Changes in oral health indicators due to implementation of the National Health Insurance Services coverage for first molar dental sealant for children and adolescents in South Korea

Abstract

Background: In South Korea, dental sealant was included in the National Health Insurance Services (NHIS) coverage for the first molar for ages 6-14 in December 2009. The second molar was included in 2012, and the age of insurance coverage was extended to under 18 in 2013. This study aimed to verify the effectiveness of an NHIS dental sealant coverage policy for children and adolescents by comparing the changes in first molar oral health indicators before and after policy implementation. Methods: The Korea National Health and Nutrition Examination Survey data were analyzed; the fourth period (2007-2009) provided data for before and the sixth period (2013-2015) provided data for after policy implementation. The proportion of individuals with first-molar sealant, decay-missing-filled first molar permanent teeth, and single crowns in the group aged 11-20 years were calculated. Data were analyzed using chi-square for complex samples and the complex samples general linear model. In addition, complex-sample logistic regression analysis was performed to confirm the association between factors. Results: Compared with non-beneficiaries, among policy beneficiaries, sealant ownership increased by 7.7% (from 27.8 to 35.5, P < 0.001), and the number of permanent teeth with sealant per capita increased by approximately 0.4 to 0.8 (P < 0.001). The proportion of individuals with decay-missing-filled permanent teeth decreased by 9.1% (from 68.4 to 59.3, P < 0.001), and the average decay-missing-filled permanent teeth index per person decreased by approximately 2.0 to 1.5 (P < 0.001). The rate of single-crown holders decreased by 2.7% (from 8.7 to 6.0, P > 0.05), and the average single-crown index decreased by approximately 0.11 to 0.08 per person(P > 0.05). The number of sealants increased with age and household income (P < 0.001). The mother's education level affected sealant experience (P < 0.05). The caries rate was higher in females and older respondents (P < 0.001).

The association of food insecurity with tooth decay and periodontitis among middle‐aged and older adults in the United States and Korea

“…34 While dental care in Korea is covered by the National Health Insurance Services (NHIS), dental benefits are more generous for children and older adults, leaving middle-aged adults with relatively less dental benefits coverage. 35 Furthermore, a set percentage of costs for dental services covered by the NHIS are paid for out-of-pocket (OOP). 36 As part of Korea's dental health reform in 2013, total dental expenditures increased from 2013 to 2017 while OOP expenses remained constant for older adults.…”

“…Furthermore, food‐insecure middle‐aged adults in South Korea are likely to experience financial burdens that serve as a barrier to dental care 34 . While dental care in Korea is covered by the National Health Insurance Services (NHIS), dental benefits are more generous for children and older adults, leaving middle‐aged adults with relatively less dental benefits coverage 35 . Furthermore, a set percentage of costs for dental services covered by the NHIS are paid for out‐of‐pocket (OOP) 36 .…”

Is value-based healthcare a strategy to achieve universal health coverage that includes oral health? An Australian case study

“…In other parts of the world, there are documented examples of universal health coverage that include oral health, in Brazil [ 36 ], Japan [ 37 ], South Korea [ 38 ], Taiwan [ 39 ], and Thailand [ 40 ]. The type of dental services funded by government varies, but countries that have introduced them more recently have used an incremental approach.…”

Effect of oral health intervention program on the self oral care of children attending childcare facilities: a quasi-experimental study

“…Therefore, oral health management in pre-school children is crucial (Bae et al 2009;Masumo et al 2020). As part of national oral health promotion, the National Health Promotion Comprehensive Plan aims to improve the rate of brushing after lunch, which is an index for reducing dental caries and facilitating the management of oral health in children (Choi and Ma 2020). However, according to the 2018 Child Oral Health Survey, 68.5% of 5-year-olds experienced dental caries, and an average of 3.43 teeth of each child developed caries (Choi 2019;You et al 2019).…”