Dentists' perceptions of providing care in long-term care facilities.

AIMS To compare the perceptions of dentists in British Columbia regarding their decisions to provide treatment in long-term care facilities and to explore changes since 1985 in Vancouver dentists' attitudes to treating elderly patients in such facilities. MATERIALS AND METHODS Dentists were randomly selected from all of British Columbia in 2008 and surveyed with a similar questionnaire to that used for a 1985 study of Vancouver dentists. The attitudes of current dentists, the patterns of their perceptions and trends over time were analyzed. RESULTS Of the 800 BC dentists approached for the survey in 2008, 251 replied (31% response rate). Only 37 (15%) of these respondents were providing treatment in long-term care facilities, and another 48 (19%) had stopped providing services in this setting. Among those providing care, important considerations were continuing education in geriatrics, the presence of a dental team and fee-for-service payment. The most common reasons for deciding to provide services in long-term care facilities were to increase the number of patients being served and to broaden clinical practice. Dentists who had stopped treating patients in long-term care facilities reported their perception that treating elderly people is financially unrewarding and professionally unsatisfying. The perceptions of dentists shifted substantially from 1985 to 2008. In particular, dentists responding to the 2008 survey who had never provided services in long-term care facilities were more likely to perceive administrative difficulties and a lack of financial reward as barriers than those surveyed in 1985. In addition, the proportion of Vancouver dentists with advanced education in geriatrics declined over the period between the 2 studies (75 [22%] of 334 in 1985, 10 [11%] of 87 in 2008). CONCLUSION Dentists who did not provide care for residents of long-term care facilities in 2008 seemed more likely to be deterred by administrative difficulties and financial costs than those not providing such care in 1985. In addition, fewer dentists had appropriate training in geriatrics. Continuing education, working with a dental team and payment on a fee-for-service basis were important factors for dentists who were providing care in such facilities.