Patterns of disease and treatment and their implications for dental health services research

An expert panel examining future goals for oral and dental health services research in the United States, considered that high on the list of priorities should be investigations of public health solutions for the control of those diseases which are of low prevalence but high morbidity and mortality such as oral cancer, and those which are of high prevalence and social impact but which represent a lesser threat to health such as dental caries. Against the background of demographic population changes, the present overview first examines trends in caries experience in the United Kingdom and their research implications, and then trends in oral cancer and precancer. It is suggested that an opportunistic screening programme for the latter conditions could be a cost-effective, feasible and appropriate approach to their prevention. An existing computer simulation model for undertaking cost evaluation studies of alternative interventions is discussed and it is concluded that such a model could provide useful background data before a national pilot study of screening for oral cancer and precancer were embarked upon.