Prevalence of dental caries and associated factors of detention center inmates in South Korea compared with Korea National Health and Nutrition Examination Survey (KNHANES) respondents: a retrospective study

Purpose: The purpose of this study was to analyze the factors associated with self-rated poor oral health and chewing discomfort among Korean elderly people in the Korea National Health and Nutrition Examination Survey(KNHANES).Materials and Methods: Data from the 7th(2016-2018) KNHANES were downloaded from the KNHANES website.Participants were older adults aged 70 years who responded to a questionnaire about their self-rated oral health or chewing discomfort. Multivariate logistic regression analysis was performed by dividing demographic and oral health factors into three models, and odds ratios with 95% confidence intervals were presented.Results: For self-rated poor oral health, up to 1.59 times increase in caries in permanent teeth and up to 1.84 times increase in severe periodontitis, and up to 2.41 times increase in negative perceptions for those with 20 or more natural teeth compared to those without. In terms of chewing discomfort, depending on the model, those with a middle school diploma or less had up to 2.05 times more discomfort than those with a college degree or higher. Having severe periodontitis was associated with up to 1.68 times more discomfort, and having fewer than 20 natural teeth was associated with up to 2.46 times more discomfort.Conclusion: Some demographic factors and a number of oral health factors were found to be associated with self-rated poor oral health and chewing discomfort in older adults. Further in-depth analyses that reflect additional factors that were not included in the study are necessary.

To derive formulas to estimate the prevalence of untreated dental caries in permanent teeth based on the DMF index and lifetime caries prevalence. Data from participants, aged 5 years or older, in the National Health and Nutrition Examination Survey 2011-2016 were analyzed. Dental caries was assessed at surface level with the Radike criteria, which matches the case definition of the Global Burden of Disease study. Participants' data were aggregated into 438 groups, based on survey strata and 5-year age brackets, to produce population estimates for the prevalence of untreated caries (DT > 0), DMFT, DMFS, DT, DS, and lifetime caries prevalence (DMFT>0). Conversion formulas were derived using fractional polynomials to characterize the association of each caries indicator with the prevalence of untreated caries. The mean prevalence of untreated caries was 23.5percent (SD: 12.9percent, range: 1.0-72.3percent). After adjustment for age, the prevalence of untreated caries was correlated with DMFT (r=0.23), DMFS (r=0.25), DT (r=0.74), DS (r=0.65) and lifetime caries prevalence (r=0.18). Using fractional polynomial models adjusted for categorical age, the prevalence of untreated caries at population level could be estimated from DMFT with power 1 (linear form), DMFS with power 0.5, DT with power 0.5, DS with powers (0.5; 1) and lifetime caries prevalence with power 1. The prevalence of untreated caries in permanent teeth can be estimated from the DMF index and lifetime caries prevalence. These conversion formulas can facilitate the inclusion of more studies in estimation of the global burden of untreated caries in permanent teeth.

Chronic kidney disease (CKD) and oral health are important public health problems worldwide, resulting in various complications. This study aimed to confirm the association between CKD and the number of teeth using data from the Korea National Health and Nutrition Examination Survey (KNHANES), which is representative of Korean adults. This study used raw data from the 6th and 7th (2013–2018) KNHANES and targeted 16,125 adults aged 40 years or older in Korea. Chronic kidney disease was defined as 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Multiple logistic regression analysis was used to examine the association between CKD and the number of teeth. The prevalence of CKD was significantly higher in the group with fewer than 20 teeth. In the multivariate logistic regression analysis, CKD was associated with having fewer than 20 teeth after adjusting for age, sex, household income, education, alcohol consumption, smoking, body mass index, hypertension, diabetes mellitus, angina, myocardial infarction, stroke, dyslipidemia, and performance of an oral examination within 1 year, daily toothbrushing frequency, and hygiene product use (Odds ratio = 1.34; 95% Confidence Interval = 1.03–1.74). Therefore, CKD may contribute to an increased risk of tooth loss. Implementing an integrated healthcare approach for oral health management in individuals with CKD could help reduce their burden of oral diseases.

Effect of Implementing Dental Services in Israeli Psychiatric Hospitals on the Oral and Dental Health of Inpatients

The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based cross-sectional survey designed to assess the health related behavior, health condition, and nutritional state of Koreans (http://knhanes.cdc.go.kr/). It was conducted as a tri-annual survey for the first 3 cycles, implemented in 1998, 2001, and 2005. Beginning with the 4th cycle of 2007, it was converted to an annual survey. The 2011 data was recently opened to the public, and is free for all researchers who want to use it. The KNHANES provides a rich source of data which are easy to access and can be quickly obtained. Its ethical problems are minimal and there are no adverse effects in conducting the study. Using the KNHANES saves time, money, and personnel that would otherwise be spent collecting data, and provides a larger and higher-quality database beyond the capacity of any one individual researcher. Further, because the study participants are representative of the Korean population, the results have external validity. Therefore, this data is helpful to young investigators. In fact, the portion of submitted articles to the Korean Journal of Family Medicine (KJFM) using the KNHANES as the primary source of data is significant. Specifically, one article in 2007, three articles in 2008, four articles in 2009, three articles in 2010, five articles in 2011, and five articles in 2012 used the KNHANES data as their primary data source, totaling 21 articles (6.2%) among 338 original articles during the previous five years. However, there are several points investigators should keep in mind when using the KNHANES data. First, the KNHANES data are open to the public and there is no systematic process to control the research topic assignment. Many researchers might investigate the same topic simultaneously, especially popular topics like obesity and metabolic syndrome. Before deciding on the study topic, a thorough search of the database like Medline, EMBASE, and the abstracts of related conferences are needed. Once the topic is decided upon, the article should be submitted as soon as possible. Otherwise someone else may publish a similar study from the same dataset before you do. Second, investigators must be familiar with the huge and complex data structure and study design of the KNHANES. Non-response and multi-stage probability sampling should be taken into account by using survey statistics to estimate the data of the whole Korean population. Despite this, lots of studies submitted to KJFM using the KNHANES do not apply sampling weight in their analysis. In such a case the estimated association might be biased and revision is required. Third, the KNHANES is a secondary data source like the Korea Youth Risk Behavior Web-based Survey and the Community Health Survey, and has the same limitations that they have.1) The main purpose of the KNHANES is to produce national statistics, not to answer a specific research question. Therefore, the particular information the investigator wants may not be collected. For these reasons, the dataset should be examined carefully to confirm that it includes the necessary data. There also exists a potential for errors or mistakes in the data, even with its rigorous documents control system. Missing data is also a problem in the KNHANES.2)

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.

This study assessed and compared the prevalence and severity of dental caries and the prevalence of periodontal disease among pregnant and nonpregnant women of reproductive age (15-44 years) using data from the National Health and Nutrition Examination Survey, NHANES (1999-2004). Estimates were derived from a sample of 897 pregnant women and 3,971 nonpregnant women. Chi-square and two-sample t-tests were used to assess differences between groups stratified by age, race/ethnicity, education, and poverty. Bonferroni method was applied to adjust for multiple comparisons. In general, there were no statistically significant differences in the prevalence estimates of dental caries and periodontal disease between pregnant women and nonpregnant women. However, results showed significant differences when stratified by sociodemographic characteristics. For example, the prevalence of untreated dental caries among women aged 15-24 years was significantly higher in pregnant women than in nonpregnant women (41 percent versus 24 percent, P = 0.001). Regardless of their pregnancy status, racial/ethnic minorities or women with less education or lower family income had higher prevalence of untreated dental caries, severity of dental caries, and periodontal disease compared to the respective reference groups of non-Hispanic whites or women with more education or higher family income. Results of this study show few clinical differences in dental caries and periodontal disease between pregnant and nonpregnant women but persistent disparities by sociodemographic characteristics. In order to reduce oral health disparities in the United States, it is important to improve access to oral health care particularly among vulnerable groups. Integrating oral health into the overall health care could benefit and improve women's oral health outcomes.

Prevalence and severity of coronal and radicular caries among patients with type 2 diabetes mellitus: A cross sectional study

This study aimed to analyse the association of self-perceived oral health status (OHS) and functions with clinical OHS in Korean adults aged 35–54 years. The study was designed as a cross-sectional study using data from the Fourth Korea National Health and Nutrition Examination Survey (2007–2009). A total of 6605 subjects aged 35–54 years who completed the oral examination and questionnaires were included. An association of self-perceived OHS and functions with clinically determined OHS was confirmed by a complex-samples general linear model. Data on socioeconomic variables, i.e., household income and education level, self-perceived OHS and functions, such as chewing and speaking, were collected by trained interviewers. The clinical OHS was determined by trained dentists and included the number of untreated decayed teeth (DT); decayed, missing, and filled teeth (DMFT); prosthetic and periodontal status. The combined score was estimated as the sum of self-perceived OHS and functions. Based on the estimation coefficient, the clinical variables that were most strongly associated with self-perceived OHS and functions were, in order, periodontal status, prosthetic status, DT, and DMFT. In addition, the combined score for self-perceived OHS and functions was associated with household income, education, and clinically determined OHS.

To assess whether proportional contribution of unprocessed or minimally processed, processed or ultra-processed foods to daily energy intake is associated with dental caries in US adults. This secondary cross-sectional analysis included adults aged 20 to 59years old with complete oral examinations, using data gathered from cycles 2011-2012 and 2013-2014 of the continuous National Health and Nutrition Examination Survey (NHANES). Dietary recall data were categorized according to the NOVA classification into four groups: unprocessed or minimally processed foods (Group 1), processed culinary ingredients (Group 2), processed foods (Group 3) and ultra-processed foods (Group 4). The proportional contribution of each of these groups to mean daily energy intake was calculated and then cut into quartiles (Group 1, Group 3 and Group 4) or tertiles (Group 2). Two separate measures were used to assess dental caries: the decayed, missing, filled teeth (DMFT) index and, after exclusion of edentulous participants, prevalence of untreated caries. Poisson regression was used to model DMFT, while logistic regression was used to model the prevalence of untreated dental caries. Models were calculated for each NOVA group. All models were controlled for age, gender, race/ethnicity, level of education, income, access to oral health services, body mass index, smoking status and total energy intake. Analyses took into account NHANES sampling weights. We analysed data from 5720 individuals, of whom 123 (2.2%) were edentulous. Mean DMFT was 9.7 (± 0.2), while the prevalence of untreated dental caries was 26.0%. Mean daily energy intake was 2170kcal (± 17). Mean contribution to overall daily energy intake was 28.6% (± 0.5) for G1 foods, 4.3% (± 0.1) for G2 foods, 10.1% (± 0.2) for G3 foods and 56.9% (± 0.5) for G4 foods. A higher intake of G3 was associated with lower DMFT at the fourth quartile (0.89; 95%: CI 0.81-0.96), while a higher intake of G4 was associated with a higher DMFT at the fourth quartile (1.10; 95% CI: 1.04-1.16). In the adjusted models for untreated dental caries, no statistically significant associations were found with any of the NOVA groups. Higher proportional intake of NOVA groups is only weakly associated with dental caries. Widespread exposure to a highly ultra-processed diet may explain these weak associations.

BackgroundDental caries is one of the most preventable oral diseases among children in developing countries. This study aims to estimate the prevalence and severity of dental caries in the first permanent molar and analyze the related risk factors among sixth-grade students in São Tomé Island.MethodsA cross-sectional study with a stratified cluster sampling method was conducted on 1855 sixth-grade school children, mainly aged 11 to 14 years old, from 10 schools in 6 regions of São Tomé Island, from April 17 to June 27, 2021. Dental caries examination was performed by using the CAST criteria (DMFT) index, and the self-administered questionnaires about family background, oral hygiene, and relevant behaviors were collected. Multivariable logistic regression was used to study risk factors related to dental caries of the first permanent molar, and all data analyses were done using SPSS version 25.ResultsThe prevalence of dental caries in the first permanent molar was 68.79%, without significant difference between gender, age, residence, and whether only child or not. The mean Decayed, Missing, and Filled Teeth (DMFT) index and mean Decayed, Missing, and Filled Surface (DMFS) index were 1.751 ± 1.514 and 3.542 ± 3.941, respectively. The rate of filling teeth was 5.50%, and Pit and Fissure Sealant (PFS) rate was 2.21%. The overall prevalence and DMFT index of dental caries of permanent teeth was 76.01% and 2.753 ± 4.569, respectively. The results of logistic regression analysis indicated that the frequency of candy/chocolate consumption (OR = 1.095) and fair self-assessment of dental health (OR = 1.354) were significantly associated with dental caries (P < 0.05).ConclusionsThe high prevalence of dental caries in the first permanent molar was a public health issue among sixth-grade school children in São Tomé Island. The prevalence of dental caries, mean DMFT and DMFS scores were higher, while the rate of filling and PFS teeth were lower than the average score of other African countries. Thus, oral health education, implement oral health preaching to school children and their parents is crucial to prevent dental caries.

(1) Background: This study examines vitamin D's impact on dental caries to inform prevention strategies, given its critical role in bone and calcium regulation, vital for dental health. (2) Methods: Data from 18,683 participants of the National Health and Nutrition Examination Survey (NHANES) 2011-2016 were analyzed. NHANES collects U.S. population data through interviews, physical exams, and tests, including vitamin D levels and dental health assessed using both the decayed, missing, and filled teeth (DMFT) index and the presence of untreated dental caries. Vitamin D levels were measured according to serum 25(OH)D concentrations, and the analyses adjusted for confounders such as body mass index (BMI) and socioeconomic status (SES) using Chi-square, Mann-Whitney U, Kruskal-Wallis tests, as well as logistic and Poisson regression. (3) Results: This study found a mean DMFT score of 7.36 and a 33.2% prevalence of untreated dental caries. A higher caries prevalence was correlated with a lower SES (p < 0.001), the male gender (p < 0.001), and a higher BMI (p < 0.001). Severe vitamin D deficiency (<25 nmol/L) doubled the risk of dental caries, with odds ratios of 2.261 and 1.953 after adjusting for demographic factors and BMI. (4) Conclusions: Our study confirms a significant relationship between low vitamin D levels and an increased risk of dental caries nationwide, even after accounting for sociodemographic factors, emphasizing the importance of maintaining sufficient vitamin D levels for preventing caries.

We aimed to investigate the relationship between bone mineral density and dental caries in adults of over 19 years of age who were categorized according to their sex and menopausal status. The Korea National Health and Nutrition Examination Survey (KNHANES) dataset was used for the study. Bone mineral density (BMD) and oral health examination data were collected between 2008 and 2011. A total of 17,141 adults of ≥19 years old were eligible for inclusion in the present study. Multiple regression analysis was performed after adjustment for age, household income, educational level, smoking status, and alcohol drinking status for men, and pre- and post-menopausal women. In men, the β-value for the mean decayed, missing, and filled teeth (DMFT) index was 0.98 (95% confidence interval (CI) = 0.71–1.25), and was significantly higher in osteoporotic participants than in participants with normal BMD (p < 0.05). In post-menopausal women, the β-value for the mean DMFT index was 0.86, and was higher in the osteoporotic participants than in the participants with normal BMD (p < 0.05). Men and post-menopausal women with osteoporosis had higher DMFT indexes than those with normal BMD. In addition, there was a correlation between DMFT index and BMD in men and post-menopausal women. Therefore, the prevention of osteoporosis should be implemented alongside proper oral care.

OBJECTIVESIn South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates.METHODSData from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error.RESULTSWith the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES.CONCLUSIONSWhen using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.

The Korea National Health and Nutrition Examination Survey (KNHANES) is a representative survey of the Korean population, providing evidence for health policy and health interest statistics. The survey is conducted annually, and the 10th cycle, 1st year (2025) survey is currently underway. In health examination of KNHANES, blood samples are collected from people aged 10 years or older, and urine samples are collected from people aged 6 years or older. To support research related to various public health concerns based on the general population, the National Bank of Korea (NBK) has been operating the KNHANES biobank project since 2005 and has distributed high-quality biospecimens collected through KNHANES. To date, biospecimens from a total of 95,455 participants have been deposited, with approximately 35,500 biospecimens available as of December 2024. This biobank provides serum, plasma, and extracted DNA to researchers in officially approved projects. Recently, urine specimens have also become available. Additionally, genotyping data (> 833,000 genetic markers) for ~19,300 participants generated from the KoreanChip are available. The vast epidemiological data linkage derived from KNHANES will provide valuable insights into public health issues. Researchers can access the resource through NBK’s online platform (HuBIS_Desk, https://biobank.nih.go.kr/Desk/).