Access to appropriate dental care.

For this review, publications were considered in the context of a broad definition of access to dental care, including the ability to gain available, appropriate services as determined by personal, economic, cultural, geographic, and other factors. None of the studies fully integrated the multiple dimensions explicit in this definition. Nonetheless, it is clear that certain segments (ie, the poor and members of racial and ethnic minoritites) of the US population use dental services less frequently. When these people do use the system, they are less likely to receive preventive services and more likely to have a dental emergency. The availability of services to poor populations through Medicaid programs is compromised due to low provider participation, which is attributed to dissatisfaction with reimbursement rates and limitations in the breadth of covered services. Concerning the appropriateness of care, it is shown that practices with homogenous patient populations vary widely in the rates of the types of services provided.