[A comparison of paying patients in private practice and in public dental service--found from the Harstad-study 1974]

Since 1950, the Public Dental Service (PDS) has gradually been developed in Norway. In addition to rendering free and systematic treatment to children aged 6--17 years, which has priority, the PDS also offers treatment to other categories of patients at fixed fees, generally lower than those in private practice. The purpose of the present study was to elucidate the impact made by PDS on the dental treatment pattern within one particular area (the district of Harstad with a population of approximately 29,000). Furthermore, the study included a description of the clientele in the PDS, excluding the "free clientele" aged 6--17, in relation to that treated in private practice. During a limited period in February--March 1974, all the 9 dentists in the PDS treating "paying clientele" and all the 9 private practitioners in the district, filled in a questionnaire by each patient visit (course of treatment) (Fig. 1). In addition to the information on social and demographic characteristics, data were also collected on dental treatment pattern, the treatment presently rendered, and the presence of teeth and possible dentures (Fig. 1). Four--fifths of the visits made by "paying clientele" were made in private practice, only one--fifth in the PDS. In private practice, rural people, women and people of young age were underrepresented. Children under 6 years of age comprised 3% of the clientele in private practice and 9% in the PDS. No significant difference was found between the two types of practice regarding the social class composition of the clientele. Dental status as measured by the occurrence of teeth and dentures was generally poorer among the PDS patients, seemingly due to the overweight of rural people and of those with an irregular or occasional treatment pattern. Totally 40% of all visits were made by regular treatment attenders. 20% of the services delivered were prophylaxes and/or periodontics, 56% were conservative and/or endodontic treatments. The introduction of the FDS in the district some 10--15 years ago has conceivably contributed to an overall increase in the demand for dental services, and to an improvement of denial treatment patterns. During this period, the number of public dentists has increased from 2--3 to a total of 12. Correspondingly, the number of private practitioners has increased from 5 to 9, of whom 2 work part time. The treatment attendance of some population subgroups is, however, still lagging behind: rural people, small children and persons over 50 years of age, and particularly people belonging to lower socio-economic brackets.