Scope of Practice Comparison: A Tool for Curriculum Decision Making

Abstract

The proportion of claims filed for specific dental procedures (ADA codes # 05110, 05120, 03320, 03330, 04260, 02150) between January 1, 2000 and June 30, 2004 by Texas general practitioners participating in a preferred provider network was compared to the proportion of these procedures performed by students graduating from the three Texas dental schools during the same period. Analysis of the data revealed that Texas dental students provide class two amalgam restorations in permanent teeth (02150) at approximately the same frequency as Texas general practitioners. Both groups provide periodontal osseous surgery (04260) at an extremely low frequency (<0.02% of total procedures). Bicuspid endodontic procedures (03320) were performed at a slightly higher frequency by students (0.43% of all procedures) than by general practitioners (0.36% of all procedures), and molar endodontic procedures (03330) were performed at a slightly higher frequency by general practitioners (0.65%) than by students (0.36%). Significant discrepancies between the groups were noted for the two complete denture procedures (05110, 05120). Students provided these procedures at frequencies fifteen times (05110) and twenty-five times (05120) greater than general practitioners. Dental schools should use data provided by scope of practice analyses to help determine an appropriate breadth and depth for their educational programs.

Concordance of chart and billing data with direct observation in dental practice

“…Accurate measures of the type and frequencies of services delivered in the practice setting are useful for quality improvement assessment, practice improvement goals, comparison with professional educational objectives, and benchmarking for practitioners performing self‐assessment. Data for these purposes are generally obtained from dental claims data, chart reviews, national surveys of dentists’ self‐reported activities, or patient report of services received (1–3). There is little empirical evidence, however, supporting the reliability or validity of these sources for measuring what has actually transpired in the provider–patient interaction.…”