[Treating, negotiating and referring. Introduction].
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Biomedical subjects
Publications and source records attributed to J L van den Heuvel.
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Decisions made by the general dental practitioner are not only based on technical considerations, but are also influenced by interpersonal factors. This might give an explanation for the fact that patients are treated in a variety of ways in otherwise comparable dental practices. This variety is more likely to be a sign of optimal individual health care, rather than of unacceptable differences.
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After a theoretical introduction concerning the relation between wealth and dental health, the consequences as deducted from a scenario which implies a yearly increase of income for the whole population of 1.5% are presented. The main results are a strong income-dependency for the implications of an increase in income for the utilization of dental care. People from the lower socio-economical classes are expected to show increase in the amount of care consumed, while people from the higher socio-economical classes are expected to show a need for more expensive and more preventive treatment. The improvement of the oral health situation due to an increase of wealth is not expected to be significant.
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An epidemiologic survey was carried out to assess the prevalence and severity of periodontal disease in randomly selected samples of employed populations in the Netherlands. Of the 1,337 persons examined by five examiners, 19.8% were edentulous; 61% of dentate persons had intense gingivitis in an average of 2.4 segments of their mouths; 53% had pockets of 3-6 mm and a further 10.1% had pockets of greater than 6 mm. The prevalence of gingivitis and pocketing increased with increasing age and decreasing levels of education. As no measures of predicting compliance were used and because treatment philosophies differ, no reasonable assessment of treatment needs could be made.