Converting the need for care into demand for services

Two strategies for converting need into demand are identified. One, a longer term programme, involves raising the level of 'want', or perceived need, through attitude change. The other has a more immediate impact and involves increasing the rate at which perceived needs are converted into demands by reducing organizational barriers. It is argued that, potentially, a quarter of the adult population is susceptible to demand expansion under the second strategy. Although racial and social class differentials in perceived need would be unaffected by such a programme, inequality in demand would be reduced. A number of quite specific initiatives are suggested. First, the retentiveness of the dental system can be increased, especially among marginal groups, through the establishment of a more egalitarian clinical relationship, by the exercise of human relationship skills, through behavioural strategies for increasing compliance and through improved access. Secondly, improved geographical access can be achieved through tapping the 'captive' populations present in two major institutional areas, the school and the work site. This requires mobility in deployment of resources and flexibility in negotiating the organization and financing of care. Finally, more rational visit schedules, organizational arrangements and payment systems need to be developed in the average dental practice.