The answer to this question will be different for every community. Before starting a program or requesting funds to do so, it is important to determine that a need exists and that the need is sufficiently great to justify a program. From a public health perspective, the following population groups are reported to have problems accessing, receiving or paying for oral health services:
For a comprehensive review of oral health needs and access problems, see the monograph Access to Oral Health Services in the United States 1997 and Beyond (PDF). Read about Alaska's unique dental access problems (PDF). The issue brief Community Efforts to Expand Dental Services for Low-Income People provides a brief, more recent commentary. The following figure of the U.S. population provides one way to visualize which populations might need services.
Courtesy of Dr. Michael Helgeson, 2006
|One way to reduce some of the access barriers is to provide services at locations where these populations gather, live or receive other services. Clinical services have been delivered using mobile or portable equipment at Head Start centers, school systems, extended care facilities, work sites, community centers, housing complexes, homeless shelters, shopping malls or other sites.|
You should be able to clearly state the need for services by using real data. If you already are providing oral screenings or services to some members of these groups in a fixed clinic or other setting, then their oral health needs are probably pretty apparent. To acquire additional information on specific population groups in your area, contact your state's oral health program using this alphabetical list by state, or a local health department, or a dental school in the state to inquire about surveys that have been conducted in recent years. To view some national and state oral health information, go to the National Oral Health Surveillance System Web site. If you have an opportunity to conduct an oral health survey that is fairly inexpensive and quick, consider using the Basic Screening Survey as an instrument. Manuals and training materials are available with the survey instrument.
Oral health services and how these services are delivered will depend on the age of the population and the type and extent of oral health needs. Pregnant women will need preventive care and possibly restorative care to help assure their overall health and the health of their child after birth. Young children will probably need mostly preventive services such as fluoride varnish, with some needing basic restorative dentistry, and a small percentage needing advanced pediatric dental services. Older children will continue to need preventive services (especially dental sealants) and restorative care, and some will need orthodontic consultation and services. Adults, on the other hand, may have more complex treatment needs from dental caries and periodontal disease, and will require more specialty care. Older adults may have more prosthetic needs related to dentures and other appliances, while some will have complex restorative and periodontal needs. Populations who have not received preventive care and treatment on a regular basis will have more advanced dental disease and complex treatment needs. Chapters 2, 3 and 4 of this manual will discuss the benefits and limitations of mobile and portable systems for addressing this wide range of oral health needs.