Orthodontists' and orthodontic residents' education in treating underserved patients: effects on professional attitudes and behavior.

The U.S. surgeon general's report on oral health in 2000 stressed the importance of providing dental care for underserved patient groups. Given that orthodontic treatment is less likely to be covered by dental plans than other procedures and is often considered an elective treatment, it is not surprising that access to orthodontic care is an especially severe problem for underserved patient groups. The purpose of this study was to explore the degree to which orthodontic residents and orthodontists perceived that their graduate orthodontic education had prepared them well to treat underserved patients and whether this education affected their professional attitudes and behavior concerning providing care for members of historically underserved patient groups. Survey data were collected from 135 residents in U.S. and Canadian graduate orthodontic programs and from 568 active members of the American Association of Orthodontists (AAO). While the majority of residents and orthodontists felt well prepared to treat patients from different ethnic/racial backgrounds (quality of clinical education: residents: 86.4 percent; orthodontists: 82.3 percent), considerably fewer respondents felt well prepared to treat patients on Medicaid (64.7 percent and 34.4 percent), pro bono cases (45.4 percent and 33.4 percent), patients with special needs (52.8 percent and 35 percent), patients with craniofacial anomalies (65.3 percent and 52.6 percent), and patients with developmental delays (45.5 percent and 30.5 percent). Perceptions of the quality of education correlated significantly with the professional attitudes and the actual/projected behavior concerning providing care for patients from these underserved patient groups. Given the lack of access to orthodontic care for patients from underserved patient groups, initiatives are needed to change this situation. These findings showed a clear relationship between how future orthodontists are educated about providing care for patients from underserved populations and their professional attitudes and behavioral intentions to provide care for individuals who historically have encountered access to care barriers. Dental education has to accept the responsibility to prepare future dental care providers to be able to treat patients from underserved groups.