OBJECTIVES: With increasing emphasis being placed on early interventions for health promotion, early dental visits to prevent early childhood caries have been receiving more attention. Infant oral health examinations have been implemented as a component of early health examination in South Korea, but there is a lack of research on its effectiveness. This study aimed to estimate the effectiveness of infant and toddler oral health examinations by performing economic analyses of infant health examinations and dental treatment costs after examinations. METHODS: The analyses were conducted using the National Health Insurance Service claims data. Subjects included in this study were children who had undergone their “3(rd) infant oral health examination (54-65 months)” between 2010 and 2014. To estimate dental treatment costs over the five years, four retrospective cohorts were evaluated, which included a total of 256,965 subjects. The direct medical costs following infant oral health examinations were calculated over five years (including only costs from health insurance claims), and the effects of infant oral health examinations were compared. RESULTS: Although the rate of infant oral health examinations showed a persistently increasing trend, differences were observed according to the type of health insurance. Children who underwent infant oral health examinations showed a higher number of visits to the dentist, but lower dental treatment costs compared with children who did not undergo examinations. CONCLUSIONS: This study confirmed, from an economic perspective, the effects of policy interventions that emphasize the necessity of early intervention and a life-course health management strategy, based on the concept that oral health is not determined at specific time points, but rather is determined by the accumulation of exposure to various factors over the course of life.
Child ; Cohort Studies ; Dentists ; Diagnosis, Oral* ; Early Intervention (Education) ; Health Care Costs ; Health Promotion ; Humans ; Infant Health ; Infant* ; Insurance, Health ; Korea ; National Health Programs ; Oral Health ; Retrospective Studies

The purpose of this study was to examine unmet dental care needs and related factors among adults in Korea. The study included a nationally representative sample of Koreans (Korea National Health and Nutrition Examination Survey 2104). The dependent variable was unmet dental care need and the independent variables were socioeconomic status and oral health status. The chi-square test and logistic regression analysis were performed to identify the associations between explanatory variables and unmet dental care needs. The major causes of unmet dental care needs included economic burden, work life, and academic reasons; in addition, dental treatment was considered to have lower priority. The factors that had statistically significant relationships with unmet dental care needs were sex, age, self-rated oral health status, and difficulty in mastication. The findings of the study, suggest a need for lower dental insurance copayments in keeping with the policies and principles aimed at strengthening the national health insurance system. In addition, groups with limited access to dental services should be identified, and effective health care policies and services should be established for these individuals.
Adult* ; Delivery of Health Care ; Dental Care* ; Humans ; Insurance, Dental ; Korea ; Logistic Models ; Mastication ; National Health Programs ; Nutrition Surveys ; Oral Health ; Social Class

As the elderly population increases, they are increasingly affected by oral health problems. Therefore, efforts are being made to improve the oral health of older people, alleviate mental discomfort, and reduce unmet dental needs. This study was conducted to confirm the relationship between the National Health Insurance Elderly Denture Coverage and the unmet dental need for the edentulous elderly, as part of the protection policy. We analyzed the 2011 and 2013 Community Health Survey data of the edentulous elderly, aged 75 years or older, before 2012. In order to more precisely confirm the effects of the denture donation policy on unmet dental care, basic life recipients who were subject to the free elderly prosthetic project were excluded from the analysis. The final analysis included 20,400 subjects. According to our investigation of the factors that affect the unmet dental needs of the elderly, the National Health Insurance Elderly Denture Coverage did not affect unmet dental needs. The statistically significant variables that affected the unmet dental needs of the elderly were education and income levels, which are representative socioeconomic status variables. The lower the level of education, the unhealthier the dental care experience, and income levels showed a similar tendency. The elderly who have a low socioeconomic status are more likely to experience unmet dental needs because they lack the knowledge and socioeconomic ability to pay for dental care. Therefore, the policy for health protection of the entire elderly population should be continuously expanded. In addition, the socioeconomically vulnerable groups may have health problems due to the restriction of medical use, which may lead to quality of life deterioration.
Aged* ; Dental Care ; Dentures* ; Education ; Health Surveys ; Humans ; National Health Programs* ; Oral Health ; Quality of Life ; Social Class

BACKGROUND: The health of the economically active population contributes to increased corporate productivity by reducing the productivity loss caused by disease and increasing job efficiency, which in turn is a national benefit. Since the economically active population is a concept encompassing workers and a source of economic development for a country, that population's health should be treated with importance not only from a personal standpoint but also at a national level. METHODS: In this study, data of 11,007 adults aged 20 years and older who participate in economic activities were analyzed in the five-year Korea Health Panel Study from 2010 to 2014 including the number of dental visits and dental medical expenses. RESULTS: Factors related to “gender,” “education level,” “age,” “duty category,” “income level,” “employment type,” “national health insurance,” and “chronic disease status” of the economically active population are affected in relation to the number of visits and dental medical expenses. The number of dental visits increased with higher education levels (p<0.001), and the number of visits to the dentist increased with older age (p <0.001). Dental medical expenses were 91,806 Korean won (KRW) more for “white-collar workers” than for “blue-collar workers” (p<0.03), and 127,674 KRW more for “regular workers” than for “atypical workers” (p<0.02). CONCLUSION: When it is necessary to improve policies to enhance the efficiency of the distribution of health and medical resources in the overall balance of the dental health sector, we should try to identify various factors of oral health disorder due to income inequality among the classes according to the country's employment type in order to find ways to reduce the health gap among the social classes.
Adult ; Dentists ; Economic Development ; Education ; Efficiency ; Employment ; Humans ; Korea ; Oral Health ; Social Class ; Socioeconomic Factors

The purpose of this study was to investigate the relationship between hormone replacement therapy (HRT) and periodontal disease in postmenopausal women using data from the 4th and 5th Korea National Health and Nutrition Examination Survey. A total of 5,482 postmenopausal women aged 45~75 years were included as study subjects in the final analysis. The HRT group comprised 1,035 postmenopausal women who had received HRT for at least one month, and the non-HRT group comprised 4,447 postmenopausal women who did not receive HRT. The chi-square test was used to confirm the bivariate relationship between the variables. Multinomial logistic regression analysis was used to adjust for covariance (age, education, family income, body mass index, age of menopause, alcohol, smoking, dental visit < 1 per year, use of oral care products, and frequency of tooth brushing per day). After adjusting for all covariates, HRT was found to be associated with periodontal disease. In particular, the relationship between HRT and periodontal disease was more evident in older women and women younger than 45 years of menopausal age. The relationship between HRT and periodontal disease was stronger in women who brushed their teeth less than 3 times per day, women without regular oral examination, and women who did not use oral hygiene products. The results of this study confirmed the importance of actively considering hormone therapy when determining policy recommendations for postmenopausal women. Especially, health programs such as HRT, regular dental examination, and oral care are needed for older women who have undergone premature menopause.
Body Mass Index ; Diagnosis, Oral ; Education ; Female ; Hormone Replacement Therapy ; Humans ; Korea ; Logistic Models ; Menopause ; Menopause, Premature ; Nutrition Surveys ; Oral Hygiene ; Periodontal Diseases ; Smoke ; Smoking ; Tooth

OBJECTIVES: Given that oral health is one of the major factors affecting the quality of life, it is necessary to measure the oral-health-related-quality-of-life dimension in order to value health. The aim of this study was to compare the dimensions of oral-health-related quality-of-life measured by a generic health measure [EuroQol-5D (EQ-5D)] and an oral health specific measure [Oral Health Impact Profile 14 (OHIP-14)]. METHODS: A questionnaire including EQ-5D, OHIP-14, self-rated general/oral health, and visual analog scale (VAS) was developed, and both patients and dentists participated in measuring the patient's oral health-related quality of life based on oral diseases. Data was collected from the Dental University Hospital from 2016 to 2017. For descriptive analysis, t-test, chi-square, ANOVA, Tukey HSD post-test, and Pearson correlation analysis were performed. To confirm the factors associated with EQ-5D, multiple regression analysis was conducted. RESULTS: A total of 305 subjects were selected for the final analysis excluding the partially missing questionnaires. EQ-5D and OHIP-14 showed a statistically significant correlation and a sensitive distribution of the values depending on the oral diseases. The values of EQ-5D and OHIP-14 ranged from highest to lowest in the following order of oral diseases: endodontic, TMJ, gingivitis, and tooth sensitivity. A 10-point increase in OHIP-14 was associated with a 0.34-point increase in EQ-5D. CONCLUSIONS: The result of this study proved to be consequential since both OHIP-14 and EQ-5D were good measures for oral health-related quality of life, and the oral disease status could also be measured in terms of health valuation weights. This increased the possibility of comparison with general health, and provided the loss of socioeconomic costs of individuals, families, and societies due to oral diseases.
Dentists ; Gingivitis ; Humans ; Oral Health ; Quality of Life ; Temporomandibular Joint ; Tooth ; Visual Analog Scale ; Weights and Measures

OBJECTIVES: Oral-specific measures are often preferred for examining oral disease outcomes; however, generic measures can add additional important information. This study measured oral health-related quality of life, reflecting the multidimensional characteristics of oral health, and we compared sub-dimensions of the Oral Health Impact Profile 14 (OHIP-14) with the EuroQual-5D (EQ-5D). METHODS: Data from 305 patients were collected from patients who visited the dental university hospital in 2016-2017 and included EQ-5D, OHIP-14, and self-rated general/oral health questionnaires. A factor analysis was performed to identify sub-dimensions of the EQ-5D and OHIP-14, and a cluster analysis was conducted to examine the degree of overlap among the sub-dimensions of two measures. RESULTS: In the factor analysis, a range of OHIP-14 items (physical pain, physical disability, and handicap) loaded on factor 3, along with EQ-5D items. In the analysis of groups with relatively low oral qualities of life, moving from the bottom towards the top of the dendrogram, the next major branch split was the dimension of EQ-5D pain/discomfort, anxiety/depression items, which clustered between the OHIP-14 interrupted meal and difficult relaxing subscales. CONCLUSIONS: The results of this study suggest that using the EQ-5D for oral health status expends the complementary role of oral health-related quality of life measures.
Humans ; Meals ; Oral Health ; Quality of Life

Background: The establishment of a strategy for the reduction and prevention of oral disease, a global pervasive disease, isconsidered one of the important national health policy strategies. In Korea, the 5th Comprehensive National Health Promotion Plan is currently in progress, but there is insufficient research on the transition process or improvement direction in the field of oral health. Methods: Changes in Comprehensive National Health Promotion Plan’s Oral health sector in three countries were compared, and the direction of the three countries (Korea, the United States, and Canada) in accordance with the recent Oral health paradigm was confirmed. In this study, we reviewed the existing literature using the narrative review method to draw implications for strategies and directions for oral health promotion in Korea. Results: In Korea, the oral health promotion strategy is included in the 5th Comprehensive National Health Promotion Plan, andthe project is being led by the government. The United States prepared a national-led oral health promotion strategy and suggested multi-disciplinary cooperation to improve overall oral health and reduce the oral health inequality. For more active intervention, Canada established an oral health-related department and assigned experts, while emphasizing cooperation between the government and the private sector. Conclusion As a result of this study, Korea is also making efforts to improve oral health, but more active government interventionis needed to reduce the inequality in oral health by population group. To this end, it is necessary to establish a strong multi-sectoral cooperation system and prepare a strategy for implementation.

Background: Smartphones are a modern necessity. While they are convenient to use, smartphones also have side effects such as addiction. This study assessed the relationship between smartphone use, a part of everyday life in modern society, and oral health. Methods: An analysis was conducted using 2017 Korea Youth Risk Behavior Web-based Survey data. The propensity score estimation algorithm used logistic regression and 1:1 matching algorithm using nearest-neighbor matching. After matching, a total of 15,032 participants were classified into two groups containing 7,516 teenagers each who did and did not use smartphones, respectively. Results: Comparison of oral health behaviors according to smartphone use revealed a statistically significant difference in the frequency of tooth brushing per day, use of oral hygiene products, intake of foods harmful to oral health, and experience of oral health education (p＜0.05). The factors affecting oral pain experience of adolescents were examined. Compared to male participants, female participants had an odds ratio of 1.627 for oral pain (p＜0.05). According to the household income level, compared to the group with higher income, the group with lower income showed higher oral pain experience (p＜0.05). Oral pain experience was 1.601 times more frequent among teenagers using smartphones (p＜0.05). Conclusion The results of this study indicated that use of smartphones by adolescents affected their oral health. These findings indicate the need for improved oral health management through the use of effective school oral health programs and individual counseling by oral health professionals, promotion of information dissemination through public media, and development of prevention strategies.

OBJECTIVES: This empirical study aimed to identify the differences in expenditures by household income level, as well as the patterns of dental care spending by dental services. METHODS: We analyzed the Korea Health Panel's data collected between 2008 and 2010. We calculated expenditures by service items by itemizing dental care services such as conservative, prosthetic, orthodontic, periodontal, surgical, preventive, dental implant care. Then we obtained the ratios of spending per item and per visit to overall out-of-pocket spending on dental care and used these as the weights for dental care cost allocation. Income quintiles were derived using the equivalence scale. Kakwani's concentration index was used to determine the degree of disparity by income quintile, and 95% confidence intervals were computed. RESULTS: Out-of-pocket expenditures on dental care steadily increased over time and income quintile. The analysis of dental care spending by income quintile revealed that the level of expenditure of the first income quintile was 3.6 times lower than that of the fifth income quintile. In terms of expenditure comparison between 2008 and 2010, the first quintile households showed an increased spending on prosthetic and periodontal treatments, whereas the fifth quintile households spent a relatively high proportion on orthodontic and dental implant care. The concentration index revealed that conservative services and root canal treatments was significant and positive, indicating that the demand for, and utilization of, these services increase as household income increases. In contrast, prosthetic services showed a significant negative trend, indicating that these services are not as common among those with higher incomes. CONCLUSIONS: To address the problems associated with the disparity in dental care expenditures based on income levels, it is necessary to establish policies that expand health insurance coverage and provide other supportive measures for low-income populations.
Cost Allocation ; Dental Care* ; Dental Implants ; Dental Pulp Cavity ; Family Characteristics* ; Health Expenditures ; Insurance, Health ; Korea ; Poverty ; Weights and Measures