Howard L. Bailit

Economic Impact of Regulating the Use of Amalgam Restorations

Objective. This article estimates the financial impact of a ban on amalgam restorations for selected population groups: the entire population, children, and children and women of childbearing age. Methods. Using claim and enrollment data from Delta Dental of Michigan, Ohio, and Indiana and the American Dental Association Survey of Dental Services Rendered, we estimated the per capita use and annual rate of change in amalgam restorations for each age, gender, and socioeconomic subgroup. We used population projections to obtain national estimates of amalgam use, and the dental component of the Consumer Price Index to estimate the annual rate of change in fees. We then calculated the number of dental amalgams affected by the regulation, and the fees for each of the years 2005 to 2020. Results. If amalgam restorations are banned for the entire population, the average price of restorations before 2005 and after the ban would increase

The development of dental practice profiles.

52 from

Heredity and morphological variation in early and late developing human teeth of the same morphological class

278 to

The demand for dental health.

330, and total expenditures for restorations would increase from

A New Intermediate Dental Outcome Measure Amalgam Replacement Rate

46.2 billion to

State case studies: improving access to dental care for the underserved.

49.7 billion. As the price of restorations increases, there would be 15,444,021 fewer restorations inserted per year. The estimated first-year impact of banning dental amalgams in the entire population is an increase in expenditures of

Controlling the cost of dental care.

8.2 billion. Conclusions. An amalgam ban would have a substantial short- and long-term impact on increasing expenditures for dental care, decreasing utilization, and increasing untreated disease. Based on the available evidence, we believe that state legislatures should seriously consider these effects when contemplating possible restrictions on the use of amalgam restorations.

Financial Feasibility of a Model School-Based Dental Program in Different States

This study examines the amount and sources of variation in dental practice profiles. Three years of insurance claims data on 227 general dental practices were used to generate practice-specific utilization rates for 16 treatment service categories. The results indicated considerable heterogeneity among and within practices in the distribution of service utilization rates such that most distributions could not be described by conventional parametric probability models. Basic standardization methods were used to examine sources of variation among practices. Of the patient and insurance characteristics investigated, only patient age had a major effect on utilization rates. However, there was considerable stability in utilization rates within practices over four consecutive six-month time intervals. The implications of these findings for profile-based utilization review and quality-assurance systems are discussed.

The quality of restorative dental care.

Abstract Analysis of the resemblance between relatives from two Melanesian populations indicated that, for each of five morphological characters scored on an earlier and a later developing member of a tooth class, the later developing tooth showed a smaller component of additive genetic variation. This finding suggests that the greater morphological variability generally observed at the distal ends of tooth classes may be due primarily to a difference between the environmental conditions experienced by earlier and later developing teeth within a morphological class. The cusp of Carabelli and groove pattern of the lower molars, on the first tooth of their respective classes, were uncorrelated and showed higher degrees of resemblance between relatives than the other three characters studied. These two characters would therefore seem to serve as relatively good and independent population discriminators.

A qualitative study of the relationship between clinician attributes, organization, and patient characteristics on implementation of a disease management program

This study evaluates the determinants of demand for dental health in the context of an econometric model where dental health and dental care are jointly endogenous. The theoretical analysis is based on the application of economic theory to production activities occurring at the individual or household level. A number of hypotheses concerning the change in demand for home and market dental care with respect to price and income changes are posited and empirically tested. Additional hypotheses concerning the relation between dental care and dental health are also examined statistically while controlling for a variety of sociodemographic and economic factors. One of the key empirical findings is that the net price elasticity for dental services is quite low (-0.2) for this sample of individuals with high dental insurance coverage.