Social exclusion, barriers and accessing dental care: thoughts on planning responsive dental services

Research investigating accessibility to dental care has changed 1 since the 1980s when Finch et al showed that dental anxiety, perception of need and costs acted as barriers to attendance. Since that time accessibility problems have been shown to lie not with the patient but with government and society as well as the dental profession. An understanding of the difficulties that exist for those, who society has delegated to its edges, together with the impoverishment of their social networks, provides government and health planners with the means to provide responsive dental services to all. This article presents the research findings associated with access to dental care. It describes how accessibility as a concept acquired a dynamic quality in the late 1980s. This argument continues by incorporating the concepts of social exclusion and social capital to illustrate how at the centre of access difficulties, is not the individual, but society. The need for government to appreciate that the physical structures and dental health care facilities together with the needs and the requirements of the planners, health professionals and people must be woven together to allow the formation of a cohesive structure which will form the basis of responsive and accessible health care for al