Effect of dental practice characteristics on racial disparities in patient-specific tooth loss

Med Care. 2006 May;44(5):414-20. doi: 10.1097/01.mlr.0000207491.28719.93.


Objective: The objective of this study was to test the hypothesis that dental practice characteristics are associated with tooth loss incidence with both tooth-specific and patient-specific characteristics already taken into account.

Research design: A population-based prospective cohort study was conducted. In-person interviews and clinical examinations were done at baseline, 24, and 48 months, with telephone interviews every 6 months. Practices that coincidentally served participants in the study completed practice characteristics questionnaires. To increase inferential power when testing practice-level effects, detailed tooth-specific and patient-specific data were simultaneously taken into account in tests for association between practice-level effects and tooth loss.

Setting: Data were from the Florida Dental Care Study. The key health outcome was tooth loss, a leading measure of a population's oral health.

Participants: Eight hundred seventy-three African-Americans and non-Hispanic whites who had at least 1 tooth.

Results: Certain practice characteristics were associated with tooth loss, including the racial mix of the practice's patient population; persons who attended practices with higher percentages of African-Americans were more likely to receive a dental extraction regardless of the individual patient's race.

Conclusions: This is the first longitudinal report of increased risk for tooth loss resulting from practice-level effects. Although a patient-level racial disparity remained evident, and even with detailed tooth-specific and patient-level characteristics taken into account, racial differences in characteristics of practices attended independently contributed to the patient-level racial disparity in health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • African Americans / statistics & numerical data*
  • Aged
  • Cohort Studies
  • Dental Implantation / statistics & numerical data
  • Florida
  • Humans
  • Incidence
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Outcome and Process Assessment, Health Care
  • Practice Patterns, Dentists' / statistics & numerical data*
  • Prospective Studies
  • Regression Analysis
  • Risk Factors
  • Tooth Extraction / statistics & numerical data
  • Tooth Loss / ethnology*
  • Waiting Lists
  • Whites / statistics & numerical data*