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Health needs vary among countries and even within the same country; many of such variations are determined by demographic, social, cultural, economic and political conditions. Measuring health needs allows the evaluation of the impact of existing interventions, as well as monitoring epidemiologic trends (8, 9). While subjective self-reported health symptoms, diseases, injuries, and disabilities offer an expedient and inexpensive way of collecting information, an approach involving trained health personnel with clinical examinations (9, 10) is often preferred. Some authors have mentioned one more approach, which is gauging the utilization of health services – both formal and informal services – assuming that an increase in utilization rates reflects increased health need (9). Studies on oral health treatment needs are especially sparse among adolescents (6) in Mexico. Most studies, focussed on Mexican adolescents, have used widely accepted but relatively coarse metrics such as the mean number of decayed, missing (due to caries), and filled teeth . Although such epidemiological assessments add to the current state of knowledge, they fail to discern between teeth affected by the disease at different stages of severity or progression, and they also omit a dynamic measure of teeth affected as a proportion of the teeth already erupted and present in the mouth. The state of knowledge about burden of disease and its implications is incomplete; it is thus important to document morbidity levels, and to develop metrics to accurately estimate distinct morbidity manifestations in the context of treatment needs. The aims of the present study were 1) to determine treatment needs for dental caries, and 2) to examine the face validity of a proposed index to gauge the prevalence of tooth extractions (signifying the likely outcome of late stages of the natural history of dental caries), among Mexican adolescents 12 to 15 years of age.