Estimating dental treatment needs among American Indians and Alaska Natives.
OBJECTIVE
This paper describes the treatment needs of the American Indian and Alaska Native (Native American) population estimated from the 1991 Indian Health Service Oral Health Status and Treatment Needs Survey (1991 IHS patient survey).


METHODS
The average per capita treatment need for the population is expressed both as the number of dental services and clinical time required to provide these services. Values for service minutes also are used to compare treatment needed with the treatment provided.


RESULTS
The need for dental care is greatest among adults aged 25-54 years. We anticipate that needs will increase with population growth and as teeth are retained longer. Large amounts of dental needs go unmet each year in the Native American population: because resources are not available to provide all needed care, dental services are prioritized and rationed. The basic premise upon which care is rationed is changing from basic care for all who have access, to more complex care for fewer individuals. This trend may be driven by the opportunity to generate third party revenue offered by more complex procedures.


CONCLUSIONS
Evaluation is needed of the effects of new approaches on oral health and access to dental care.
Indian Health Service, Parklawn Building, Room 6A-30, 5600 Fishers Lane, Rockville, MD 20857, USA. ebroderi@hqe.ihs.gov
E B
EB
Broderick
W J
WJ
Niendorff
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000413:Alaska / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003729:Dental Care / Q000706:statistics & numerical data*; D015276:Health Care Rationing / Q000706:statistics & numerical data; D006292:Health Priorities / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D004930:Inuit / Q000706:statistics & numerical data*; D008875:Middle Aged; D009909:Oral Health; D011158:Population Growth; D013997:Time Factors; D014481:United States / Q000453:epidemiology