Skip to main content
Toggle Menu of ADA WebSites
ADA Websites
Partnerships and Commissions
Toggle Search Area
Toggle Menu
e-mail Print Share

A systematic review of oral health outcomes produced by dental teams incorporating midlevel providers

Wright, J. T., Graham, F., Hayes, C., Ismail, A. I., Noraian, K. W., Weyant, R. J., Tracy, S. L., Hanson, N. B., Frantsve-Hawley, J. . Journal of the American Dental Association. 2013;144(1):75-91


BACKGROUND: The authors conducted a systematic review on this research question: "In populations where nondentists conduct diagnostic, treatment planning, and/or irreversible/ surgical dental procedures, is there a change in disease increment, untreated dental disease, and/or cost-effectiveness of dental care?" METHODS: The authors searched 12 electronic databases for articles published through February 2012 and hand searched relevant articles. They assessed the risk of bias of included studies and extracted data. RESULTS: The authors screened 7,701 citations, resulting in 18 observational studies that met the inclusion criteria. They judged 13 of the studies to be at high risk of bias, five at moderate risk and one at low risk. The authors found no data regarding cost effectiveness, irreversible diagnostic procedures or diseases other than caries. CONCLUSIONS: The authors concluded that the quality of the evidence was poor. They found that in select groups in which participants received irreversible dental treatment from teams that included midlevel providers, caries increment, caries severity or both decreased across time; however, there was no difference in caries increment, caries severity or both compared with those in populations in which dentists provided all irreversible treatment. In select groups in which participants had received irreversible dental treatment from teams that included midlevel providers, there was a decrease in untreated caries across time and a decrease in untreated caries compared with that in populations in which dentists provided all treatment. CLINICAL IMPLICATIONS: Generalizability of results to populations other than those studied is limited owing to the age of some of the studies, as well as to clinical and methodological heterogeneity; consequently, the conclusions should be viewed with caution.

Poor-quality evidence for differences in oral health outcomes produced by dental teams incorporating midlevel providers

Rebecca Schaffer, DDS FAPD .


Overview

Systematic Review Conclusion

In select groups, teams incorporating midlevel providers showed a decrease in untreated caries across time, but no difference in caries increment or severity, when compared with teams in which dentists provided all irreversible treatment.

Critical Summary Assessment

In select groups, teams incorporating midlevel providers showed a decrease in untreated caries across time, but no difference in caries increment or severity, when compared with teams in which dentists provided all irreversible treatment.

Evidence Quality Rating

Poor Evidence

This summary is published in the Journal of the American Dental Association and can be accessed at: http://jada.ada.org/article/S0002-8177(14)00024-5/fulltext


Critical Summary Publication Date:

2/2/2015

These summaries are not intended to, and do not, express, imply, or summarize standards of care, but rather provide a concise reference for dentists to aid in understanding and applying evidence from the referenced systematic review in making clinically sound decisions as guided by their clinical judgment and by patient needs. American Dental Association © 2019