December 2012

Volume 29, Issue 4

Letter from America: UK and US state-funded dental provision

Authors: R.B. Currie I.A. Pretty M. Tickle G. Maupomé
doi: 10.1922/CDH_2776Currie06

Abstract

Objectives: Current UK and US economic conditions have re-focussed attention on the need to deliver dental care with limited finance and resources. This raises hard questions determining which services will be offered and what they should achieve to satisfy public demands and needs. We consider impending dental health reforms in the US and UK within the context of contemporary experiences to identify issues and delivery goals for the two nations. Background: The paper provides a brief history and background of the development of social dental care models in the UK and US, highlighting some differences in state-funded delivery of dental care. Shifting Demand: From the 1950s, demand for dental treatment has increased and acquired a more complex composition growing from predominantly surgical and restorative treatment to encompass preventive care and cosmetic services. Prioritising care according to need: Despite improvements in general health and technology, inequalities in access and utilisation of dental care are still experienced, primarily by groups with low socio-economic status. Delivery: balancing resources, demand and need: In developing and delivering reform agendas, much can be learned from previous policy interventions. Pressures of cost, coverage, and capacity, besides demand versus need must be carefully considered and balanced to deliver quality service and value for users and taxpayers. Conclusions: Ethical and moral consideration should be given to making services needs-driven to address high treatment requirements rather than the high care demands of the worried well. This challenge brings the additional political pressure of convincing many of the voters (and subsequent complainers) that their demands may be less important than the needs of others. Key words: health care reform, dental care, comprehensive dental care, dental health services, health services accessibility, national health programs, United States, United Kingdom

£10 single article

Other articles in this issue

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Editorial - Do we really need another system for recording caries? Thoughts on ICDAS 258-259 £10 single article
Dental Public Health in Action - Maintaining a survey programme during structural change 260-262 £10 single article
Dental health of Irish alcohol/drug abuse treatment centre residents 263-267 £10 single article
Recent trends in incidence and mortality of oral and pharyngeal cancer in Schleswig-Holstein in Northern Germany 268-273 £10 single article
A description of oral health in three French jails 274-278 £10 single article
Dental erosion among 12 year-old Libyan schoolchildren 279-283 £10 single article
Children’s views on the experience of a visual examination and intra-oral photographs to detect dental caries in epidemiological studies 284-288 £10 single article
Child dental anxiety, parental rearing style and referral status of children 289-292 £10 single article
Caries status in 16 year-olds with varying exposure to water fluoridation in Ireland 293-296 £10 single article
Caries prevalence in 12-year-old Cypriot children 297-301 £10 single article
Cost-effectiveness models for dental caries prevention programmes among Chilean schoolchildren 302-308 £10 single article
Industry structures in private dental markets in Finland 309-314 £10 single article
Letter from America: UK and US state-funded dental provision 315-320 £10 single article

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