Effectiveness of oral health care--some Danish experiences

The paper presents an overview of the oral health situation in Denmark with consideration to the effectiveness of dental health care services to children, adolescents, and adults. According to the Act on Dental Health consolidated in 1986, the Municipal Dental Service provides systematic preventive and curative care free of charge to the child population and adolescents. The adults are responsible for a substantial part of the payments at the private dental practitioners but some of the payments, in particular the curative services, are covered by the National Health Insurance Scheme. The Municipal Dental Service is attended by nearly 100%. In order to plan and evaluate the service, a standardized recording system has been established. Thereby, national oral epidemiological data have been provided since 1972. Partly due to the preventive approach, a general decrease over-time in the prevalence of dental caries has been documented for children and adolescents. For example, in 1972 children in first class had a mean caries experience of 12.4 def-s against 3.9 def-s in 1990. Moreover, the distribution of dental caries has become even more skewed which means that an increasing number of the children are free of caries while a limited number of the children still show a significant caries experience. According to interview data from 1987, 72% of the adult population 16 years of age and above reported regular dental visits at least once a year. The proportion of regular dental visitors were high in 16-24-years-old (92%) but lower in the age group 65-74 (35%). In 1982, clinical epidemiological data were collected as part of a national oral health survey. The results indicated that the amount of untreated dental caries and the number of missing teeth were significantly lower among regular dental visitors than irregulars. As to periodontal health, treatment needs were also prominent among regular dental visitors. In a longitudinal survey, over-time changes in the occurrence of denture wearers have been observed. In 1976, 30% of the 35-44-year-olds were denture wearers against 11% in 1986. One important finding from this survey was that social inequality in oral health seems to be reduced in younger adults. Finally, experiences from implementation of health education and preventive dental care in industrial settings are discussed, and the health outcome of a comprehensive public dental health care programme for old-age pensioners is reviewed.