Health Policy

Potential utilization of expanded function dental auxiliaries to place restoratives

Darling, B.G.; Kanellis, M.J.; McKernan, S.C.; Damiano, P.C.
Jan-04-2015

Abstract

Objectives

The Affordable Care Act is predicted to increase dental benefits coverage for millions of Americans. Utilization of expanded function dental auxiliaries (EFDAs) can contribute to increased workforce capacity. Iowa currently allows EFDAs to perform certain nonrestorative procedures. This study investigated dentists' willingness to use auxiliaries for restorative procedures in order inform recent discussions about expanding scope of practice for EFDAs to include such procedures.

Methods

This study examined responses from 677 primary care dentists who responded to the 2013 Survey of Iowa Dentists (response rate = 59 percent). The authors performed univariate and bivariate analyses (χ2 and t-tests) to examine characteristics of dentists who indicated willingness to utilize an auxiliary for newly proposed restorative functions.

Results

Thirty-seven percent of respondents indicated they would delegate at least one of the newly proposed restorative functions to an auxiliary. Pediatric dentists were significantly more likely to be willing to delegate (P = 0.042). Placing stainless steel crowns was most acceptable (31.9 percent of respondents), followed by amalgam restorations (22.3 percent), and composites (18.6 percent).

Conclusions

Many dentists are willing to delegate reversible restorative procedures. Increasing scope of practice for auxiliaries may increase capacity of the existing dental workforce and improve access for newly insured populations. Expanding scope of practice for dental auxiliaries offers a viable mechanism to rapidly increase states' dental capacity in response to rising demands for dental care, including newly insured Medicaid populations.