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Teenagers had an average of 25.3 sound teeth: DMFT was 1.15, with 0.82 decayed, 0.05 missing, and 0.28 filled teeth. Those teenagers who had at least one dental visit in the past year had lower treatment needs and higher restorative care index, while those who had no dental visit during the last year showed greater TEI. With regard to socio-economic status, those teenagers whose families were in the highest tertile of the SEP (based on occupation), whose parents had attained education beyond elementary school, and whose mothers indicated they could read and write, had lower treatment need for dental caries (TNI) and greater experience of restorative care (CI). Although the experience of extractions (TEI) among teen-agers was similar between the categories of schooling and occupational variables, the self-reported ability to read and write in the mother of the teenager was associated with a three-fold TEI difference. Teenagers who did not have health insurance coverage showed higher need for restorative treatment (TNI) and higher experience of tooth extractions (TEI), and had fewer restorations in their mouths (lower CI) – compared to teenagers who had public or private health insurance. However, there were substantial unmet treatment needs, and also evidence that some carious lesions had progressed to a stage in which the tooth had to be extracted. In a perfect world, little or no disease would exist; in a slightly less perfect world, existing disease would be treated in a timely manner, therefore rendering the unmet treatment need and the signs of advanced progression of disease to a mini-mum. But in our real world, we must discuss the likely factors why people have dental caries lesions without treatment. One such factor is the concept that people have about oral diseases. If dental caries are not perceived as a real (or an important) health problem, individuals would not assume the “sick role” and contribute to high rates of untreated illness. The subjective perception of disease is a result of several biopsychosocial factors: “feeling sick” and “medically evaluated disease” are important components in the context of health.