FUTURE OFDENTISTRY
dental care" and a "needs approach to dental care."
The two concepts derive from very different disci-
plinary frameworks (Tuominen, 1994).
A clear distinction must be drawn between
demand and unmet need for services in order to
understand how future access to care is likely to
evolve and what interventions are likely to be effec-
tive in altering access to care for some subpopula-
tions in the future.
Unmet Need Approach for Determining Access to
Dental Services
The need-based approach uses normative judg-
ments regarding the amount and kind of services
required by an individual in order to attain or main-
tain some level of health. The level of unmet need
in a society is usually determined from health level
measurements based on epidemiological founda-
tions or other research identifying untreated dental
disease. The underlying assumption is that those in
need should receive appropriate care. Once the level
of need is determined, the quantity of resources that
should be devoted to such a social problem is then
determined based on a matching of unmet need and
appropriate care.
Evaluation of unmet need is important for identi-
fying populations in which access, for whatever rea-
son, may be a problem. Epidemiological and health
research in dentistry are designed to identify popu-
lation-based dental care problems such as segments
of the population with unmet need. An under-
standing of the economic and social conditions sur-
rounding such groups, their reasons for not seeking
professional dental care, and the role that price
plays in determining effective demand helps analysts
to identify weaknesses in the existing care system
and establish a foundation for effective remedies.
Financing of and Access to Dental Services
Trends in Endentulism, by Age,
Adults 18-74 in the United States, 1971-1994
50
45
40
35
30
25
20
15
10
5
0
PERCENT
EDENTULOUS
AGE GROUP
1 8-7 4
14. 7
- (^00). 0
- 2
- 0 9.^3
- 4
- 1
- 6
- 6
- 0
- 8
- 7
- 7
1 8- 24 25 - 34 35 - 44 45 - 54 55 - 64 65 -7 4
FIG URE 4. 2
Source: Brown and Lazar, 1998.
1971-1974
1988-1994
