title: Dental services. An analysis of utilization over 20 years.
abstract: BACKGROUND
  Utilization studies serve as an important tool for oral health policy decision-making. A number of important reports have been published that help to characterize the dental utilization patterns of most Americans. For the most part, these studies have focused on utilization estimates for a particular survey period or year. Fewer studies have examined changing utilization patterns over time.
  
  
  METHODS
  This article focuses on dental utilization and the changes in utilization for the civilian, community-based U.S. population during 1977, 1987 and 1996. Using data from the National Medical Care Expenditure Survey, National Medical Expenditure Survey and Medical Expenditure Panel Survey, the authors provide national estimates of dental visits for each of several socioeconomic and demographic categories during 1977, 1987 and 1996.
  
  
  RESULTS
  Although the dental use rates for children between 6 and 18 years of age were the highest of any age group in each of the three years studied, the use rate for children and the elderly increased during this same 20-year period. Data also showed that the gap in use rates between lower- and higher-income people widened during the 20-year period. Generally, use rates according to sex and race/ethnicity were unchanged in each of the survey years, except for a narrowing of the gap between whites and nonwhites by 1996.
  
  
  CONCLUSIONS
  These data are unique and comparable and establish a mechanism by which dental visits can be compared during a 20-year period. While aggregate utilization rates generally were stable during this 20-year period, some differences within socioeconomic and demographic groups are notable. For instance, the use rate increased during the 20-year period for people 65 years of age and older and for children younger than 6 years of age.
  
  
  CONCLUSIONS
  By understanding these analyses, U.S. dentists will be better positioned to provide care and meet the needs of all Americans.
authors.affiliation: Department of Oral Health Care Delivery, Dental School, University of Maryland, 666W. Baltimore St., Baltimore, Md. 21201, USA. Manski@Dental.umaryland.edu
authors.forename: R J
authors.initials: RJ
authors.lastname: Manski
authors.forename: J F
authors.initials: JF
authors.lastname: Moeller
authors.forename: W R
authors.initials: WR
authors.lastname: Maas
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002648:Child; D003710:Demography; D003729:Dental Care / Q000706:statistics & numerical data*; D016321:Dental Care for Aged / Q000706:statistics & numerical data; D019140:Dental Care for Children / Q000706:statistics & numerical data; D004522:Educational Status; D004651:Employment; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011203:Poverty; D044469:Racial Groups; D012044:Regression Analysis; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data