A sociodental approach to assessing dental needs of children: concept and models.
OBJECTIVE
Traditional normative methods of assessing dental needs do not correspond to current concepts of 'health' and 'need'. Although there is dental research on quality of life, evidence-based practice, and oral behaviours, those concepts are rarely applied to dental needs estimation. Dental needs are usually calculated mainly from clinical data and are likely to be inaccurate. A structured comprehensive method for assessing dental needs is required. The objectives of this study are to develop and test a new sociodental system of needs assessment for overall dental needs of primary schoolchildren. Furthermore, normative and sociodental estimates of need are compared.


METHODS
The study developed a theoretical framework and pathway algorithms of sociodental needs assessment and applied them to assessing overall dental needs. Normative dental needs were assessed using standard normative criteria. The child oral impacts on daily performances (Child-OIDP) was used to assess oral impacts, and a self-administered questionnaire was used to obtain information on demographic variables and oral behaviours. Data were analysed according to the developed algorithms.


METHODS
A cross-sectional survey in Suphanburi Province, Thailand.


METHODS
All 1,126 children aged 11-12 years in a town.


RESULTS
The sociodental approach was acceptable and not costly. In all, 54.4% had normative need under the dental needs model for life-threatening and progressive conditions, but only 16.6% had high propensity-related need; the remaining 37.8% would require dental health education or oral health promotion (DHE/OHP) or both and appropriately adjusted clinical interventions. Under the basic model of dental needs, 45.1% had normative need. Two-thirds of them (30.9%) had impact-related need and the remaining 14.2% did not have oral impacts and therefore should only receive dental health education. Only one-third of those with impact-related need had high propensity and were suitable for evidence-based conventional treatments; the remaining two-thirds should receive DHE/OHP and alternative clinical interventions.


CONCLUSIONS
A sociodental system of dental needs assessment was developed and tested on school children. It decreased the estimates of conventionally assessed dental treatment needs and introduced a broader approach to care.
Gherunpong
S
S
Department of Epidemiology and Public Health, Royal Free and University College London Medical School, London, UK.
Tsakos
G
G
Sheiham
A
A
D000465:Algorithms; D002648:Child; D003430:Cross-Sectional Studies; D003729:Dental Care; D003753:Dental Health Surveys; D005260:Female; D015438:Health Behavior; D015276:Health Care Rationing / Q000379:methods*; D006267:Health Education, Dental; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D020380:Needs Assessment; D011788:Quality of Life; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013785:Thailand