Children's Dental Sealant Use and Caries Prevalence Affected by National Health Insurance Policy Change: Evidence from the Korean National Health and Nutrition Examination Survey (2007-2015).

Sujin Park,Sungwon Lim,Hee-Jung Park,Minsung Sohn

doi:10.3390/ijerph16152773

Abstract

We evaluated the effect of the National Health Insurance (NHI) policy including dental sealant on changes in the prevalence of sealant and caries, and examined how NHI affected sealant utilization and untreated caries in children from diverse income groups in South Korea. We used a multivariate logistic regression analysis to explore the effects of three stages of dental sealant policy (pre-policy: 2007–2009, first post-policy: 2010–2012, and second post-policy: 2013–2015) on the prevalence of dental sealant and untreated caries. Participant data (N = 8161, aged 6–14 years) were derived from the Korea National Health and Nutrition Examination Survey (2007–2015). We also conducted subgroup analysis to determine the effects of the NHI policy on dental sealant and untreated caries by income level. Implementation of dental insurance coverage was associated with higher likelihood of using dental sealant (odds ratio (OR) = 1.39 (95% confidence interval (CI): 1.18–1.63) for the first period and OR = 1.58 (95% CI: 1.33–1.87) for the second period) and lower odds of having untreated caries (OR = 0.79 (95% CI: 0.64–0.98) for the first period and OR = 0.65 (95% CI: 0.51–0.83) for the second period) after controlling for covariates. Results revealed that there was a greater prevalence of dental sealant and a lower prevalence of untreated caries in both middle- and low-income households compared to high-income households. The higher prevalence of dental sealant and lower untreated caries after the policy implementation. Moreover, we demonstrated children from low-or middle-income households were more associated with increasing dental sealant use and a declining prevalence of caries.

Highlights

Dental caries can be preventable, but it is one of the most prevalent chronic diseases among children worldwide [1]
Aid and reporting excellent self-rated implementation, the proportion of individuals receiving Medical Aid and reporting excellent selfdental health status were lower than pre-policy andand first period of of policy implementation, while the rated dental health status were lower than pre-policy first period policy implementation, while proportion of the frequency of teeth brushing per day, number of dentists per 1000per residents the proportion of the frequency of teeth brushing per and day,the and the number of dentists were higher pre-policy, and firstand period policyofimplementation
We revealed a difference by household income in the prevalence of dental sealant use, showing a significantly greater prevalence of having been treated with dental sealant in the first (OR = 1.29 for middle-income and odds ratios (ORs) = 1.83 for low-income) and second period (OR = 1.58 for middle-income and OR = 2.05 for low-income) for middle- and low-household income groups

Summary

Introduction

Dental caries can be preventable, but it is one of the most prevalent chronic diseases among children worldwide [1]. Since dental caries affect most dental and periapical tissues diseases [2], and oral health behaviors in childhood have significant effects on oral health in adulthood [3], it is crucial to control them during children’s development. To solve children’s oral health problem, dental sealant an effective, widespread solution to prevent dental caries [4]. Res. Public Health 2019, 16, 2773; doi:10.3390/ijerph16152773 www.mdpi.com/journal/ijerph

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