Public Dental Clinics Research Articles

Oral health in the indigenous Sámi population in Norway – the dental health in the North study

Objective: This study aims at presenting the feasibility of using the public oral health clinics in indigenous Sámi communities, as arena for a comprehensive data collection for population-based epidemiological oral health research among adults (age, 18–75 years) in a multi-ethnic setting.Material and methods: The study design was cross-sectional. The data collection was incorporated into the clinical procedure at six public dental clinics situated in the Administrative Area for the Sámi Language in Finnmark County, Northern Norway, during 2013–2014. Both clinical- and questionnaire-data were collected. The quality of clinical data was thoroughly calibrated and validated.Results: Altogether, 2235 people participated in the study gave a crude response rate at 88.7%. In the final data sample (n = 2034), 56.9% were female. We constructed three ethnic groups (Sámi, Mixed Sámi/Norwegian and Norwegian). Altogether, 67.7% reported Sámi or mixed Sámi ethnicity. The internal validity of the clinical data was found to be satisfactory when assessed by comprehensive quality procedure, calibration and reliability assessments.Conclusion: This study design and method assessments provide solid documentation that public dental clinics are suitable as arenas for data collection in epidemiological oral health studies in the Sámi population in this region.

Evaluation of the ability of dental clinicians to rate dental anxiety.

The aim of this study was to evaluate the ability of dental clinicians to rate dental anxiety. A total of 104 clinicians from 24 public dental clinics in the Region of Östergötland, Sweden, examined 1,128 adult patients undergoing their regular dental examination. The patients rated their dental anxiety using the Modified Dental Anxiety Scale and a Visual Analogue Scale. After the examination, the clinicians rated the patients’ levels of dental anxiety on a Visual Analogue Scale. The correlation (r s) between the clinicians’ and patients’ ratings of dental anxiety was 0.45. Among highly dentally anxious patients, there was no correlation between clinicians’ and patients’ ratings. Dental clinicians rated dental anxiety lower than their patients did, especially if the patients were highly anxious. The ability of clinicians to rate dental anxiety was better when the clinician was older and the patient was older. There was an inverse association between clinicians’ confidence and their ability to rate a patient's dental anxiety. In conclusion, clinicians are unsuccessful in identifying a dentally anxious patient without the concurrent use of patient self‐assessment tools. A Visual Analogue Scale is a suitable screening tool in general practice for detection of dental anxiety.

Analysis of dental services distribution in Malaysia: a geographic information systems – based approach

The aim of this study was to analyse, in detail, the distribution of primary dental clinics in relation to the Malaysian population and relative population wealth, to test the hypothesis that an uneven distribution of dental services exists in Malaysia. This 2016 study located every dental practice in Malaysia (private and public) and mapped these practices against population, using Geographic Information Systems (GIS) tools. Population clusters within 5, 10 and 20 km of a dental clinic were identified, and clinic-to-population ratios were ascertained. Population data were obtained from the Population and Housing Census of Malaysia 2010. Population relative wealth was obtained from the 2014 Report on Household Income and Basic Amenities Survey for Malaysia. The physical address for each dental practice in Malaysia was gathered from the Official Portal of Ministry of Health Malaysia. All data for analysis were extracted from the integrated database in Quantum GIS (QGIS) into Microsoft Excel. The population of Malaysia (24.9 million) was distributed across 127 districts, with 119 (94%) having at least one dental clinic. Sixty-four districts had fewer than 10 dental clinics, and 11.3% of Malaysians did not reside in the catchment of 20 km from any dental clinic. The total dental clinic-to-population ratio was 1:9,000: for public dental clinics it was 1:38,000 and for private clinics it was 1:13,000. Dental services were distributed relative to high population density, were unevenly distributed across Malaysia and the majority of people with the highest inaccessibility to a dental service resided in Malaysian Borneo.

Evaluation of the Jönköping dental fear coping model: a patient perspective

Objective: This study is a part of a project with the aim to construct and evaluate a structured treatment model (the Jönköping Dental Fear Coping Model, DFCM) for the treatment of dental patients. The aim of the present study was to evaluate the DFCM from a patient perspective.Material and methods: The study was performed at four Public Dental Clinics, with the same 13 dentists and 14 dental hygienists participating in two treatment periods. In Period I, 1351 patients were included and in Period II, 1417. Standard care was used in Period I, and in Period II the professionals had been trained in and worked according to the DFCM. In the evaluation, the outcome measures were self-rated discomfort, pain and tension, and satisfaction with the professionals.Results: In comparison with standard care, less tension was reported among patients treated according to the DFCM, (p = .041), which was also found among female patients in a subgroup analysis (p = .028). Additional subgroup analyses revealed that patients expecting dental treatment (as opposed to examination only) reported less discomfort (p = .033), pain (p = .016) and tension (p = .012) in Period II than in Period I. Patients with low to moderate dental fear reported less pain in Period II than in Period I (p = .014).Conclusions: The DFCM has several positive effects on adult patients in routine dental care. In a Swedish context, the differences between standard care and treatment according to the model were small but, in part, statistically significant. However, it is important to evaluate the model in further studies to allow generalization to other settings.

Barriers and facilitators for adolescent girls to take on adult responsibility for dental care – a qualitative study

ABSTRACTPurpose: This study aims to explore and describe experiences of the dental care system among adolescent dental patients with a recent history of missed dental appointments at public dental clinics (PDCs) in a Swedish county.Methods: Twelve adolescent girls participated in the study. Data were collected by individual, semi-structured, open-ended interviews and analysed with qualitative content analysis.Results: The study findings could be summed into the theme “Triggers for adolescent girls to take on or not take on adult responsibility for dental care”. The experience of free dental care could be summarized in five main categories: Pain and discomfort; Attractive and healthy teeth; Feeling safe and secure; Taking on the responsibility; and Free of charge. These five categories consisted of 15 subcategories.Conclusions: The results of this study should increase the knowledge on how to meet and treat adolescent girls in dental care. Knowing what will happen during the dental visit was highlighted by the participants as decisive to whether or not they would attend their dental appointments. Therefore, we should as far as possible ensure that our patients feel safe at their dental visits and by trying to avoid painful treatments.

A knowledge, attitude, and practice in fixed prosthodontic: Survey among Qassim dental practitioners

AimTo evaluate the knowledge, attitude, and fixed prosthodontics practice guidelines amongst Qassim dental practitioners of Qassim, Saudi Arabia. MethodsA descriptive cross-sectional study was done amongst Dental Practitioners of Qassim Province, Saudi Arabia in 2018. A total of 290 dentists were selected randomly (public and private dental clinics and dental schools). A survey was conducted through printed and online questionnaire composed of 24 open as well as multiple choice questions. Data from the completed questionnaires were analysed using the SPSS Statistical Software Package (version 15). All statistical analyses were carried out at a significance level of p. ResultsThis study showed that (78.3%) 227 of participants radiographically assessed abutment tooth, also most of them fabricated study cast before start crown & bridge work 37.2% (108). Vitality test for restored abutments were always done by 132 (45.5%) respondents. 111 (38.3%) of them used poly vinyl siloxane for making final impression which provides the level of quality of final impression. 117 (40.3%) of them always used retraction cord before making final impression. Both written prescriptions as well as verbal instructions were used by 209 (72.1%) of practitioners for communication with the lab. The study revealed no significant differences between male and female. ConclusionFixed prosthodontic restorative procedures are widely practiced for dental rehabilitation in Saudi Arabia. Dental practitioners (DP's) of Qassim displayed acceptable level of knowledge, level of awareness in fixed prosthodontic practices. However, to further enhance the proficiency; efforts should be made to encourage the practitioners to be aware of the advances in fixed prosthodontic practice through state-of-the-art continuous education programs.

The knowledge, attitude and practice of fixed prosthodontics: A survey among Qassim dental practitioners.

Aim:The aim of this study was to evaluate the knowledge, attitude and fixed prosthodontics practice guidelines amongst dental practitioners of Qassim in Saudi Arabia.Materials and Methods:A descriptive cross-sectional study was done amongst the Dental Practitioners of Qassim Province, Saudi Arabia in 2018. A total of 290 dentists were selected randomly (from public and private dental clinics and dental schools). A survey was conducted through printed and online questionnaire composed of 19 open and multiple-choice questions. Data from the completed questionnaires were analysed using the SPSS Statistical Software Package (version 25). All statistical analyses were carried out at a significance level of P < 0.05. Results were analysed and compared using the Chi-square test and frequency test.Results:This study showed that 227 (78.3%) of the participants assessed abutment tooth radiographically, also most of them fabricated study cast before starting crown and bridge procedures 37.2% (108). The vitality test for restored abutments was always done by 132 (45.5%) respondents, and 111 (38.3%) of them used poly vinyl siloxane for making final impression, which provides the level of quality of final impression. A total of 117 (40.3%) of them always used retraction cord before making final impression. Both written prescriptions and verbal instructions were used by 209 (72.1%) of the practitioners for communication with the lab. The study revealed that there were no significant differences between males and females in answering questions 11, 13 and 17.Conclusion:The dental practitioners (DPs) of Qassim displayed an acceptable level of knowledge and a level of awareness of fixed prosthodontics practicing. However, to further enhance the proficiency, efforts should be made to encourage the practitioners to be aware of the advances in fixed prosthodontics practice through state-of-the-art continuous education programmes.Clinical Significance:As fixed prosthodontic restorative procedures are widely practiced for dental rehabilitation in Saudi Arabia, it was very important to measure and evaluate the knowledge of DPs about the details of basic steps in the field of fixed prosthodontics and the way of practicing this important branch of dentistry.

Detection of Hepatitis B Antigen in The Dental Instruments Used in Public Dental Clinics in Duhok Province, kurdistan Region/ Iraq

Detection of Hepatitis B Antigen in The Dental Instruments Used in Public Dental Clinics in Duhok Province, kurdistan Region/ Iraq

Indications for root canal treatment in a Swedish county dental service: patient- and tooth-specific characteristics.

To study patient- and tooth-specific characteristics of teeth indicated for root canal treatment, in the public dental service of the county of Västra Götaland, Sweden. During a designated 8-week period, general dental practitioners working at 20 different public dental clinics consecutively registered indications for undertaking root canal treatment. The patients' subjective level of pain was also registered (visual analogue scale) at the very first appointment. The following information was retrieved from computerized dental records and radiographs: gender, age, number of remaining teeth, tooth group, previous restoration, number of restored surfaces, dental caries and tooth substance loss. Gender and age were compared using both descriptive and analytical statistics. The material comprised 243 teeth in 243 patients: 128 (52.7%) women and 115 (47.3%) men, mean age 48.3years. Molar teeth predominated (47.7%). Most of the teeth (83.5%) had previously been restored and exhibited significant loss of tooth substance, more than a third of the crown (71.3%). Dental caries was present in 127 teeth (62.9%). Dental trauma was implicated in only seven cases (2.9%). Initial treatment was frequently undertaken at an emergency visit, for relief of symptoms (64.9%). The most commonly registered indication was pulpal necrosis with apical periodontitis (38.1%), followed by pulpitis (37.7%). Retreatment of a root filled tooth was reported in 18 teeth (7.4%). In the general Public Dental Service of Sweden, root canal treatment is most frequently undertaken in molars. The primary indication is relief of symptoms. Retreatment of root filled teeth is uncommon.

Dentinogenesis imperfecta type II in Swedish children and adolescents

BackgroundDentinogenesis imperfecta (DGI) is a heritable disorder of dentin. Genetic analyses have found two subgroups in this disorder: DGI type I, a syndromic form associated with osteogenesis imperfecta (OI), and DGI type II, a non-syndromic form. The differential diagnosis between types I and II is often challenging. Thus, the present cross-sectional study had two aims: to (i) investigate the prevalence and incidence of DGI type II among Swedish children and adolescents and (ii) search out undiagnosed cases of DGI type I by documenting the prevalence of clinical symptoms of OI in these individuals. We invited all public and private specialist pediatric dental clinics (n = 47) in 21 counties of Sweden to participate in the study. We then continuously followed up all reported cases during 2014−2017 in order to identify all children and adolescents presenting with DGI type II. Using a structured questionnaire and an examination protocol, pediatric dentists interviewed and examined patients regarding medical aspects such as bruising, prolonged bleeding, spraining, fractures, hearing impairment, and family history of osteoporosis and OI. Joint hypermobility and sclerae were assessed. The clinical oral examination, which included a radiographic examination when indicated, emphasized dental variables associated with OI.ResultsThe prevalence of DGI type II was estimated to be 0.0022% (95% CI, 0.0016–0.0029%) or 1 in 45,455 individuals. Dental agenesis occurred in 9% of our group. Other findings included tooth retention (17%), pulpal obliteration (100%), and generalized joint hypermobility (30%). Clinical and radiographic findings raised a suspicion of undiagnosed OI in one individual, a 2-year-old boy; he was later diagnosed with OI type IV.ConclusionsThese results show a significantly lower prevalence of DGI type II than previously reported and point to the importance of excluding OI in children with DGI.

Does a facilitated pathway improve access to dental services for homeless and disadvantaged adults?

Access to dental care is poorer for people experiencing homelessness and disadvantage due to barriers such as lengthy waiting lists, lack of transport, lack of information and fear of authorities and treatment. This study aimed to evaluate a system integration model for oral health care for clients of homeless services in Brisbane, Australia. This model aimed to provide a facilitated access pathway between homeless community organisations and a public dental service to improve access to dental care. Participants were adult (≥18 years) clients Brisbane homeless community organisations. Those who participated in the intervention evaluation completed a questionnaire, had their oral health screened and followed up for feedback at their dental appointment. Seventy-six clients of community organisations in Brisbane participated in the intervention and its evaluation. Fear was a barrier to accessing dental services for 23% (n = 18). Attendance to the subsequent appointments at the public dental clinic was high, with 85% (n = 64) attending their first appointment. A higher proportion of participants who had surgical and prosthodontic treatment needs at the screening did not attend their appointment compared to those with other needs. Overall the model piloted in this study had positive outcomes; with high attendance rates to the dental facility and positive experiences by participants.

A Comparison of Three Payment Systems for Public Paediatric Dental Services

Objective: This study investigated the delivery of paediatric (0-17 years) government dental services in New South Wales (NSW), Australia through public dental clinics and the commissioned payments models of Fee-for-Service and Capped-Fee. &#x0D; Method: De-identified patient data from government provided dental care and the commissioned services was sourced from NSW Oral Health Data Warehouse for evaluation and interpretation using descriptive analysis during the period 1 January 2012 to 31 December 2013. &#x0D; Result: The breakdown of dental care provided the associated cost analysis for the study’s cohort that resulted in both years, more than 50 percent dental services offered to paediatric patients were preventive care in all payment systems. The most common preventive items offered were fluoride treatment, dietary advice, oral health education and fissure sealants.&#x0D; Conclusion: There was little difference in the mix of dental care provided between study years and age groups through the three payment systems in NSW. The difference between the government services and those provided via the Fee-for-Service and Capitation payment systems was negligible.&#x0D; This has important implications for the delivery of dental care to public dental care, particularly when patients may not live close to a public dental clinic and also with the interest nationally in giving patients greater choice.

A Comparison of Three Payment Systems for Public Paediatric Dental Services

Objective: This study investigated the delivery of paediatric (0-17 years) government dental services in New South Wales (NSW), Australia through public dental clinics and the commissioned payments models of Fee-for-Service and Capped-Fee. Method: De-identified patient data from government provided dental care and the commissioned services was sourced from NSW Oral Health Data Warehouse for evaluation and interpretation using descriptive analysis during the period 1 January 2012 to 31 December 2013. Result: The breakdown of dental care provided the associated cost analysis for the study's cohort that resulted in both years, more than 50 percent dental services offered to paediatric patients were preventive care in all payment systems. The most common preventive items offered were fluoride treatment, dietary advice, oral health education and fissure sealants. Conclusion: There was little difference in the mix of dental care provided between study years and age groups through the three payment systems in NSW. The difference between the government services and those provided via the Fee-for-Service and Capitation payment systems was negligible. This has important implications for the delivery of dental care to public dental care, particularly when patients may not live close to a public dental clinic and also with the interest nationally in giving patients greater choice.

Interproximal grinding (disking) of caries in primary molars, attitudes and the extent utilized in a Swedish County

Objective: To assess the occurrence of interproximal grinding as a caries therapy in primary molars, to what degree grinding replaced conventional restorative caries therapy, to what extent anaesthesia was used while grinding and to assess open comments about attitudes about grinding.Materials and methods: A questionnaire was sent to 108 public dental service clinics with questions concerning the use of grinding as a therapy and alternative to restorative treatment, the use of anaesthesia prior to conventional caries therapy and grinding, respectively. In addition, a content analysis of open comments about grinding was performed.Results: Grinding had been performed in 96% of the clinics. Two-thirds of the dentists used grinding as an alternative to conventional restorative treatment at some point. Most dentists used anaesthesia prior to restorative therapy. Prior to grinding, the frequency of anaesthesia was lower (median 5.0) than for conventional restorative therapy (median 8.7) (p < .001). The open comment analysis revealed complex reasons for the use of grinding.Conclusions: Grinding has been widely practiced in parts of Sweden, is presently a technique employed by a multitude of dentists, and that anaesthesia is used less frequently prior to grinding, in comparison to conventional restorative therapy. Dentist considered grinding as a treatment option in specific situations.

Management preferences of deep caries in permanent teeth among dentists in Saudi Arabia.

Objective:To report the management preferences of deep caries in permanent teeth among dentists.Materials and Methods:This observational cross-sectional study included a convenience sample of 177 dentists selected from private and public dental clinics in different cities of the Eastern Province of Saudi Arabia. Four clinical scenarios about the absence or presence of pain/symptoms and the risk of pulp exposure in deep caries were presented to the dentists in a pilot-tested questionnaire.Results:Most dentists (82.5%) preferred complete caries excavation when there was no risk of pulp exposure and no pain/symptom was associated with deep caries in permanent teeth. The stepwise technique was the procedure of choice reported by 57.8% of dentists when there was no pain but a risk of exposure was present. In case of no exposure risk but the presence of nonspontaneous pain (pain on thermal testing), complete caries removal was chosen by 55.9% of the respondents. Root canal treatment and stepwise caries removal were preferred by 42.4% and 38.4%, respectively, when there was a risk of exposure and nonspontaneous pain. The risk of exposure (81.4%), the progression of caries (73.4%), and treatment failure (58.8%) were the most common concerns with different caries removal techniques. The hardness was the most commonly used criterion (85.3%) followed by the color of caries (50.3%) during caries excavation.Conclusions:The majority of dentists preferred to completely remove caries in case of no risk of pulp exposure. The dentists should update their knowledge and adopt latest concepts about minimally invasive caries removal approaches.

Factors associated with dental pain related to last dental visit among adult patients.

Most dental visits are made to seek dental care to relieve dental pain. However, the factors associated with behavior regarding dental visits due to pain are not fully understood. The objective of this study was to assess the factors associated with dental pain related to last dental visit among adults. The data was obtained from a cross-sectional study conducted on adults, aged 18-69 years, who visited public and private dental clinics in Dammam, Saudi Arabia. A pilot-tested, self-administered questionnaire was employed for data collection. Dental pain related to last dental visit was a dependent variable in the study. Gender, age, nationality, income and education levels, time since last dental attendance, type of dental clinic visited, and chronic systemic disease were important independent variables. The Pearson's χ2 test and multiple logistic regression analysis were used. The participants returned 671 questionnaires. Most of the participants were females (75.4%), and the majority (68.0%) attended private dental clinics. The prevalence of dental pain as the reason of last dental visit was 70.4%. A logistic regression model showed that odds ratio for subjects who visited the dentist due to pain in ≤1 year was 0.34 (95% CI = 0.24, 0.49) compared with patients who visited the dentist in >1 year. Similarly, male gender (OR = 0.64; 95% CI = 0.42, 0.97) subjects aged ≤35 years (OR = 0.61; 95% CI = 0.40, 0.95) were less likely to make pain-related dental appointments than females and individuals over 35 years. The respondents who attended private dental clinics were 1.56 (95% CI = 1.12, 2.37) times more likely to visit the dentist because of pain than those who attended a public clinic. Delayed dental visits, female gender, age over 35 years, and private clinic attendance were significant factors associated with dental consultations motivated by pain.

Twenty-year analysis of implant treatment in an Australian public dental clinic.

This retrospective cohort study reviewed dental implant treatment completed at the Adelaide Dental Hospital over a 20-year period. The database of implant treatment completed between 1996 and 2015 was analysed for patient, implant, prosthesis and operator specifics together with known implant status. Three hundred and twenty patients (mean age, 51.50 years) were treated with 527 implants. One hundred and eighty-four female patients received 296 implants and 136 males received 231 implants. Three hundred implants were restored with single crowns, 147 implants were restored with 63 mandibular implant overdentures, five implants were restored with two maxillary implant overdentures and 67 implants were restored with 20 full-arch fixed prostheses. The overall known implant survival rate was 87.67%. Mandibular implant overdentures had a risk of implant failure four times that of single implant-retained crowns that was statistically significant (P = 0.0100). Implant treatment completed in this public sector clinic using finite resources and a defined system of patient and restorative selection criteria demonstrated a high known implant survival rate. Utilizing a structured and maintained patient recall protocol, it would be ideal to investigate further parameters of interest, particularly those that could improve treatment delivery and longevity.

Effect of risk-based payment model on caries inequalities in preschool children assessed by geo-mapping

BackgroundTo describe, with aid of geo-mapping, the effects of a risk-based capitation model linked to caries-preventive guidelines on the polarization of caries in preschool children living in the Halland region of Sweden.MethodsThe new capitation model was implemented in 2013 in which more money was allocated to Public Dental Clinics surrounded by administrative parishes inhabited by children with increased caries risk, while a reduced capitation was allocated to those clinics with a low burden of high risk children. Regional geo-maps of caries risk based on caries prevalence, level of education and the families purchasing power were produced for 3-6-year-old children in 2010 (n = 10,583) and 2016 (n = 7574). Newly migrated children to the region (n = 344 in 2010 and n = 522 in 2016) were analyzed separately. A regional caries polarization index was calculated as the ratio between the maximum and minimum estimates of caries frequency on parish-level, based on a Bayesian hierarchical mapping model.ResultsOverall, the total caries prevalence (dmfs > 0) remained unchanged from 2010 (10.6%) to 2016 (10.5%). However, the polarization index decreased from 7.0 in 2010 to 5.6 in 2016. Newly arrived children born outside Sweden had around four times higher caries prevalence than their Swedish-born peers.ConclusionsA risk-based capitation model could reduce the socio-economic inequalities in dental caries among preschool children living in Sweden. Although updated evidence-based caries-preventive guidelines were released, the total prevalence of caries on dentin surface level was unaffected 4 years after the implementation.

Sociodemographic Characteristics as Predictors of Satisfaction in Public and Private Dental Clinics.

Objective:This study aimed to investigate influence of multiple sociodemographic characteristics on the patient satisfaction levels in outpatient public and private dental practices of Riyadh, Saudi Arabia.Methods:Questionnaire-based survey data were collected from 500 patients, 250 each from the public and private dental clinics of Riyadh, Saudi Arabia from September to December, 2017. Questions related to demographic factors and service attributes were included. A Likert scale of 5-points was used to measure satisfaction levels. Data was analyzed to calculate the descriptive and inferential statistics (analysis of variance and multiple regression analysis) to find the statistical difference (p < 0.01).Results:Satisfaction level differed significantly by education level (P< 0.001) and the type of clinic (P<0.001). The multiple regression analysis suggest that all variables influenced satisfaction, except age and marital status. The satisfaction score was higher by 27% for private clinics compared to public clinics.Conclusion:This study was exploratory and revealed an effect of individual variables on overall satisfaction score of the services attributes. Future plans for patient care could be developed with the help of this research.

Valuing the delivery of dental care: Heterogeneity in patients’ preferences and willingness-to-pay for dental care attributes

ObjectivesTo examine the amount of heterogeneity in patients’ preferences for dental care, what factors affect their preferences, and how much they would be willing to pay for improvement in specific dental care attributes. MethodsA discrete choice experiment (DCE) was used to elicit patients’ preferences. Three alternative dental care services that differed in the type of care provider, treatment explanation, dental staff behavior, waiting time and treatment cost were described to patients. Patients (n=265) were asked to choose their preferred alternative. The study was conducted at a public dental clinic of the School of Dental Medicine, University of Zagreb. Mixed logit and latent class models were used for analysis. ResultsOn average, the patients would be willing to pay €45 for getting a detailed explanation of treatment over no explanation. This was the most valued attribute of dental care, followed by dental staff behavior with marginal willingness-to-pay (WTP) of €28. Dental care provided by the faculty members and private dental care were valued similarly, while student-provided care was valued €23 less. Patients also disliked longer waiting time in the office, but this was the least important attribute. Four classes of patients with distinct preferences for dental care were identified. Older and/or more educated patients tended to give relatively less importance to treatment explanation. Higher education was also associated with a higher propensity to substitute faculty dental care with the private care providers. ConclusionsLarge heterogeneity in patients’ preferences was detected. Understanding their preferences may improve the delivery of dental care. Clinical significanceDental care providers should pay particular attention to providing a detailed treatment explanation to their patients. Dental care for older and/or more educated patients should be more attentive to interpersonal characteristics. Faculty dental care provided by faculty members could be price competitive to private care, and student-provided care more affordable.