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

AIMTo review the perceptions of dental/medical educators and their students in the United States on the adequacy of didactic and clinical preparation to provide service for individuals with disabilities.

METHODOLOGYAn e-mailed questionnaire with follow-up was sent to 198 deans of dental/medical schools, 1,628 directors of residency programs in nine medical/dental residency programs, 427 medical students in 12 medical schools, and 368 health related organizations, facilities and programs.

RESULTSMore than half (58%) of the responding deans of reported that a curriculum for patients with disabilities was not a high priority at their school. A majority (61%) of deans of medical schools, and 47% of the deans of dental schools, reported that their graduates were competent to treat patients with disabilities. However, majorities of dental/medical school seniors and graduates expressed inadequate competency in the care of these patients. A majority of the directors of medical/dental residencies indicated a need for additional training for their residents.

CONCLUSIONThere is need for increased didactic and clinical preparation of dental/medical school graduates in the care of individuals with special health needs. The interest expressed by health profession educators in an effort to develop appropriate curriculum modules provides an opportunity to prepare new graduates for the care of an increasing population of individuals with disabilities.

Administrative Personnel ; Attitude of Health Personnel ; Clinical Competence ; Curriculum ; Dental Care for Disabled ; Disabled Persons ; Education, Dental ; Education, Medical ; Electronic Mail ; Faculty, Dental ; Faculty, Medical ; Health Services ; Humans ; Internship and Residency ; Schools, Dental ; Schools, Medical ; Students, Dental ; Students, Medical ; Surveys and Questionnaires ; United States

OBJECTIVETo investigate the utilization of oral health services and to analyze the factors associated with oral health services for the community residents.

METHODSHousehold health interview and oral health condition survey were conducted to obtain information about oral health services. The respondents were recruited by a multi-stage random cluster sampling procedure. Multiple dummy regression analyses were performed for the assessment of the relative effect of behavioural factors on dental attendance.

RESULTSA total of 2003 families, 4459 people participated in this study. The people seeking dental treatment accounted for 11.3% (502/4459) per year. Young people (OR = 2.072), having medical insurance system (OR = 2.835), short distance to see dentist (OR = 3.535), oral health awareness (OR = 2.595), poor self-assessment of oral health status (OR = 2.014) were the main factors which influenced dental attendance of community residents.

CONCLUSIONSThe utilization of oral health service was low, particularly for middle-aged people and the elderly. Oral health education and medical insurance system should be strengthened.

Adolescent ; Adult ; Aged ; Dental Care ; economics ; utilization ; Dental Health Services ; economics ; utilization ; Health Services Accessibility ; statistics & numerical data ; Health Services Needs and Demand ; Humans ; Income ; statistics & numerical data ; Insurance, Dental ; statistics & numerical data ; Logistic Models ; Middle Aged ; Sampling Studies ; Self-Assessment ; Surveys and Questionnaires ; Urban Health Services ; utilization ; Urban Population ; Young Adult

PURPOSE: This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. METHODS: In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. RESULTS: The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on weekends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. CONCLUSION: The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.
Adult ; Attitude to Health/*ethnology ; Chicago ; Child ; Child, Preschool ; Clinical Competence/standards ; Continuity of Patient Care/standards ; Cultural Diversity ; Dental Care for Children/economics/*utilization ; Emigration and Immigration ; Female ; Focus Groups ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility/standards ; Health Services Needs and Demand ; Hispanic Americans/education/*ethnology ; Humans ; Mexico/ethnology ; Mothers/education/*psychology ; Multivariate Analysis ; Nursing Methodology Research ; Poverty/economics/*ethnology ; Puerto Rico/ethnology ; Questionnaires

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

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

OBJECTIVES: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. METHODS: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). RESULTS: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model. CONCLUSIONS: This study's findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.
Adult ; Aged ; Aged, 80 and over ; Demography ; Dental Care/*utilization ; Female ; Health Services Needs and Demand ; Humans ; Logistic Models ; Male ; Middle Aged ; Residence Characteristics ; Socioeconomic Factors ; Surveys and Questionnaires ; Young Adult

China ; Contract Services ; legislation & jurisprudence ; Delivery of Health Care ; legislation & jurisprudence ; Dental Caries ; therapy ; Dentists ; legislation & jurisprudence ; Female ; Humans ; Liability, Legal ; Middle Aged ; Pulpitis ; therapy ; Tooth Extraction ; Treatment Failure