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 Indian Health Service Oral Health Status and Treatment Needs Survey (1991 IHS patient survey). METHODS: The average per capita treatment need for the population is expressed both as the number of dental services and clinical time required to provide these services. Values for service minutes also are used to compare treatment needed with the treatment provided. RESULTS: The need 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 American 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 the opportunity to generate third party revenue offered by more complex procedures. CONCLUSION: Evaluation is needed of the effects of new approaches on oral health and access to dental care.