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 Indi an Health Service Oral Health Status and Treatment Needs Survey (1991 IHS p atient survey). Methods: The average per capita treatment need for the popu lation is expressed both as the number of dental services and clinical time required to provide these services. Values for service minutes also are us ed to compare treatment needed with the treatment provided. Results: The ne ed 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 Amer ican 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 th e opportunity to generate third party revenue offered by more complex proce dures. Conclusion: Evaluation is needed of the effects of new approaches on oral health and access to dental care.