Dental Needs and Dental

Demands
Prof. Dr. Nevine Waly
Prof. of Pediatric Dentistry & Dental Public
Health

Faculty of Dentistry
Cairo University

I- Dental Needs
Types of Need:
1- Normative need:
A condition which a professional e.g.
dentist defines as requiring treatment.
E.g. presence of carious cavity.
2- Felt need:
Assessed by asking people if they feel
they need a dental service or not. This is
inadequate because there are some
asymptomatic conditions.

3- Expressed need:
Felt need turned into action. E.g. a
patient feels pain from a cavity and
asks for treatment.
4- Comparative need:
Identified in an area by comparing it
with other areas regarding disease or
service. E.g. if other areas have a
decrease in level of disease or increase
of service, therefore there is a need in
the examined area.

Factors which influence Dental Need

1- Degree of Development:
a- Underdeveloped countries:
Their demands are to be kept alive and
free of pain.
Dental services are simple:
1- Exodontia.
2- Little amount of dental health
education. E.g. instructions in good oral
hygiene and nutrition.
3- Water fluoridation may be valuable.

b- Developing countries:
Their demands are mainly for:
1- Exodontia.
2- Prosthodontia.
Dental services include:
1- Extraction of painful teeth.
2- Insertion of partial denture or
complete denture of simple design.
3- Dental health education.
4- Prevention and early treatment of
dental diseases for young generations.

c- Well developed countries:

Dental services include:
1- Restoration of serviceable teeth.
2- Replacement of missing teeth.
3- Routine dental examination for early
control of dental diseases.
4- Preventive and educational measures e.g.
fluoride application, pit and fissure sealants,
tooth brushing techniques and dietary
control .
This is called Comprehensive dental care.

2- Age:
* Need for treatment of traumatic injuries
to anterior teeth is maximum at age of
12-14 years.
* Need for fillings a peak between 1524 years.
* Need for extraction increase with
age.

* Need for periodontal treatment high

at middle age but reaches a peak at 40
years.
* Need for crown and bridge high in
middle age (only a small group of teeth
have been extracted).
* Need for partial dentures follows.
* Need for complete dentures peak in
later years of life.

3- Sex:
* Need for fillings and periodontal
treatment is the same in both sexes.
* Need for extraction and dentures is
lower in women than in men (women
care about their appearance more than
men).

4- Income:
a- In developed societies:
Dental needs are lower among patients with
increased income due to:
better preventive measures.
better education.
more frequent visits to dentist.
b- In undeveloped societies:
People with increased income need more
dental care especially young age groups.

5- Race:
* In USA blacks need filling,
periodontal treatment, extraction and
prosthodontia more than whites.
* Indian and Chinese groups have high
needs for periodontal treatment than
USA citizens but lower needs for caries
treatment.

II- Demand for Dental Care

Factors affecting demand:
a- Automatic factors:
Any increase in one or more of them is
automatically associated with an
increase in the demand.
A- Gross increase in population:
The larger the community the greater the
demand for dental care.

B- Urbanization:
More persons in urban than in rural areas visit
the dentist more regularly.
C- Education:
Demand for dental services increases with the
increase in the level of education.
D- Occupational changes:
Persons in professional occupation visit the
dentist more frequently than manual workers.
E- Income per capita:
Income per capita is correlated positively with
demand of dental services.

b- Dentists efforts to stimulate demand:

This includes dentists efforts in the
dental health education to make the
patient recognize the sequel of neglected
oral and dental condition and to maintain
the dental apparatus healthy and
functioning.

Organization of Dental Care

Organization of Dental Care

* The reason for division of work is due
to:
1- Different levels of knowledge and
training among people, so one worker
does a part of the work and leaves the
other parts to other workers.
E.g. cleft palate
( surgeon, orthodontist, pedodontist,
speech therapist, )

2- Certain parts of the work require top skill

and knowledge ( professional service);
e.g. cavity preparation is done by the dentist,
Other parts require less skill and knowledge;
e.g. carving restorations can be done by
trained auxiliary personnel.
3- Until now number of dentists > number of
auxiliaries.

Types of Dental Auxiliaries

Dental auxiliaries are trained persons who help
the dentist in delivering dental care.
1- Dental Assistant:
Duties:
1- Reception of patient.
2- Preparation of mouthwashes and napkins.
3- Sterilization and preparation of instruments,
cleaning away instruments and preparing new
instruments for next appointment.

4- Mixing of restorative materials and

impression materials.
5- Filing of patients.
6- Assistance in x-ray work, developing
and processing.
7- Instructions to patient in good oral
hygiene e.g. tooth brushing.
8- After care of patients with general
anesthesia.

2- Chair Side Dental Assistant:

* One chair-side dental assistant increase
number of treated patients by 33%.
* Two chair-side dental assistant increase
number of treated patients by 62%.
* Dentist will work under less physiological and
mental strain better service.

* Four-handed dentistry dentist and

assistant are seated to reach easily
patients mouth, with patient in fully
supine position.
Duties:
1- Handling instruments and materials.
2- Retraction.
3- Aspiration.

3- Dental Auxiliaries:
Trained for 2 years to perform operations
of limited nature i.e. repairable
procedures (can be redone or corrected).
They do not prepare cavities but
complete the restorative procedures.

Duties:
1- Application of rubber dam.
2- Application of temporary restorations.
3- Application of matrices.
4- Condensation and carving amalgam.
5- Finishing and polishing restorations.

4- Dental Hygienist:

Dental Hygienist
Hygienist
Dental

A- Public
Public health
health dental
dental
Ahygienist
hygienist

B- Clinical
Clinical dental
dental
Bhygienist
hygienist

A- Public Health Dental Hygienist

Trained for one or more years in dental
health education and public health.
Duties:
1- Screening or examination of school
children or workers in industries and
refer them to the dentist.
2- Classroom teaching in dental health.
3- They are very efficient in public health
programs.

B- Clinical dental hygienist

They receive less training.
Duties:
1- Dental prophylaxis.
2- Polishing restorations.
3- Topical fluoride application.

5- Dental laboratory technician:

* They are usually men.
* Originally training was done in dental office
variation in quality of training.
* Nowadays there are commercial dental
laboratories working for a lot of dentists.
This is better because:
1- Dentists do not have enough work to employ
a full-time technician.
2- Technician can profit by division of labour in
these laboratories e.g. expert in gold, expert
in porcelain..

6- New auxiliary types for underdeveloped

areas:
In these areas there is dentist shortage. So
they can make use of 2 types of dental
auxiliaries.
A- The Dental Licentiate:
Trained for not less than 2 years.
Duties:
1- Dental prophylaxis.
2- Cavity preparation and filling.

3- Extractions under local anesthesia.

4- Treatment of common gingival and
periodontal diseases.
5- Early diagnosis of serious conditions
requiring referral.
They are responsible from a dentist.

B- The Dental Aid:

Has briefer training (4-6 months).
Performs first aid procedures for relief of
pain.
Duties:
1- Extraction under local anesthesia.
2- Control hemorrhage.
3- Early diagnosis of dental conditions
for referral.