The Association between Dental Implant Treatment Experience and Socioeconomic Factors in Korean Adults: A Cross-Sectional Survey Data Analysis.

Background: We examined the Korean adults' experience with dental implants and analyzed its association with various socioeconomic factors. Methods: This study was based on the participants enrolled in the 2013-2015 KNHANES. Using the variables associated with dental implant treatment experience and other socioeconomic factors, we evaluated the statistical significance and potential associations between the dental implant treatment experience and its related factors. The final analysis in this study was performed on adults aged 20 yr and over. It comprised 4,893 subjects in the year 2013, 4,431 subjects in 2014, and 4,430 subjects in 2015. Results: An increasing number of individuals had reported undergoing dental implant treatment. An older age was associated with a higher likelihood of undergoing dental implant treatment, particularly in adults aged ≥40 years. Additionally, the likelihood was higher in individuals with a greater income level, low-level of educational background, and married status. Factors that were observed to influence dental implant treatment experience included age, education level, income level, marital status. Conclusion: Our analysis confirmed the growing accessibility to dental implants among Korean adults and an association between dental implant treatment experience and socioeconomic factors. We recommend a healthcare policy on dental implants that considers relevant socioeconomic factors, in order to provide dental implant treatment to individuals who are in absolute need of treatment.

The impact of national health insurance coverage on pit and fissure sealing experience.

INTRODUCTION: The purpose of this study was to review the change of supplied amount of oral pit and fissure sealing (PFS) in urban and rural areas of South Korea after including PFS into the list of treatments covered by the National Health Insurance (NHI), and to check whether there is a difference in supplied amount in areas where the dental treatment accessibility is different based on the data of the Korean National Health and Nutritional Examination Survey (KNHANES). METHODS: The KNHANES data year used for 'before coverage' was 2007, and that of 'after coverage' was 2012. Data analysis was done using STATA software. RESULTS: Areas were classified as urban or rural. Reduction of out-of-pocket expenses, according to the NHI coverage PFS experience of children aged 6-14 years, increased from 28.7% before coverage to 34.9% after coverage. PFS experience of children aged 6-14 years in the urban area was increased from 29.2% before coverage to 35.6% after coverage. The increase in rural areas was from 27.2% before coverage to 31.5% after coverage. CONCLUSIONS: Although PFS supplying was increased after inclusion in NHI coverage, it is still insufficient to reduce the decayed, missing, filled teeth index effectively. To reduce inequality, supply of PFS in rural area by community oral health program should be strengthened. And also, waiving out-of-pocket money for PFS in NHI should be considered.

Oral healthcare systems for an ageing population: concepts and challenges.

Oral healthcare systems (OHCS) are designed to maintain the health and function through Communication (Health promotion and education), Prevention, Assessment and Diagnosis, and Treatment. The complexity of these OHCS functions for the ageing are described utilizing the spectrum of dependency of the Seattle Care Pathway framework. Barriers and disparities which challenge the development of OHCS for the ageing can be universal but often vary between developed and developing countries. Recognizing that oral diseases are largely preventable, strategies to improve OHCS must be targeted locally, nationally, and internationally at oral health policy, education, research, and clinical care.

Systemic effect of water fluoridation on dental caries prevalence.

OBJECTIVES: The aim of this study was to evaluate the systemic effect of water fluoridation on dental caries prevalence and experience in Cheongju, South Korea, where water fluoridation ceased 7 years previously. METHODS: A cross-sectional survey was employed at two schools where water fluoridation had ceased (WF-ceased area) and at two schools where the water had never been fluoridated (non-WF area). The schools in the non-WF area were of a similar population size to the schools in the WF-ceased area. Children of three age groups were examined in both areas: aged 6 (n = 505), 8 (n = 513), and 11 years (n = 467). The differences in the mean number of decayed or filled primary teeth (dft) and the mean number of decayed, missing, or filled permanent teeth (DMFT) scores between areas after adjusting for oral health behaviors and socio-demographic factors were analyzed by a Poisson regression model. RESULTS: The regression model showed that the DMFT ratio for children aged 11 years in the WF-ceased area was 0.581 (95% CI 0.450-0.751). In contrast, the dft ratio for age 6 in the WF-ceased area was 1.158 (95% CI 1.004-1.335). Only the DMFT ratio for age 8 (0.924, 95% CI 0.625-1.368) was not significant. CONCLUSIONS: While 6-year-old children who had not ingested fluoridated water showed higher dft in the WF-ceased area than in the non-WF area, 11-year-old children in the WF-ceased area who had ingested fluoridated water for approximately 4 years after birth showed significantly lower DMFT than those in the non-WF area. This suggests that the systemic effect of fluoride intake through water fluoridation could be important for the prevention of dental caries.

Global self-rating of oral health, concerns about oral health, and history of jaw injury related to temporomandibular joint symptoms in Korean adults.

AIMS: To examine the association between temporomandibular joint (TMJ) symptoms and the global self-rating of oral health, concerns about oral health, and a history of jaw injury or third molar extraction in a representative Korean population. METHODS: From the Korean National Oral Health Survey 2006, 4,546 adults aged 18 years and older were included in the analysis. The dependent variable was TMJ symptoms. The independent variables were the global self-rating of oral health, concerns about oral health, and a history of jaw injury or third molar extraction. The demographic information (age and gender), socioeconomic status (education level, monthly household income, vocation, and residence), and behavioral factors (recent dental visit and smoking) were evaluated as confounders. Multivariate linear and logistic regression analyses were applied. RESULTS: The overall prevalence of TMJ symptoms in Koreans was 15.3%. The younger, more educated, middle class, those employed in office and sales, and those who resided in city areas had more TMJ symptoms. The TMJ symptoms were significantly associated with the global self-rating of oral health, concerns about oral health, and history of jaw injury. No significant association was found between the TMJ symptoms and a history of a third molar extraction. The global self-rating of oral health, concerns about oral health, and history of jaw injury had a dose-effect relationship with the severity of TMJ symptoms. Age and gender modified the effect of the global self-rating of oral health, concerns about oral health, and the history of jaw injury on TMJ symptoms. CONCLUSION: The global self-rating of oral health, concerns about oral health, and a history of jaw injury might be associated with TMJ symptoms.

The decline in dental caries among children of different ages in Korea, 2000-2006.

AIM: To determine the prevalence of dental caries in Korean children with time after the introduction of the nationwide public oral health programme. DESIGN: Cross sectional oral health surveys of children aged from 6-16 years carried out in 2000 and 2006. PARTICIPANTS: After stratified cluster sampling, 11,947 (2000) and 9,740 (2006) children aged 6-16 years of age were examined at school. METHODS: DMFT and fissure sealants were recorded according to the WHO criteria. The significant Caries Index (SiC index) was calculated. MAIN OUTCOME MEASURES: DMFT, SiC index, and the prevalence of fissure sealants. RESULTS: The mean DMFT scores for the 12-year-old Koreans decreased from 2.86 in 2000 to 2.16 in 2006. The prevalence of caries free permanent dentition also increased in the same period. The average SiC index from 6-16 years also decreased. There was a 20% prevalence of subjects with fissure sealants in 9-11-year-old children in 2000. The corresponding figures increased to 40% in 2006. CONCLUSIONS: The oral health of Korean children improved considerably between 2000 and 2006 through improvement in lifestyle and the strong public oral health programme, which should be continued in order to improve oral health in Korea

Validation of the Korean version of the oral health impact profile among the Korean elderly.

OBJECTIVES: This study aimed to validate a Korean version of the oral health impact profile (OHIP) and to develop a short-form of OHIP for the Korean elderly. METHODS: The original English version of OHIP was translated into Korean using a forward-backward method. Internal consistency was measured by Cronbach's alpha among 1098 subjects aged 56 or more. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) with a 3-month interval among 155 subjects aged 57 or more. The validity of the Korean version of OHIP (OHIP-K) was assessed by comparing OHIP scores with the perceived dental treatment needs and by identifying associations between OHIP scores and the number of natural teeth among 128 subjects aged 54 or more. The short-form of OHIP for the Korean elderly (OHIP-14K) was developed using linear regression models and was also validated and compared with the short-form of OHIP by Slade (OHIP-14S). RESULTS: The Cronbach's alpha value for OHIP-K was 0.97. The ICC for OHIP-K was 0.64. Adults with perceived dental treatment needs had a higher OHIP score than adults without any such needs (P < 0.001). The number of natural teeth was negatively associated with the OHIP score (r = -0.44, P < 0.001). OHIP-14K and OHIP-14S shared seven identical items out of a total of 14 items. OHIP-14K results correlated with OHIP-K almost exactly (r(2) = 0.96), as did OHIP-14S (r(2) = 0.95). CONCLUSIONS: OHIP-K showed excellent reliability and validity. OHIP-14S may be a better choice for the evaluation of oral health-related quality of life among the Korean elderly for an international comparison.

Effects of two preparation designs and pontic distance on bending and fracture strength of fiber-reinforced composite inlay fixed partial dentures.

STATEMENT OF PROBLEM: Joint fractures observed in Targis/Vectris inlay adhesive fixed restorations may be related to the preparation design. PURPOSE: This in vitro study investigated the effects of the proximal tooth preparation design and the pontic distance on the fracture strength and the amount of bending of fiber-reinforced inlay adhesive fixed partial dentures. MATERIALS AND METHODS: Forty extracted premolars and 40 molars were embedded in a PMMA resin to represent a premolar and molar mesiodistal separation distance of 7 mm and 11 mm, respectively. Two preparation designs were used (proximal box and tub-shaped). The sample size was 10 for each group. Fiber-reinforced inlay adhesive fixed partial dentures were fabricated by use of the Targis/Vectris system and luted adhesively to the teeth with Variolink luting agent. A vertical force was loaded to the center of the fixed partial dentures at a crosshead speed of 1 mm/min. The initial bending (mm) prior to fracture was evaluated by measuring the distance the test rod moved from a 10 N preload to fracture. The differences in the mean fracture strength and the average amount of bending as a function of the preparation designs and pontic distances were compared by use of a 2-way analysis of variance (alpha=.05). The specimens were examined optically for the type of failure with a stereomicroscope. The fracture surface of the specimens was examined by scanning electron microscopy, and radiography was used to investigate the surface morphological features at the failure sites and to determine the fracture mode. A chi-square test was used to identify the differences in the debonding rates between the types of preparation designs and the pontic distance (alpha=.05). RESULTS: The mean fracture strength and the standard deviation of the fiber-reinforced inlay retained adhesive fixed partial denture group was 1368+/-212 N for the 7-mm tub group, 885+/-109 N for the 11-mm tub group, 1779+/-317 N for the 7-mm box group, and 1336+/-281 N for the 11-mm box group. The fracture strength was significantly higher in the 7-mm pontic distance (P<.001) and for the box-shaped tooth preparation (P<.001). The amount of bending was significantly greater in the 7-mm pontic distance (P=.025) and the box-shaped tooth preparation (P=.002). Debonding was observed only in premolar teeth and tub-shaped design groups. CONCLUSION: The box-shaped tooth preparation may be considered for restoration of a missing single posterior tooth with fiber-reinforced inlay adhesive fixed partial dentures.