PubMed · 6584123
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1984-03-10. The missing patients.. https://doi.org/10.1038/sj.bdj.4805292
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The objective of this study is to describe for a diverse sample of dentate adults the incidence of dental care use and predisposing, enabling, and need correlates of that use. The Florida Dental Care Study (FDCS) is a prospective longitudinal cohort study of persons who at baseline had at least one natural tooth, were 45 years or older, and who resided in north Florida, U.S.A. An in-person interview and clinical dental examination were conducted at baseline and 24 months after baseline, with 6-monthly telephone interviews between those times. Seventy-seven percent of subjects reported one or more dental visits during the 24 months of follow-up. Six-monthly use ranged from 46% to 55%. Incident perceived need for care and certain incident self-reported oral signs and symptoms were strongly predictive of incident dental care use. Decrements in oral functional limitation, oral disadvantage, and self-rated oral health were predictive of less care bivariately, but were not salient in a multivariate model, with two notable exceptions: two measures related to esthetics. The conclusions are that certain measures of need (perceived need and specific self-reported signs and symptoms) were important predictors of incident dental care. However, persons with need as determined by direct clinical examination and persons with need as determined by self-reported decrements in the more distal measures of oral health (oral functional limitation, oral disadvantage, and self-rated oral health) were actually less likely to seek dental care. The salience of esthetics in predicting use is consistent with cross-sectional findings that dental esthetic cues are important to oral "health". Typical approach to care, dental attitudes, ability to pay for care, race, and sex were also important for understanding incident dental care use.
Although the total number of active private dentists increased by 21.7 percent between 1982 and 1995, the number of active private part-time dentists increased by 104 percent, while the number of active private full-time dentists increased by 8 percent. Thus, the total number of hours active private dentists spent in the office has not increased to the same extent as the number of active private dentists. During the same period, however, the average number of hours spent treating patients increased, indicating that dentists are becoming more efficient in directing their office hours toward clinical dentistry. The distribution of active private part-and full-time dentists and the actual number of hours they spent in the dental office and spent treating patients provide a more complete picture of the capacity of the dental care delivery system than only looking at the increase in the total number of dentists.