2012 Survey Of Dental Practice Pediatric Dentists In Private . - AAPD
2012 Survey of Dental PracticePediatric Dentists in Private PracticeCHARACTERISTICS REPORT
INTRODUCTIONKEY FINDINGSThe American Dental Association’s Health Policy Resources Centermailed the 2012 Survey of Dental Practice to dentists to collectinformation about the previous year of operation, 2011. For this surveyyear, the American Academy of Pediatric Dentistry Pediatric Oral HealthResearch and Policy Center collaborated on the survey and pediatricdentists were oversampled in order to obtain enough responses fromthose specialists to allow for reliable statistical analysis. The surveyfocused on aspects of private practice including characteristics of dentistsand patients, operating room use, charitable care, and employment ofnon-dentist personnel.DemographicsTables 1 through 25 (starting on page 5) summarize characteristics ofpediatric dentists, their practices, and their patients. Results are groupedby employment situation, dentist gender, and perceived workload(busyness).In April 2012, the three-page questionnaire was mailed to a nationalrandom sample of dentists in private practice regardless of membershipstatus in the American Dental Association. The sample was made up ofapproximately 16,000 dentists, including about 4,000 pediatric dentists.The percentage of pediatric dentists in the sample exceeded thepercentage of specialists in the dental population in order to provide anadequate number of responses from the specialty for statistical analysis.Non-respondents received an additional opportunity to participate,receiving another copy of the survey at the end of May 2012. Datacollection was completed in July 2012, resulting in 781 responses frompediatric dentists. The final adjusted overall response rate from alldentists was 16.5%, while the response rate among pediatric dentists was18.9%.This report presents an overview of survey results for pediatric dentists.For additional information or custom analysis of the survey data, pleasecontact the ADA Health Policy Resources Center at 312.440.2568 orsurvey@ada.org.Data collected by the 2012 survey and historical trend information startwith Table 1 on page 5. The following two pages include key findingsfrom the survey for pediatric dentists. Female pediatric dentists tend to be younger than malepediatric dentists. The average age of pediatric dentists in 2011was 50.9 overall, 54.4 for males, and 43.9 for females. (SeeTable 3.) Most pediatric dental practices have one dentist in thepractice. Practices with one dentist accounted for 69.8% of allpediatric dental practices in 2011; 19.6% of practices had twodentists, and 10.6% of practices had three or more dentists. (SeeTable 7.) Busyness increases as county population decreases. While34.0% of pediatric dentists reported that they were “not busyenough” in counties with more than 1.5 million people, only 25.3%of pediatric dentists reported the same in counties withpopulations of 88,001 to 275,000. (See Table 14.) Incidence of patients on public assistance increases ascounty population decreases.Among pediatric dentists’patients, a proportion is covered by a public assistance programthat paid for at least a part of their dental care. This proportion ofpatients was 17.9% in counties with the highest populations but41.9% in counties with the lowest populations. (See Table 18and Figure 6.)Operating Room Use, Special Health Care Needs, and CharitableCareTables 26 through 30 (starting on page 22) summarize characteristics ofpediatric dentists’ use of operating rooms, their patients with special
health care needs, and charitable care provided by the dental practice.Results are grouped by employment situation. Most pediatric dentists use operating rooms. The share ofpediatric dentists who use an operating room in a hospital oraccredited surgical facility for treatment of inpatient and/oroutpatient cases is 59.5%. (See Table 26.) Most pediatric dentists report treating patients with specialhealth care needs. The proportion of pediatric dentists treatingpatients with special health care needs is 99.5%. (See Table 28.) Most practices of pediatric dentists provide charitable care.Almost three-quarters, or 73.6%, of pediatric dentists worked inpractices that provided charitable dental care either free of chargeor at a reduced rate to some patients in 2011. When a reducedfee was offered, the average percent reduction was 25.3%. (SeeTable 29.)Employment of PersonnelTables 31 through 35 (starting on page 28) summarize characteristics ofnon-dentist staff of pediatric dentists. Most practices of pediatric dentists employ chairsideassistants, secretaries/receptionists, and dental hygienists.The three non-dentist staff positions most commonly employed inpractices of pediatric dentists are chairside assistants (97.9%),secretaries/receptionists (95.3%), and dental hygienists (54.6%).(See Table 31.)2
CHARACTERISTICS OF PEDIATRIC DENTISTS
SUMMARYlifespan and the need for progress in patient transition to adult-orientedproviders.The 2012 Survey of Dental Practice of the American Dental Association’sHealth Policy Resources Center portrays a pediatric dentistry specialtythat has changed over the last decade and now represents a segment ofthe profession more representative of the population, one committed toaddressing access to care for low income and rural populations, and onewhich demonstrates successful practice characteristics aimed atefficiency and effectiveness. The following is a summary of the specialtydemographics excerpted from the latest survey.The survey suggests that the pediatric dentist in the small town may be amajor point of dental access for rural children. Of all population densitiesin the study, counties with 88,000 or fewer people saw pediatric dentistswith the most patients on public assistance, the most patient visits in ayear, more walk-in emergencies, and the least likely to feel that they couldbe busier. One implication of this finding is that pediatric dentists in thesecommunities are providing consistent dental home services acrosssocioeconomic strata and by doing so, helping to maintain a singlestandard of care for all children. Another implication is that preventiveservices are more available to higher caries-risk children in thesecommunities than in larger population-dense areas.Gender BalanceThe survey demonstrates that the percentage of women in pediatricdentistry is increasing. Women pediatric dentists comprise about 44percent of the specialty, as indicated by the AAPD member database.This is reflective of gender-related changes in career choice, and a morebalanced dental school acceptance process based on merit. The surveyalso disputes the opinion that women dentists work fewer hours than theirmale counterparts, with women pediatric dentists differing from males byonly about an hour per work week. Female and male dentists also tend toview their workloads very similarly.Practice Efficiencies and OpportunitiesThe literature suggests that non-biologic social determinants of healthplay a role in the initiation of dental caries. The practice that can addressthese factors may be better positioned to care for a wider variety ofpatients and provide preventive services. Pediatric dentists almostuniformly employ dental assistants and over half of them employ dentalhygienists. The staffing patterns suggest that there are opportunities toperform early intervention, apply sealants and fluoride varnish. Pediatricdentists appear to be well-positioned for care coordination with almost allemploying receptionists and about one quarter with a financialcoordinator.Contribution to AccessThe contemporary pediatric dental practice demonstrates the specialty’scommitment to access to care. The specialty appears to have taken thebanner of improving access. In 1998, government programs accountedfor only about 12 percent of practice billings, but by 2012, that percentagehad risen to almost 23 percent. Close to 70% of pediatric dentist treatMedicaid, CHIP or both. Over half of the pediatric dentists accept newMedicaid patients, a good sign for those children who will be covered as aresult of the Affordable Care Act. Almost 60 percent of pediatric dentistsreport using the operating room, providing a source of care for very youngand special needs patients. The use of dental anesthesiologists iswidespread with over a third of pediatric dentists reporting use of thisimportant access-expander. Not surprisingly, almost all pediatric dentists(99.5 percent) report that they care for patients with special needs. Whilemost pediatric dental patients are under 17 years of age, about 5 percentthof their patients are older with some patients well into the 7 decade oflife. This is possibly a further indicator of the commitment of pediatricdentists to persons with special health care needs throughout theirImplications of the Affordable Care ActUnder the Patient Protection and Affordable Care Act (PPACA), it isprojected that three million additional children will gain access to dental1benefits through the state health insurance exchanges by 2018. Thisrepresents a five percent increase over the number of children currentlyinsured by commercial dental benefit plans. In addition, it is expected thatan additional significant number of children will gain dental benefitsoutside of the health insurance exchanges through employer-sponsoreddental plans with dependent coverage. Since many of these children willbe entering the dental delivery system for the first time, or will haveaccessed it only rarely or sporadically in the past, they can be expected toexhibit a higher burden of dental disease and treatment needs than thecurrently-insured population.4
General dentists will play an important role in providing care for this newlyinsured population. Studies, however, indicate relatively few generaldentists provide regular care for children under three years of age and69.5 percent of dentists report that fewer than 20 percent of their patients2are children. The survey data indicates pediatric dentists will be wellpositioned to provide for this expected additional demand for servicesunder the PPACA, as they can expand existing office delivery capacity(Tables 8, 12), have high rates of access to the operating room (Table 26)or utilize an anesthesiologist in the office (Table 27), and almost withoutexception provide care for patients with special healthcare needs (Table28). They also report that over 40% of their patients are under five yearsof age (Table 15 and Figure 3).Table 1: Age of Responding Pediatric Dentists, 2011Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric 325.3-21.855-6430.0%30.030.0-26.665 andolder14.8%14.115.5-16.0Total N63033329793751Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 2: Average Age of Responding Pediatric Dentists, 1998 – 2011Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric 50.4201151.851.652.144.950.9Source: American Dental Association, Health Policy Resources Center, Surveys of Dental Practice.Table 3: Age of Responding Pediatric Dentists by Gender, 2011Pediatric DentistsMalesFemalesAll pediatric 665 andolder22.7%-16.0Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* This category had too few responses to allow for reliable statistical analysis.5Total N502248751
Table 4: Average Age of Responding Male Pediatric Dentists, 1998 – 2011Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric 154.354.354.353.354.4Source: American Dental Association, Health Policy Resources Center, Surveys of Dental Practice.Table 5: Average Age of Responding Female Pediatric Dentists, 1998 – 2011Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric 6.146.146.136.643.9Source: American Dental Association, Health Policy Resources Center, Surveys of Dental Practice.1This category had too few responses to allow for reliable statistical analysis.6
Table 6: Current Employment Status of Pediatric Dentists by Years since Graduation, 2011Pediatric DentistsSole proprietorPartnerEmployeeIndependent contractorTotalYears since Graduation21 or10 or less 11 to 20moreAll ----100.0100.0100.0100.0Total N4551769722750Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 7: Distribution of Dentists in the Private Practice of Pediatric Dentists, 2011Pediatric Dentists**All ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsNumber of NonownerNumber of DentistsNumber of Owner DentistsDentistsThree orThree orTwo 3.769.819.610.686.410.53.178.015.76.3Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* This category had too few responses to allow for reliable statistical analysis.** The percentages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.7
SYSTEM CAPACITY AND ACCESS TO ORAL HEALTH SERVICESWhile the survey cannot provide definitive answers to dental servicecapacity questions, it does indicate (Table 12) that one-quarter ofpediatric dentists have the facilities, ability and willingness to easilyexpand services. Especially significant, from an access to careperspective, is that close to 70% of pediatric dentists report acceptingpatients covered by public assistance programs (Medicaid and CHIP)(Table 19), which comprise slightly over 25% of their patient population(Table 17). In regards to the treatment of patients with special healthcareor developmental needs, virtually all pediatric dentists report including thispopulation in their practice (Table 28).Oral health advocates have debated extensively in recent years over thecapacity of the current dental delivery system to meet the oral healthneeds of the population, especially for the Medicaid population and3,4,5patients with special healthcare needs.In fact, under the PatientProtection and Affordable Care Act (PPACA), a National Health CareWorkforce Commission is established, for which oral health care6workforce capacity is a designated high priority area for review.Table 8: Time Spent in the Primary Private Practice of Pediatric Dentists, by Employment Situation, 2011Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsWeeks per Year(Average)In thedentalPracticeofficeis open*47.448.447.647.947.350.145.950.247.248.6Hours per Week(Average)In 230.229.827.433.930.0Hours per Year(Average)In 3Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* The averages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.8
Figure 1: Average Hours per Week in the Dental Office, All Pediatric Dentists, 2011Treatingpatients, 30.0hours88.5%Not treatingpatients, 3.9hours11.5%Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 9: Time Spent in the Primary Private Practice of Pediatric Dentists, by Gender, 2011Pediatric DentistsMaleFemaleAll pediatric dentistsWeeks per Year(Average)In thedentalPracticeofficeis open*47.248.647.248.647.248.6Hours per Week(Average)In 930.0Hours per Year(Average)In .91,354.91,612.31,424.3Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* The averages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.9
Table 10: Time Spent in the Primary Private Practice of Male Pediatric Dentists, by Age, 2011Weeks per Year(Average)Pediatric DentistsUnder 3535-4445-5455-6465 and olderAll male pediatric dentistsIn thedentaloffice--**48.348.147.245.247.2Practiceis open*-48.749.048.448.248.6Hours per Week(Average)In ts-32.532.430.826.530.7Hours per Year(Average)In 9.6Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 11: Time Spent in the Primary Private Practice of Female Pediatric Dentists, by Age, 2011Pediatric DentistsUnder 3535-4445-5455-6465 and olderAll female pediatric dentistsWeeks per Year(Average)In thedentalPracticeofficeis rs per Week(Average)In 428.930.326.8--33.128.6Hours per Year(Average)In 4.9Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* The averages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.** This category had too few responses to allow for reliable statistical analysis.10
Figure 2: Pediatric Dentists’ Average Hours per Week in the Dental Office,Selected Age Groups, by Gender, 20114035.933.636.034.933.434.3Hours per week30.333.1302010035 - 4445 - 5455 - 64All agesAge groupMaleFemaleSource: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 12: Perceived Workload of Pediatric Dentists, by Employment Situation, 2011Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsToo busy totreat all7.2%--*--7.2Treated allbutoverworked16.6%15.118.2-16.2Treated allbut notoverworked48.8%46.551.447.949.3Not busyenough27.4%30.524.0-27.3Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* This category had too few responses to allow for reliable statistical analysis.11Total N62733129694747
Table 13: Perceived Workload of Pediatric Dentists, by Gender, 2011Pediatric DentistsMaleFemaleAll pediatric dentistsToo busy totreat all6.0%--*7.2Treated allbutoverworked16.3%16.116.2Treated allbut notoverworked49.9%48.249.3Not busyenough27.8%26.127.3Total N497249747Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 14: Perceived Workload of Pediatric Dentists, by County Population, 2011Pediatric Dentists88,000 or less88,001 to 275,000275,001 to 675,000675,001 to 1,500,0001,500,001 or moreAll pediatric dentistsToo busy totreat all-----7.2%Treated allbutoverworked-----16.2%Treated allbut notoverworked-43.7%52.851.451.449.3Not busyenough-25.3%26.429.334.027.3Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* This category had too few responses to allow for reliable statistical analysis.12Total N55158182181144747
PATIENT CHARACTERISTICS
Table 15: Distribution of Patient Ages in the Primary Private Practice of Pediatric Dentists, by Employment Situation, 2011Pediatric Dentists*All ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsUnder 5years41.2%42.138.442.541.45 to 17years54.3%53.855.851.454.018 to 34years3.7%3.44.44.73.735 to 54years0.5%0.40.80.60.555 to 64years0.3%0.20.40.50.365 yearsor older0.1%0.10.20.30.1Total N57431026473666Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Figure 3: Distribution of Patient Ages in the Primary Private Practice of All Pediatric Dentists, 2011Under 5 years41.4%18 years orolder4.6%5 to 17 years54.0%Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* The percentages and averages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.14
Table 16: Distribution of Patient Gender in the Primary Private Practice of Pediatric Dentists, by Employment Situation, 50.949.250.8Pediatric Dentists*All ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsSource: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Tables 17 and 19 require some explanation. Table 17 reports thepercentage of patients in pediatric dental practices covered bycommercial, public assistance, and no dental benefit programs. Pediatricdentists reported that, in the aggregate, 25.5% of their patients werecovered by public assistance programs. This is different from theinformation in Table 19, which reports that close to 70% of pediatricdentists report accepting patients covered by public assistance programs(Medicaid and CHIP)Table 17: Distribution of Patient Insurance Coverage in the Primary Private Practice of Pediatric Dentists and General Practitioners,by Employment Situation, 2011Insurance Coverage1Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsGeneral Practitioners*All ownersSolo practitionersNonsolo ownersEmployedAll general PublicAssistance25.3%26.222.625.025.5Notcovered .25.04.95.79.95.429.829.631.222.629.4Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* The percentages and averages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.15
Figure 4: Distribution of Patient Insurance Coverage in the Primary Private Practice of All Pediatric Dentists, 2011Not coveredby e25.5%Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Figure 5: Distribution of Patient Insurance Coverage in the Primary Private Practice of Pediatric Dentists and General Practitioners, vate insurancePublic assistancePediatric dentistsNot covered by insuranceGeneral practitionersSource: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.16
Table 18: Patient Insurance Coverage in the Primary Private Practice of Pediatric Dentists, by County Population, tric Dentists*88,000 or less88,001 to 275,000275,001 to 675,000675,001 to 1,500,0001,500,001 or moreAll pediatric otcovered byinsurance12.9%14.816.215.616.215.4Total N48145158155126655Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Figure 6: Percentage of Patients on Private Insurance and Public Assistance in thePrimary Private Practice of Pediatric Dentists, by County Population, 3.3%30%23.1%18.8%20%17.9%10%0%88,000 or less88,001 to 275,000275,001 to 675,000675,001 to 1,500,0001,500,001 or moreCounty populationPrivate insurancePublic assistanceSource: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* The percentages and averages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.17
Table 19: Percentage of Pediatric Dentists Who Had Patients Covered by Various Types of Insurance, by Employment Situation, 2011Pediatric Dentists*All ownersSolo practitionersNonsolo ownersEmployedAll pediatric cassistance68.6%67.372.673.369.1Notcovered byinsurance96.8%96.498.196.896.6Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 20: Pediatric Dentists Treating and Accepting Medicaid- and CHIP-insured Patients, 2011Pediatric Dentists*All ownersSolo practitionersNonsolo ownersEmployedAll pediatric 4.058.0Accept atCHIPcoveredpatients46.3%46.645.250.046.7Accept newCHIPcoveredpatients44.2%44.842.449.644.8Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* The percentages and averages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.18
Table 21: Primary Practice’s Definition of Active Patient among Pediatric Dentists, 2011Pediatric Dentists*All ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentists12 months35.1%34.337.540.935.4Patients treated within the last Does not18 months24 monthsdefine .413.6Other--**-----Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 22: Number of Active Patients on Record in the Primary Practice of Pediatric Dentists, 2011Pediatric Dentists*MeanAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentists3,3602,8504,8504,2903,390st1 003,000rd3 2,340N45824021835498Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 23: Patient Wait for Scheduled Appointments and After Arriving among Pediatric Dentists, by Employment Situation, 2011Pediatric Dentists*All ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsFor InitialAppointment (Days)Patient .1After Arrival(Minutes)Patient urce: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.* The percentages and averages in this group have been weighted by the inverse of the number of dentists in the practice. For more details regarding weights, please see page 31.** This category had too few responses to allow for reliable statistical analysis.19
Table 24: Number of Patient Visits per Pediatric Dentist per Hour, Week, and Year Including Dental Hygienist Appointments,by Employment Situation, 2011Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsPatient visits per pediatricdentist per 3.90.23.53.60.22.42.60.23.43.6Patient visits per pediatricdentist per tient visits per pediatricdentist per yearWalk-in/EmerSchedgencyuledTotal259.0 5,260.0 5,490.1252.3 5,596.9 5,827.4266.8 4,892.8 5,122.4256.4 3,055.6 3,312.0257.1 4,932.7 5,164.7Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.Table 25: Number of Patient Visits per Pediatric Dentist per Hour, Week, and Year Excluding Dental Hygienist Appointments,by Employment Situation, 2011Pediatric DentistsAll ownersSolo practitionersNonsolo ownersEmployedAll pediatric dentistsPatient visits per pediatricdentist per 3.00.22.93.10.22.42.60.22.83.0Patient visits per pediatricdentist per 9.794.95.688.594.15.768.874.55.485.590.8Patient visits per pediatricdentist per yearWalk-in/EmerSchedgencyuledTotal259.0 4,212.4 4,468.6252.3 4,226.7 4,476.0266.8 4,195.7 4,460.0256.4 3,055.6 3,312.0257.1 4,017.7 4,271.9Source: American Dental Association, Health Policy Resources Center, 2012 Survey of Dental Practice.20
OPERATING ROOM USEAlthough GA, on the surface, carries a higher cost than utilizing otherpharmacologic methods of behavior guidance, it can lead to lower overallcosts for extensive dental treatment. GA allows the clinician to perform allindicated extensive and complex procedures during one outpatient orinpatient visit with minimal discomfort to the child. When the records ofpatients who received dental and one other procedure under shared GAwere reviewed, an estimated savings was identified due to the efficiency12of combined care.General anesthesia (GA) is a medical procedure that renders the patientunconscious allowing for the safe and humane provision of medical anddental diagnostic and surgically invasive procedures. Dental treatmentunder GA is an effective way to provide medically necessary care to thosechildren who may be cognitively-immature, highly anxious or fearful, havespecial needs, or be medically-compromised and unable to receivetreatment in a traditional office setting. Delivering dental treatment underGA can have significant positive effects on the quality of life for childrenand their families and can improve access to dental care. GA may be amedically necessary when treating some dental patients and, t
non-dentist personnel. Table In April 2012, the three-page questionnaire was mailed to a national random sample of dentists in private practice regardless of membership status in the American Dental Association. The sample was made up of approximately 16,000 dentists, including about 4,000 pediatric dentists.
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