A factor analysis of traits as measured by COCSTOC-MOT to identify occlusal trait combinations.

Occlusal conditions which vary significantly from accepted social norms for dental appearance may socially handicap an individual. An instrument is required by which socially unacceptable occlusal conditions can be identified by members of the public who have internalized society's norms for acceptable dental appearance. The factors identified in this paper make it possible to select a reasonable number (100) of models for constructing a measurement instrument which depicts the full range of occlusal patterns found in a natural population for use in assessing the social acceptability of occlusal conditions. This paper presents the methodology and process used to identify individual occlusal traits which tend to occur together in trait combinations or independently and their range from "normal" to extreme. Data on the frequency distribution of the individual COCSTOC measurements found in a natural population was subjected to a factor analysis which identified 18 occlusal patterns (combinations of traits) and five unique or independent traits or anomalies.

Provider expectations and consumer perceptions of the importance and value of dental care.

Seventy-eight inner city mothers of third and fourth grade children in three racial groups--white, black, and American Indian--known to need dental treatment for disease on permanent teeth, were interviewed at home by a trained community resident interviewer. Sixty-two per cent of the mothers were on public assistance. Information relating to the mothers' perceptions of the importance and value of dental care both for herself and for her children were collected. Utilization data were obtained via two dental examinations conducted one year apart. Data were also collected from a sample of provider dentists via mail questionnaire. A yield of 315 usable questionnaires was obtained, a return rate of 53 per cent. Provider-dentists felt that low socioeconomic consumers do not value dental services, as compared to other types of consumer goods and services, and that they do not believe dental care is important. Low income mothers in the same city reported that they did value dental care and believed it important. Expectations of and orientations toward the importance of dental care were found discongruent between the two groups of respondents. These discongruities on the dentist-patient relationship are discussed as a barrier to utilization. Although financial resources were available to many of the study families, only 49 per cent of these children received the needed care. It is suggested that the psychological cost to a patient of seeking care in inhospitable settings may act as a barrier to utilization.

Dental health status of third grade children and their families within the context of a community's dental health care system.

Utilizing structure, process, and outcomes as conceptual dimensions of appraisal of quality, data were analyzed to present an evaluation of the quality of a community's dental health care system as reflected in a population subgroups' dental health status. Data were collected from 838 Caucasian third-graders and their parents through interviews, mail questionnaires, and dental screening examinations. Indicators of structure were: status of community water fluoridation in the study community, dentist to population ratio, and dental care resources in the public sector available to eligible residents. Process indicators of quality were: 1) screening, case finding, examinations, and quality of restorations as measures of provider behaviors, and 2) complaints, compliance, conditioned behaviors, level of dental health knowledge, and utilization of dental services as measures of client behaviors. Outcomes, subjected to analysis included indices indicative of dental disease experience. Variables operationally defined as indicators of the subgroup's dental health status were subjected to a descriptive analysis and were then crosstabulated with the socioeconomic status of the child's family to identify socioeconomic differences in the process of obtaining care and in dental health outcomes. Findings indicate which elements in a community's prevailing dental health care system function well and which would need alteration to maximize dental health for the subgroup.