Aged ; Dental Health Services ; standards ; Health Services for the Aged ; standards ; Humans ; Nursing Homes ; Oral Health ; Singapore

Conception of public health was firstly put forward by American professor Winslow. Ensuring and promoting the health of general population is the key connotation for the definition of public health. Oral disease has become a public health problem. Caries which preventable and curable is the most common oral disease and the etiology is also clear. Oral health comprehensive intervention program for children in central and western regions was set up in 2008 by Chinese government. The program included sealing on the first permanent molar and oral health education towards primary school children covering mid-west area. This was the first oral health program invested by government and managed by Chinese Stomatological Association. Six years later, the program was popularized to the whole nation, and renamed as national oral health comprehensive intervention program for children in China. The program had made deep impact on development of oral health service in China. The study tries to analyze the challenges of oral health service through reviewing the background, content, organization and effectiveness of the program, aiming to provide suggestions on policy, financing, system, ability and technology for the future development.
Child ; Humans ; China ; Dental Caries/epidemiology* ; Oral Health ; Public Health ; Dental Health Services

PURPOSE: This 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. METHODS: A 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. RESULTS: Adjusting 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. CONCLUSIONS: The 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.
Adult ; Delivery of Health Care* ; Dental Care* ; Dental Health Services ; Dental Scaling ; Education ; Health Policy ; Health Services Accessibility ; Humans ; Insurance Benefits ; Korea ; National Health Programs ; Periodontal Diseases

China ; Dental Implants ; Health Services Needs and Demand ; Humans ; Periodontics ; manpower

To compare the levels of agreement and the survival rates of sealant retention for different sealing materials over a 2-year period assessed using the visual clinical examination and replica methods, sealant retention data were obtained by visual clinical examination and from replicas of the same sealed tooth at baseline and at 0.5-, 1- and 2-year evaluation points in 407 children and were compared for agreement using kappa coefficients. Survival curves of retained sealants on occlusal surfaces were created using modified categorisation (fully retained sealants and those having all pits and fissures partly covered with the sealant material versus completely lost sealants that included pit and fissure systems that had ≥1 pit re-exposed) according to the Kaplan-Meier method. The kappa coefficient for the agreement between both assessment methods over the three evaluation time points combined was 0.38 (95% confidence interval (CI): 0.35-0.41). More sealant retention was observed from replicas than through visual clinical examination. Cumulative survival curves at the three evaluation times were not statistically significantly higher when assessed from replicas (P=0.47). Using the replica method, more retained sealant material was observed than through visual clinical examination during the 2-year period. This finding did not result in a difference in the survival rates of sealants assessed by the two assessment methods. When replicas cast in die stone are used for assessing sealant retention, the level of reliability of the data is higher than that of data obtained through the commonly used visual clinical examination, particularly if such assessments are conducted over time.
Dental Health Services ; Humans ; Physical Examination ; Pit and Fissure Sealants

OBJECTIVES: This study was conducted to find the relationship between oral health conditions of elderly people and closures of public dental health clinics in rural areas. METHODS: Oral examinations and surveys were conducted in 2011 from May 11 through November 4 on 383 seniors over 65-years and under 74 years old. RESULTS: The results of this study were as follows: 1. The results of comparative analysis of the usage behaviors of health clinics of subjects in relation to the closures of public dental clinics within the area showed that the usage level and frequency of public health agencies in areas with public dental clinics were high, and that the trend of influence on personal oral health conditions and improvement in prevention was high. When compared to 3 years ago, there was an 11.6 percentage point reduction in areas without public dental clinics (24.4%) compared to areas with public dental clinics (12.8%). 2. The results of comparative analysis of the oral health conditions and behaviors of subjects in relation to the closures of public dental clinics showed that the level of dental caries was high in areas with no public dental clinics, and the number of toothbrush usage and oral health supplemental product usage were shown to be high in areas with public dental clinics. CONCLUSION: The closures of public dental clinics were found to affect oral health behavior and conditions of elderly people in rural areas.
Aged* ; Dental Care for Aged ; Dental Caries ; Dental Clinics* ; Diagnosis, Oral ; Humans ; Oral Health* ; Public Health* ; Rural Health Services

OBJECTIVES: This study aims to investigate the trends and progress in oral health status, dental service items, and fees among children receiving community-based registered dental care over a three-year period. METHODS: The study subjects were selected from nine community children centers in J district of S city, in the Korean province of Gyeonggi-do. The sample included 222 children who had received care in 2011 and 2012, and 205 children, in 2013. The dependent variables were oral health status (df index and decayed-missing-filled teeth index), dental service items (total number of visits and dental fillings by type), and dental fees (total fees, National Health Insurance [NHI] coverage, and NHI non-coverage), analyzed by year. The percentages of dental caries and dental service items were tested using chi-square analysis, and the mean of each variable, including dental fees, was tested using the Kruskal-Wallis method, owing to non-parametric distribution. RESULTS: There was a statistically significant decrease in the rate of dental clinic visits for treatment, and an increase in the mean numbers of filled teeth and sealants performed per year. The rate and number of dental fillings increased steadily, whereas the services for oral health promotion and prevention were decreased. The number of dental visits and the total fees decreased steeply, especially within the second half of the last measured year: around 90,000 earned within that time, compared to 170,000 earned during the first year. CONCLUSIONS: Dental clinic visits should be encouraged on a regular basis for oral health promotion and prevention by both patients and providers using capitation payment systems, for example. It is necessary to monitor and provide training for all related staff by developing a manual for oral health examination and treatment, adjusted for the registered dental system. Policy measures addressing the needs of vulnerable social groups are needed more than ever. Therefore, it is important to provide as much targeted support and training to the registered dental system as possible.
Child Health Services ; Child* ; Dental Care ; Dental Caries ; Dental Clinics ; Dentists* ; Fees and Charges* ; Fees, Dental ; Gyeonggi-do ; Humans ; Insurance, Dental ; National Health Programs ; Oral Health* ; Tooth

OBJECTIVES: Unmet needs for dental treatment are one of the potential contributing factors to poor oral health because oral health problems worsen if left untreated. This study aimed to demonstrate the prevalence of and the causes for unmet dental needs, and to evaluate the association between unmet needs for dental treatment and oral health status. METHODS: Data on 3,883 subjects aged ≥18 years from the Korean National Oral Health Survey 2006 were analyzed. Information regarding unmet needs for dental treatment was obtained using standardized questionnaires. Eight trained dentists examined decayed, missing, or filled teeth (DMFT). Multiple regression models were built to assess the association between unmet needs for dental treatment and the DMFT scores. RESULTS: The prevalence of perceived unmet needs for dental treatment was 34.7% among the adult Korean population. Economic constraints were the main cause (38.6%) for unmet dental needs. The average DMFT scores were higher in the subjects with unmet needs for dental treatment than in those without. In individuals with unmet needs for dental treatment within the past 1 year, the number of decayed teeth after adjusting for confounders was likely to be greater by 0.58 and that of missing teeth by 0.27 compared to that in their counterparts with no unmet dental needs in the past 1 year. CONCLUSIONS: Perceived unmet needs for dental treatment were significantly associated with poor oral health status among the adult Korean population. Further studies are needed to clarify the direct and indirect effects of unmet needs for dental treatment on an individual's oral health status by investigating critical variables of the causal pathways among perceived dental needs, dental care utilization, and oral health status.
Adult* ; Dental Care ; Dental Health Surveys ; Dentists ; DMF Index ; Health Services Needs and Demand ; Humans ; Oral Health ; Prevalence ; Tooth

OBJECTIVES: This study aimed to identify a relationship between dental service items and fees among dental clinics; this is important when deciding capitation rates for a registered system. The status of oral health, use of dental service items, and amount of dental fees for community care children were compared according to the dental clinics with which they were registered. The dental fees were analyzed using the oral health risk assessment components to identify the relationship between them. METHODS: The study subjects comprised 182 children from 8 community children centers in J district, S city, Gyeonggi-do. The independent variables were the dental clinics and the dependent variables were oral health status (decayed, missing, filled teeth [DMFT] index or df index), dental service items (total number of visits and dental filling type), and dental fees (total fees, National Health Insurance [NHI] coverage, and NHI non-coverage). The variables displayed a nonparametric distribution and were hence analyzed by the Kruskal-Wallis test. The nonparametrically distributed oral health risk assessment components were analyzed by the Mann-Whitney test. RESULTS: The higher the DMFT index, the higher the number of dental clinic visits and number of children with dental fillings. There were differences in the number of dental fillings between clinics except for resin-based fillings; this gap was wider for amalgam and gold inlay fillings. The dental fees differed between clinics and was probably dependent on the whether the major dental service type was NHI-covered or non-covered. "Anterior caries or restorations" in children with caries and "plaque retaining factors" in children with periodontal disease experience/plaque displayed statistically significant differences for total fees and NHI non-covered fees, respectively. CONCLUSIONS: The preference for specific service items leads to a difference in dental fees. It is essential to develop guidelines under a capitation agreement and practice them in order to achieve a successful registered dental system.
Child ; Child Health Services ; Dental Care ; Dental Clinics ; Dentists ; Fees and Charges ; Fees, Dental ; Humans ; Inlays ; Insurance, Dental ; National Health Programs ; Oral Health ; Periodontal Diseases ; Risk Assessment ; Tooth

This study collected opinions about the design and management of toothbrushing facilities from schoolteachers and the people in charge of public centers, through a focus group interview (FGI), for the development of guidelines. Four moderators conducted eight FGIs of 32 subjects in charge of toothbrushing facilities across all the regions. The qualitative data was analyzed by constant comparative analysis. The findings indicated that more students utilized the facility and brushed their teeth after the installation of toothbrushing facilities. To enhance students' accessibility and safety, guidelines for design and management guidelinesfor toothbrushing facilities need to be developed; the location, sink height and depth, drain size, etc. should be comprehensively considered in the development of the guidelines. This study can help to improve students' satisfaction by enhancing the accessibility, safety, and functionality of toothbrushing facilities, and by providing fundamental data for toothbrushing facilities' development. Finally, this study can maximize the effects of management of toothbrushing facilities management on the improvement of students' oral health and behaviors.
Dental Caries ; Focus Groups* ; Humans ; Oral Health ; School Health Services ; Tooth ; Toothbrushing*