Clinical measures and treatment needs.

Clinically evaluated oral health outcome variables from the ICS-II USA data set were examined in the diverse ethnic groups, for two adult age cohorts (35-44 and 65-74 years). These measures were derived from epidemiological examinations and include the DMFT components, loss of attachment, and an indicator of treatment need--the ratio of decayed teeth over decayed and filled teeth. The ratio of decayed over decayed and filled teeth was used in multivariate analysis, since this measure represents an area where public policy could have an impact if determinants were understood. The most important independent variables were race-ethnicity, educational attainment, no fear of dental visits because of pain, and oral hygiene practices. Having a usual source of dental care and visiting the dentist within the past 12 months did not appear to be as important in predicting unmet needs as these other variables. To bridge the gap between the oral health status of majority and minority populations, health educators in minority communities need to become more accessible, have a pro-active interest in oral health, and also be cognizant of the various socio-cultural issues influencing oral health. The problems regarding Native American adults are more complex and require more careful study.