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[Position of preventive dentistry in Belgium: overview of private and public aspects].

The authors provide a summary of the situation with regard to preventative dental medicine in Belgium, with special emphasis on the health insurance system, the attitude of Belgian dentists to prophylaxis, the status of preventative dentistry at universities, and the estimated requirements with respect to prevention together with some initiatives in this area.

Belgium↗

Preventive dentistry in private practice: a survey in Kentucky.

General practitioners in Kentucky were surveyed to establish a profile of preventive practice in the state and to identify factors influencing the profile. Both questionnaire and interview methods were used. A Kentuckian has a 55% chance of seeing a dentist who advises all his patients about prevention, and an 87% chance of seeing one who adivses some of his patients. Persons between the ages of 6 and 24 are most likely to receive preventive services. The dentist is selective about who receives a preventive-oriented examination, and he is more likely to perform the services than auxillaries. The profile shows the need for a greatly increased emphasis on preventive dentistry in undergraduate and continuing education courses and for the increased use of auxiliary personnel in the delivery of preventive services.

Adolescent↗

Preventive dentistry in a health centre: effectiveness and cost.

The clinical and economic effects of a programme of preventive dentistry for children in an inner-city health centre are compared with those for traditional restorative care. Reductions in the rate of dental caries are estimated to be 70% for children aged 4-6 after 4 years in the programme (dmft) and 85% for children aged between 7 and 10 years after 4 years (DMFT). The cost-effectiveness analysis on which the economic appraisal is based identifies the issue of differences in the quality of output as critical to choices between the two treatment regimes. The preventive programme was primarily intended for pre-school children; for this younger group, assumptions about the quality of the preventive outcome would have to value it at between 0.8 and 1.2 times the quality of the restorative outcome in order to make up the difference in cost between the two regimes. For 7-10 year olds, the 4-year analysis showed the preventive programme to be more costly than restorative care largely because of low rates of incremental change at these ages. These rates were partly influenced by the design of the study and partly by the eruption status of the permanent dentition across this age-group. There is a need for further study of measures of dental outcome which combine aspects of both the quality and length of life of teeth.

Child↗