Journal List > J Korean Acad Oral Health > v.38(4) > 1057619

Kim, Jung, Kim, Kim, Jun, Kim, Joeng, and Kim: Factors related to the experience of illegal dental treatments among Korean adults: The Fourth Korea National Health and Nutrition Examination Survey, 2007-2009

Abstract

Objectives

The aim of the study was to analyze the factors related to the illegal dental treatment experience (IDTX) among Korean adults.

Methods

The raw data for the analysis of IDTX among Korean adults were obtained from the dataset of the Fourth Korea National Health and Nutrition Examination Survey conducted in 2007-2009. Stratified weighted subjects aged ≥45 years were selected according to region by using clustered sampling methods. In total, the data of 9,254 subjects, who participated in the interview and dental examinations related to the experience of illegal dental treatments, were analyzed using chi-square test, general linear model, and logistic regression analysis with complex sampling design by considering demographic and socioeconomic variables (age, gender, region, educational level, household income, and medical and dental delivery system) as well as oral status variables (prosthesis and number of natural remaining teeth).

Results

IDTX rate was <10% among adults aged 35-44 years or below. However, it increased to 15% among adults aged 45-54 years and was >30% among adults aged ≥65 years. The age group with a high IDTX rate coincided with the age group with a high number of lost teeth. Most of the IDTX cases were presumed to be prosthetic treatments. The model comprising demographic, socioeconomic, and oral status variables had the highest explanation power. Significant variables were educational level, household income, prosthesis status, and number of remaining teeth. Women and persons under the medicaid system were more likely to undergo illegal dental treatments.

Conclusions

Comprehensive prosthetic treatments are suggested to be included in the care services of the national health insurance and medicaid system to reduce the number of illegal dental treatments.

References

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Fig. 1.
Number of natural remaining teeth and experience rate of illegal dental treatments.
jkaoh-38-254f1.tif
Table 1.
Distribution of study samples, experience rate of illegal dental treatments by age group
Age (yr) N (unweighted) Experience rate (%)*
Total 17,073 16.3
20-24 880 1.1
25-29 1,217 2.5
30-34 1,539 5.0
35-44 3,624 7.5
45-54 3,285 15.4
55-64 2,641 24.8
65-74 2,658 30.1
75-84 1,095 35.2
85+ 134 36.6

*P<0.001 by chi-square test.

Table 2.
Number of analyzed samples aged 45+ years by complex sampling designa
Age (yr) N (unweighted) N (weighted)b
Total Male Female Total Male Female
Total 9,254 3,932 5,322 16,153,261 7,695,052 8,458,209
45-54 3,141 1,338 1,803 7,366,341 3,719,417 3,646,923
55-64 2,513 1,120 1,393 4,281,268 2,091,034 2,190,234
65-74 2,486 1,059 1,427 2,986,854 1,345,218 1,641,636
75-84 995 375 620 1,352,815 484,225 868,590
85+ 119 40 79 165,983 55,158 110,825

a Samples of the Fourth Korean National Health and Nutrition Examination Survey conducted from 2007 to 2009 were selected by comple sampling design.

b Samples were weighted by age and gender to variables.

Table 3.
Experience rate of illegal dental treatments of samples aged 45 years and more by variable concerning demographic, socioeconomic andprosthetic status
Variables Contents N Experience rate (%) P*
Total 9,254 21.8
Age (yr) 45-54 3,141 15.0 <0.001
55-64 2,513 23.6
65-74 2,486 29.8
75-84 995 32.9
85+ 119 40.6
Gender Male 3,932 18.6 <0.001
Female 5,322 24.7
Region City 6,036 21.1 0.039
Rural 3,218 23.9
Education Elementary or less 4,611 31.1 <0.001
Middle school 1,541 21.2
High school 2,017 15.6
College or higher 1,085 7.6
Household income Low 2,902 29.1 <0.001
Middle-low 2,406 25.7
Middle-high 1,938 18.4
High 2,008 14.0
Health insurance National health service 8,726 21.3 <0.001
Medicaid 528 31.9
Prosthesis of upper arch None 4,475 12.1 <0.001
One bridge 1,769 29.4
More than one bridge 920 32.6
Both partial denture & bridges 1,144 34.7
Complete denture 946 40.2
Prosthesis of lower arch None 4,637 12.4 <0.001
One bridge 1,598 28.9
More than one bridge 1,077 32.8
Both partial denture & bridges 1,337 36.9
Complete denture 605 41.7

*By chi-square test using complex sampling design.

Table 4.
Number of remaining natural teeth by experience of illegal dental treatments among samples aged 45+ years
Age (yr) No experience Experience Difference P*
Mean SE Mean SE
Total 23.78 .13 18.89 .25 4.89 <0.001
45-54 26.99 .09 24.34 .28 2.65 <0.001
55-64 23.98 .18 20.12 .39 3.86 <0.001
65-74 19.10 .28 15.68 .41 3.42 <0.001
75-84 13.57 .48 10.42 .55 3.15 <0.001
85+ 6.76 1.05 9.36 1.67 ―2.6 0.204

*By general linear model using complex sampling design.

Table 5.
Bivariate logistic regression analysis by variable concerning demographic, socioeconomic and prosthetic status related to illegal dental treatment experience among samples aged 45+ years using complex sampling design*
Variables Contents Model I Model II Model III
P OR 95% CI P OR 95% CI P OR 95% CI
Age .000 1.02 1.02-1.03 .173 .990 .99-1.00
Gender Female .078 1.12 .99-1.26 .293 1.07 .94-1.22
Male 1 1
Region City .242 1.09 .94-1.26 .127 1.13 .97-1.32
Rural 1 1
Education Elementary school or less .000 3.69 2.70-5.04 .000 3.37 2.46-4.62
Middle school .000 2.76 2.06-3.70 .000 2.54 1.88-3.44
High school .000 2.06 1.55-2.74 .000 2.03 1.52-2.71
College or higher 1 1
Household income Low .070 1.23 .98-1.53 .138 1.19 .95-1.48
Middle-low .002 1.38 1.13-1.69 .005 1.35 1.10-1.65
Middle-high .331 1.11 .90-1.36 .452 1.08 .88-1.34
High 1 1
Health insurance Medicaid .151 1.19 .94-1.50 .060 1.27 .99-1.63
National heath service 1 1
Prosthesis of upper arch Complete denture .391 1.16 .82-1.64 .350 1.18 .83-1.67
Both partial denture & bridges .012 1.38 1.07-1.77 .015 1.36 1.06-1.74
More than one bridge .000 1.91 1.53-2.39 .000 1.85 1.48-2.31
One bridge .000 2.24 1.90-2.65 .000 2.24 1.89-2.65
None 1 1
Prosthesis of lower arch Complete denture .037 1.42 1.02-1.98 .022 1.47 1.06-2.05
Both partial denture & bridges .000 1.75 1.37-2.22 .000 1.69 1.33-2.16
More than one bridge .000 2.10 1.72-2.57 .000 2.07 1.69-2.54
One bridge .000 2.08 1.75-2.46 .000 2.06 1.74-2.45
None 1 1
Number of natural remaining teeth .000 .95 .94-.96 .000 .96 .95-.97

*By multivariable logistic regression. † Model I: Nagelkerke R square=0.086, df1=10, df2=465, wald F=28.85, P<0.001. Model II: Nagelkerke R square=0.140, df1=9, df2=466, wald F=74.40, P<0.001. Model III: Nagelkerke R square=0.171, df1=19, df2=456, wald F=35.91, P<0.001.

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