Features of oral health care across cultures

This paper sets out to draw together the findings from the five individual studies and to draw tentative conclusions from them. It is pointed out that the comparisons made are between system factors and not between whole systems of oral health care. An attempt is made to evaluate the effectiveness of individual system features in the hope of being able to suggest ways in which those shown to be most beneficial might be incorporated into complete systems. In relation to caries experience, measured as DMF teeth, there is a wide variation, not only by each of the separate components to that total. In those studies where extensive school dental services exist, the F component accounts for almost all the score while in the other study groups it forms only about half the total, the proportion tending to be greater in the non-metropolitan than in metropolitan populations. In the same way treatment/need ratios and amounts of retreatment required show the benefits of the existence of the school dental service. The treatment/need ratio is then examined in relation to selected variables such as method of payment, utilization of auxiliaries, the existence of specified target groups etc. When the method of stepwise regression analysis is applied to the pooled samples utilization of services remains the most important predictor of treatment/need ratio. Others in order of importance are whether dental personnel decide on frequency of visits, whether the last visit was made for symptomatic reasons alone and whether lack of severity of symptoms had been a reason for avoiding oral health care. In relation to periodontal conditions no clear picture has emerged and this may demonstrate how systems of all types have failed to deal with this problem. Although much remains to be elaborated three main findings have already emerged from this study: (i) The need for reinforcement of preventive behaviour and services. (ii) The effectiveness of regulated contact between consumer and provider in meeting treatment needs. (iii) The need to concentrate on quality as well as volume of care in providing adequately for the needs of child and adolescent populations.