalin. An emotional response today no longer is conducive to appropriate objectives and the constructive thinking that are required of a profession. Consideration of the control of the quality of services provided now seems t o demand a sound concept if the profession is t o survive as a sdf-governed body. The concept developed from the experience of the Indian Health Service appears worthy of reporting.The legislative and executive branches of government are becoming more and more sensitive t o the public's conclusion that Americans have a right t o health care and to the public's spreading passion for social justice which has been aroused by gross dissatisfaction with the cost-effectiveness of the current manner for delivering health services.Dental care has begun to be accepted as an essential element in the quality of American life. Since the quality of dental care, therefore, now pervades all facets of dental practice, each member of the profession has a legitimate concern and a clear responsibility t o help develop and implement a system that will ensure the satisfaction of the public that is served. The alternative t o professional action appears to be the creation of a system imposed by society, Communication between the profession and the public has to be developed so that both the perceived needs of the public and the capabilities of the profession become clear and accepted.The dental personnel of the Indian Health Service (IHS) have accepted the challenge to develop a satisfactory system for evaluating quality. The dental program is responsible for ensuring that 415,000 American Indians and Alaska Natives attain the highest level of oral health possible from prevailing resources. Although this mission is partly accomplished by encouraging people t o use private care and other agencies than IHS, the preponderant accomplishment is gained through the resources of this program. Comprehensive oral health services are provided in its hospitals, health centers, health stations, and mobile units in 24 states. The IHS employs 149 dental officers, 181 dental assistants and 15 additional supportive personnel. I t contracts with approximately 200 private practitioners and with a variety of local, state, and other Federal agencies. Many accepted concepts and technics of public health practice are used in the pursuit of its goal, but the Indian and Alaskan groups who benefit from these services are consulted in the planning, direction, and evaluation of the dental program.All personnel realize that the demand for care and the health problems which confront the IHS dental program are much greater than its resources for coping with them. The chronic disparity between dental needs and IHS resources has stimulated for years a keen interest in the most efficient and effective use of dental resources. Methods employed by the IHS t o improve ef...

A Method for Recording and Numerically Scoring Quality of Dental Restorations

“…function dental assistants. Abramowitz,8,9 in reporting on the Indian Health Service study of expanded functions for dental assistants, described a different approach to evaluate the quality of restorations. In this study, two dentists clinically examined the restorations independently and rated them unsatisfactory or satisfactory according to specific criteria provided.…”