JKAOH Journal of Korean Academy of Oral Health J Korean Acad Oral Health 1225-388X 2093-7784 Journal of Korean Academy of Oral Health 10.11149/jkaoh.2014.38.4.193 jkaoh-38-193 Original Article An analysis of oral health status, dental service items, and fees among children receiving care from registered dentists over a three-year period RyuJae-In12 KimYong-Jin2 ParkJoo-Hyun2 KimHyun-Joo2 KimJong-Ae2 JungJong-Il2 HongMin-Kyeong2 JungSe-Hwan23 Department of Dental Hygiene, Shingu College, Seongnam, Korea Association of Dentists for Health Society, Seoul & Seongnam, Korea Department of Preventive and Public Health Dentistry, Gangneung-Wonju National University & Research Institute of Oral Science College of Dentistry, Gangneung, Korea Corresponding Author: Jae-In Ryu Department of Dental Hygiene, Shingu College, 377, Gwangmyeong-ro, Jungwon-gu, Seongnam 462-743, Korea Tel: +82-31-740-1362 Fax: +82-31-740-1589 E-mail: jaeinryu@shingu.ac.kr 122014 12122014 38 4 193 202 18082014 02102014 20102014 Copyright © 2014 Journal of Korean Academy of Oral Health 2014 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract 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.

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Percentage of the children’s ora health status.

Mean of the children’s deciduous teeth status.

Mean of the children’s permanent teeth status.

Distribution of total study sample by demographic information

2011 2012 2013
N % % N % % N % % P-value*
Total 222 100.0 Cumulative 222 100.0 Cumulative 205 100.0 Cumulative
Community A center 29 13.1 - 21 9.5 - 22 10.7 - <0.0001
Children center B center 27 12.2 - - - - - - -
C center 35 15.8 - 36 16.2 - 31 15.1 -
D center 22 9.9 - 23 10.4 - 27 13.2 -
E center 21 9.5 - 19 8.6 - 18 8.8 -
F center 34 15.3 - 32 14.4 - 26 12.7 -
G center 24 10.8 - 31 14.0 - 29 14.1 -
H center 30 13.5 - 32 14.4 - 22 10.7 -
I center - - - 28 12.6 - 30 14.6 -
Sex Boys 119 53.6 - 118 53.2 - 96 46.8 - 0.299
Girls 103 46.4 - 104 46.8 - 109 53.2 -
Grade 1st 26 11.7 11.7 27 12.2 12.2 20 9.8 9.8 0.537
2nd 38 17.1 28.8 39 17.6 29.7 34 16.6 26.3
3rd 51 23.0 51.8 41 18.5 48.2 42 20.5 46.8
4th 30 13.5 65.3 44 19.8 68.0 45 22.0 68.8
5th 46 20.7 86.0 34 15.3 83.3 36 17.6 86.3
6th 31 14.0 100.0 37 16.7 100.0 28 13.7 100.0
Oral exam & tx Exam & tx 148 66.7 66.7 142 64.0 64.0 67 32.7 32.7 <0.001
Exam only 54 24.3 91.0 66 29.7 93.7 132 64.4 97.1
Tx only 20 9.0 100.0 14 6.3 100.0 6 2.9 100.0

*Used Chi-square test.

The percentage of the children with the following oral health status and behavior

2011 2012 2013
N % N % N % P-value*
Total 202 100.0 208 100.0 199 100.0
Experience of deciduous caries Yes 124 61.4 121 58.2 110 55.3 0.463
No 78 38.6 87 41.8 89 44.7
Experience of permanent caries Yes 88 43.6 82 39.4 85 42.7 0.668
No 114 56.4 126 60.6 114 57.3
Presence of deciduous caries Yes 73 36.1 73 35.1 60 30.2 0.400
No 129 63.9 135 64.9 139 69.8
Presence of permanent caries Yes 52 25.7 44 21.2 37 18.6 0.213
No 150 74.3 164 78.8 162 81.4
Dental treatment within 1 yr Yes 104 51.5 143 68.8 144 72.4 <0.001
No 98 48.5 65 31.3 55 27.6
Perceived oral health condition Good 142 71.0 181 87.0 172 86.4 <0.001
Poor 58 29.0 27 13.0 27 13.6
Anxious for dental tx Yes 89 45.4 177 85.1 164 82.4 <0.001
No 107 54.6 31 14.9 35 17.6
Tx need No need 44 21.8 65 31.3 60 30.2 0.085
Observation 37 18.3 23 11.1 31 15.6
Tx need 121 59.9 120 57.7 108 54.3

*Used Chi-square test.

The mean comparison of the oral health status and behavior by year

Year Mean S.D. Min. Max. P-value*
dt 2011 0.96 1.78 0 12 0.323
2012 0.82 1.46 0 8
2013 0.76 1.64 0 9
ft 2011 1.72 2.22 0 9 0.889
2012 1.62 2.18 0 9
2013 1.62 2.15 0 8
dft 2011 2.68 2.84 0 12 0.100
2012 2.43 2.69 0 9
2013 2.07 2.60 0 11
DT 2011 0.54 1.12 0 6 0.204
2012 0.45 1.07 0 6
2013 0.40 1.14 0 11
FT 2011 0.50 1.09 0 5 0.015
2012 0.64 1.29 0 8
2013 0.88 1.60 0 12
DMFT 2011 1.06 1.47 0 6 0.766
2012 1.10 1.72 0 10
2013 1.29 2.04 0 12
Sealant 2011 1.56 1.70 0 8 <0.001
2012 2.06 1.98 0 10
2013 2.36 2.13 0 14
Frequency of toothbrushing 2011 2.01 1.08 0 5 0.242
2012 2.06 1.04 0 5
2013 2.20 0.99 0 5

*Used Kruskal-Wallis test due to non-parametric distribution.

The percentage of children with oral health service by types

2011 2012 2013
N % N % N % P-value*
Total 168 100.0 156 100.0 73 100.0
For promotion
Yes 25 14.9 30 19.2 2 2.7 0.004
No 143 85.1 126 80.8 71 97.3
For prevention Sealant
Yes 54 32.1 54 34.6 21 28.8 0.673
No 114 67.9 102 65.4 52 71.2
Fluoride application Yes 59 35.1 30 19.2 6 8.2 <0.001
No 109 64.9 126 80.8 67 91.8
PMTC Yes 104 61.9 52 33.3 20 27.4 <0.001
No 64 38.1 104 66.7 53 72.6
Scaling Yes 30 17.9 34 21.8 13 17.8 0.623
No 138 82.1 122 78.2 60 82.2
For treatment
Filling Yes 87 51.8 59 37.8 29 39.7 0.029
No 81 48.2 97 62.2 44 60.3
Endo Yes 23 13.7 10 6.4 6 8.2 0.078
No 145 86.3 146 93.6 67 91.8
Extraction Yes 41 24.4 29 18.6 16 21.9 0.446
No 127 75.6 127 81.4 57 78.1
Prosthetics Yes 2 1.2 5 3.2 2 2.7 0.456
No 166 98.8 151 96.8 71 97.3

*Used Chi-square test.

Mean comparison of total visit and oral health service by year

Oral health service Year Mean S.D. Min. Max. P-value*
Total visit
2011 2.86 2.34 1 16 <0.001
2012 2.10 1.50 1 10
2013 1.82 1.61 1 10
For promotion
2011 0.18 0.46 0 2 0.002
2012 0.44 0.93 0 3
2013 0.04 0.26 0 2
For prevention
Sealant 2011 0.60 1.07 0 5 0.516
2012 0.87 1.49 0 8
2013 0.68 1.24 0 4
Fluoride application 2011 0.77 1.48 0 11 <0.001
2012 0.35 0.74 0 3
2013 0.10 0.34 0 2
For treatment
Fillings 2011 1.46 2.21 0 12 0.007
2012 0.90 1.67 0 13
2013 0.67 1.07 0 5
Amagam 2011 0.18 0.66 0 4 0.784
2012 0.19 0.66 0 4
2013 0.11 0.43 0 2
Miracle mix 2011 0.21 0.70 0 4 0.001
2012 0.03 0.18 0 1
2013 0.00 0.00 0 0
Resin 2011 0.39 1.35 0 12 0.105
2012 0.44 1.36 0 13
2013 0.40 0.80 0 3
Glass ionomer 2011 0.59 1.30 0 8 <0.001
2012 0.19 0.78 0 6
2013 0.15 0.52 0 3
Gold inlay 2011 0.08 0.46 0 3 0.635
2012 0.06 0.33 0 2
2013 0.01 0.12 0 1
Endo 2011 0.24 0.72 0 5 0.065
2012 0.08 0.36 0 3
2013 0.08 0.28 0 1
Extration 2011 0.40 0.81 0 4 0.379
2012 0.26 0.61 0 3
2013 0.33 0.78 0 5
Prosthetics 2011 0.02 0.17 0 2 0.463
2012 0.03 0.18 0 1
2013 0.03 0.16 0 1
SM Band 2011 0.01 0.08 0 1 0.796
2012 0.01 0.08 0 1
2013 0.00 0.00 0 0
SS Crown 2011 0.01 0.15 0 2 0.323
2012 0.03 0.16 0 1
2013 0.03 0.16 0 1

*Used Kruskal-Wallis test due to non-parametric distribution.

Mean comparison of dental treatment fees (unit=won) by year

Year Mean S.D. Min. Max. P-value*
Total fee 2011 169,113 180,201 20,130 1,142,480 <0.001
2012 122,428 142,178 11,980 922,560
2013 92,807 104,443 12,290 507,101
NHI coverage 2011 94,125 76,074 13,870 538,710 <0.001
2012 61,380 53,641 0 319,040
2013 50,220 46,553 12,290 253,540
NHI non-coverage 2011 74,988 162,161 0 1,120,000 0.103
2012 61,047 133,536 0 900,000
2013 42,586 89,407 0 400,000

*Used Kruskal-Wallis test due to non-parametric distribution.