A carrier like Delta Dental possesses valuable information in the form of millions of dental claims processed over the years. Today’s data warehouse and mining technology allows us to tap into that information, question industry traditions and set new dental policy based on evidence from the historical claim record.

Delta Dental’s data warehouse contains information on 150 million services, which we mine to study patterns of care and improve our dental benefits plans. For example, we recently conducted a study of crown replacement to test the validity of the five-year time limitation on crowns, which has been industry standard for years. We looked for evidence in the claim record of any crown replacement over a seven-year period. After isolating the tooth number of every patient who received a crown in the baseline year of 1998, we were able to see if that particular tooth had a replacement crown in the six years that followed.

The study found a replacement rate of less than five percent after seven years. This result suggests that the time limit on crowns could be increased beyond the standard five years without adversely affecting the vast majority of plan enrollees. When considering that the materials and techniques used for placing crowns have been improving since the industry standard was established, a change to the time limitation could reduce costs for plan purchasers.

Powerful data mining techniques revealed other interesting information from the same data warehouse study. In another example, crowns in the front teeth were more likely to be replaced than molars or bicuspids. This result may indicate that some early replacements are made for cosmetic reasons, thus reaffirming the need for a time limitation for this treatment.

Other data warehouse-based investigations that Delta is conducting include optimal time limitations for sealant replacement and the cost-effectiveness of dental implants as a standard benefit.