Author: Jessica Kent

A team from Regenstrief Institute and the Indiana University School of Medicine is applying data analytics techniques to previously inaccessible dental record information with the goal of improving oral health outcomes.

Researchers assessed de-identified data from electronic dental records (EDRs) of 217,887 patients of 99 solo or small dental practices across the US. These EDRs included more than 11 million observations, with observation periods as long as 37 years.

Information on demographics, reason for visit, medical and dental history, social history, tooth characteristics and treatment, and practice and practitioner characteristics was collected for each patient visit.

Dentists could share their data for research in an anonymized process with the help of their EDR vendor. Data from two EDR systems with different formats and operating systems were combined, where interoperability has previously proved difficult with medical data.

Additionally, the study looked at the oral health and treatment options of both insured and uninsured patients, in contrast to previous studies which have relied on insurance records and haven’t provided any information on uninsured patients.

The group found that it was possible to mine and utilize massive amounts of dental record data to determine which dental therapies work and which don’t, which could lead to quality improvement from individual dentists. The study showed that EDR data is reliable for purposes beyond clinical patient care.

Dental practitioners can learn from aggregated data across practices and compare their practice with their peers, researchers said. Information collected at each patient’s visit can contribute to improved outcomes and the development of a true learning health system. This study is the largest to evaluate data quality in a regular patient setting.

“Here in the real world of the dentist’s office we are seeing patients with all kinds of real-world conditions – pain, underlying medical conditions, lack of adequate past oral health care — so this large data set provides a unique insight into the treatments offered in the type of dental offices where most Americans receive care,” said Dr. Thyvalikakath, the founding director of Regenstrief-IU School of Dentistry dental informatics program.

Past research has shown that evaluating dental record data from both insured and underinsured individuals can help inform care delivery and expose gaps in oral care.

A 2019 study showed that racial minorities, lower-income individuals, and uninsured or publicly insured patients were significantly less likely to report that they had received screenings for oral cancer, revealing glaring disparities in oral healthcare.

Investigators can examine this real-world data to better understand the quality of care delivered to patients in different populations.

Now that they have completed the proof-of-concept, the Regenstrief and Indiana School of Medicine team will leverage the data to assess the long-term effectiveness of two common dental procedures performed on permanent teeth: root canal therapy and tooth-colored teeth fillings in rear teeth.

This part of the study will determine how well and how long root canal treated teeth and back teeth filled with tooth-colored fillings continue to function. Data analysis for this portion of the study will help dentists and patients make evidence-based care decisions. Data analysis is currently nearing completion and the researchers will publish their findings in the future.

“Findings derived from patient data in real-world conditions is typically less difficult for clinicians to translate at the point of care than studies performed in large health systems which often represent a patient population that does not mirror the community dentists see in their practices,” said Thyvalikakath.

“We are presenting a mechanism for dentists, many of whom practice by themselves or with only one or two others, to learn from their own experience and from the experiences of their peers to assist in improving skills and facing problems.”

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