Socioeconomic disparities of periodontitis in K oreans based on the KNHANES IV

Han

Experimental and Therapeutic Medicine

et al. 2016

Abstract. Socioeconomic status (SES) has been reported to be associated with oral health behavior. Therefore, the present study was conducted to assess the relationship between SES and oral health behaviors in a large sample of the Korean population. Data from the Korea National Health and Nutrition Examination Survey, which was conducted between 2008 and 2010 by the Division of Chronic Disease Surveillance under the Korea Centers for Disease Control and Prevention and the Korean Ministry of Health and Welfare, were used in the present study. Daily tooth brushing frequency and the use of secondary oral products according to demographic variables and anthropometric characteristics of the participants were assessed. Multivariate logistic regression analyses were used to analyze the associations between daily tooth brushing frequency and the use of secondary oral products, and SES, urban/rural residence, body mass index (BMI), alcohol intake and smoking. An association between SES and tooth brushing frequency and the use of secondary oral products was detected after adjustment. Following adjustment for age, gender, BMI, smoking, drinking, exercise, energy intake, fat intake, periodontal treatment needs and education or income, the adjusted odds ratios and 95% confidence intervals (CI) of tooth brushing ≥3 per day in the highest income group were 1.264 (95% CI, 1.094-1.460) and 2.686 (95% CI, 2.286-3.155) for highest education level group. The adjusted odds ratios for the use of secondary oral products in the highest income and highest education groups were 1.835 (95% CI, 1.559-2.161) and 5.736 (95% CI, 4.734-6.951), respectively, after adjustment for age, gender, smoking, BMI, exercise, calorie intake, periodontal treatment requirements or income. The present study demonstrated an association between SES and oral health behaviors in a large sample of the Korean population. Within the limits of the present study, income and education were suggested as potential risk indicators for oral health behaviors; therefore, patients with a low SES should be investigated further, in relation to oral health.

Section: Discussionmentioning

confidence: 99%

“…In a previous study, individuals in the lower socioeconomic groups of the Korean Population were significantly more likely to require periodontal treatment (11). However, information regarding the association between SES and oral health behaviors in the Korean population remains limited.…”

Section: Introductionmentioning

confidence: 99%

Association between socioeconomic status and oral health behaviors: The 2008–2010 Korea national health and nutrition examination survey

Han

Experimental and Therapeutic Medicine

et al. 2016

“…These demands result from increases in the aging population, household income, and education levels, and changes in health policies and the medical care systems [1]. Recently, the importance of oral-health-related quality of life has been recognized [2, 3]. Periodontal disease (PD) is a disease of the oral cavity, and a major cause of tooth loss in adults [4].…”

Section: Introductionmentioning

confidence: 99%

“…In South Korea, several cross-sectional studies, have investigated the association between PD, national dental policies, and socio-demographic factors. However, an observational cohort study has not been conducted [3, 18]. The Korean National Health Insurance Cohort Database (KNHICD) includes 12 years of accumulated individual socio-demographic factors, and is useful for evaluating changes in the incidence of periodontal treatments.…”

Section: Introductionmentioning

confidence: 99%

National dental policies and socio-demographic factors affecting changes in the incidence of periodontal treatments in Korean: A nationwide population-based retrospective cohort study from 2002–2013

Lee

Choi

et al. 2016

BMC Oral Health

BackgroundDental insurance coverage has recently expanded in Korea. The number of patients diagnosed with periodontal disease (PD), and the actual number of periodontally compromised patients has increased. However, few studies have investigated the relationships between the prevalence of periodontal disease and the incidence of PD treatment, dental insurance policies, and socio-demographic factors. To determine the incidence of periodontal treatments required, the comprehensive longitudinal data of the National Health Insurance Service were used. This study evaluated changes in the incidence of periodontal treatments, using data from the Korean National Health Insurance Cohort Database.MethodsA random stratified sample of 1,025,340 Korean patients was selected from National Health Insurance database, using 1,476 multistage samplings (of sex, age, and income level) for 12 years from 2002 to 2013. Chi-square analysis, and univariate, and multivariate logistic regression were used to evaluate the association of socio-demographic factors with the prevalence of PD and the incidence of periodontal treatment.ResultsThe incidence of periodontal treatment steadily and significantly increased, in both male and female participants, from 2002 to 2013. The increase was associated with socio-demographic factors and changes in national dental insurance policies. The incidence of periodontal treatment evaluated by age is influenced by the changes in national dental policies. These results suggest that the increase in patients diagnosed with PD reflects changes in dental policies and insurance benefits.ConclusionsThis study confirms that national dental policies and socio-demographic factors are related to the incidence of periodontal treatments. The incidence of periodontal treatment is significantly related to the expansion of insurance coverage in South Korea.

“…Although regular dental checkups, scaling, and consistent supportive periodontal therapy even after undergoing periodontal treatment have been strongly emphasized as measures to decrease the incidence of tooth loss and periodontal disease, many Koreans who require dental scaling or preventive dental care are not receiving sufficient care [7]. In particular, people with low socioeconomic status, as defined by income, level of education, and/or residential area, have been found to have more prevalent and more severe periodontal disease [58910]. …”

Section: Introductionmentioning

confidence: 99%

Changes in dental care access upon health care benefit expansion to include scaling

Lee

J Periodontal Implant Sci

et al. 2016

PurposeThis study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level.MethodsA nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010–2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed.ResultsAdjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits.ConclusionsThe expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.