Abstract
Objectives
The purpose of this study was to review the supplied amount of pit and fissure sealing (PFS) by age and dental accessibility of children after PFS was included in the list of treatments covered by National Health Insurance (NHI).
Methods
The comparison period was selected by considering the availability of data and the initiated time of PFS inclusion into NHI. The selected data period after inclusion was 2010-2012. Data were collected from the NHI database. To categorize the areas by high and low dental accessibility, the number of dental institutions was standardized by population per width of area.
Results
Supplied amount of PFS to the first permanent molars in children aged 6 to 8 years constituted to about 70% of the total supplied amount during 2010-2012. However, this supplied amount was less than 8% of the total number of the first permanent molars in that age group. Number of supplied PFS for ages 6 to 8 years was 8.4% and 6.3% of the total number of first permanent molars for high and low dental accessibility areas, respectively.
Conclusions
Although PFS supply was increased after inclusion in NHI coverage, it is still insufficient to reduce the decayed-missing-filled teeth (DMFT) index effectively. To increase the supplied amount of PFS and to reduce inequality of supply between areas of high and low dental accessibility, strengthening of and focus on education related to PFS, reduced out-of-pocket expenditure, and advocacy are needed for appropriate target age groups and areas.
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Table 1.
Characteristics of National Health Insurance data
Table 2.
Rank of area by standardized population and number of dental institution
Classification |
Population* [Per 1 km2] |
Number of dental institution† [Per 1 km2] |
||||||
---|---|---|---|---|---|---|---|---|
2010 | 2011 | 2012 | Rank | 2010 | 2011 | 2012 | Rank | |
Seoul | 1,540 | 1,455 | 1,378 | 1 | 7.6 | 7.7 | 7.7 | 1 |
Busan | 417 | 389 | 367 | 2 | 1.4 | 1.4 | 1.5 | 2 |
Daegu | 365 | 347 | 330 | 3 | 0.8 | 0.9 | 0.9 | 4 |
Incheon | 321 | 307 | 293 | 4 | 0.7 | 0.7 | 0.7 | 5 |
Gwangju | 305 | 287 | 271 | 5 | 1.0 | 1.0 | 1.0 | 3 |
Daejeon | 285 | 272 | 259 | 6 | 0.8 | 0.9 | 0.9 | 4 |
Ulsan | 134 | 128 | 124 | 7 | 0.3 | 0.3 | 0.3 | 6 |
Gyeonggi | 123 | 116 | 110 | 8 | 0.3 | 0.3 | 0.3 | 6 |
Gangwon | 37 | 36 | 35 | 9 | 0.0 | 0.0 | 0.0 | 8 |
Chungbuk | 34 | 32 | 31 | 10 | 0.0 | 0.0 | 0.0 | 8 |
Chungnam | 25 | 24 | 24 | 11 | 0.1 | 0.1 | 0.1 | 7 |
Jeonbuk | 25 | 24 | 23 | 12 | 0.1 | 0.1 | 0.1 | 7 |
Jeonnam | 22 | 21 | 20 | 13 | 0.0 | 0.0 | 0.0 | 8 |
Gyeongbuk | 16 | 15 | 14 | 14 | 0.0 | 0.0 | 0.0 | 8 |
Gyeongnam | 14 | 13 | 12 | 15 | 0.1 | 0.1 | 0.1 | 7 |
Jeju | 9 | 9 | 9 | 16 | 0.1 | 0.1 | 0.1 | 7 |
Table 3.
The amount of NHI supplied PFS by age
Age |
Year |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
2010 |
2011 |
2012 |
||||||||||
PFS* | Population | RT (%)† | NT‡ | PFS* | Population | RT (%)† | NT‡ | PFS* | Population | RT (%)† | NT‡ | |
Total | 688,325 | 3,924,661 | 4.4 | 0.18 | 626,361 | 3,719,359 | 4.2 | 0.17 | 615,470 | 3,547,584 | 4.3 | 0.17 |
6 | 148,030 | 473,718 | 7.8 | 0.31 | 142,433 | 435,724 | 8.2 | 0.33 | 139,015 | 449,057 | 7.7 | 0.31 |
7 | 177,046 | 493,551 | 9.0 | 0.36 | 179,579 | 473,970 | 9.5 | 0.38 | 171,239 | 435,863 | 9.8 | 0.39 |
8 | 124,466 | 495,212 | 6.3 | 0.25 | 114,833 | 493,658 | 5.8 | 0.23 | 114,692 | 474,009 | 6.0 | 0.24 |
9 | 93,418 | 560,067 | 4.2 | 0.17 | 71,305 | 495,288 | 3.6 | 0.14 | 68,036 | 493,679 | 3.4 | 0.14 |
10 | 70,016 | 640,166 | 2.7 | 0.11 | 56,221 | 560,042 | 2.5 | 0.10 | 50,849 | 495,216 | 2.6 | 0.10 |
11 | 47,399 | 620,740 | 1.9 | 0.08 | 39,817 | 640,027 | 1.6 | 0.06 | 42,397 | 559,908 | 1.9 | 0.08 |
12 | 27,950 | 641,207 | 1.1 | 0.04 | 22,173 | 620,650 | 0.9 | 0.04 | 29,563 | 639,852 | 1.2 | 0.05 |
Table 4.
The amount of NHI supplied PFS by dental care accessibility of areas
Year | PFS* Total |
Area of high accessibility |
Area of low accessibility |
P-vaule§ | ||||||
---|---|---|---|---|---|---|---|---|---|---|
PFS* | Population | RT (%)† | NT‡ | PFS* | Population | RT (%)† | NT‡ | |||
2010 | 688,325 | 524,565 | 2,715,591 | 4.8 | 0.19 | 163,760 | 1,209,070 | 3.4 | 0.14 | <0.001 |
2011 | 626,361 | 470,183 | 2,575,025 | 4.6 | 0.18 | 156,178 | 1,144,334 | 3.4 | 0.14 | <0.001 |
2012 | 615,470 | 459,889 | 2,459,267 | 4.7 | 0.19 | 155,581 | 1,088,317 | 3.6 | 0.14 | <0.001 |
Table 5.
Amount of NHI supplied PFS among 6-8 years-olds by dental care accessibility of areas
Year | PFS* Total |
Area of high accessibility |
Area of low accessibility |
P-vaule§ | ||||||
---|---|---|---|---|---|---|---|---|---|---|
PFS* | Population | RT (%)† | NTmax‡ | PFS* | Population | RT (%)† | NTmax‡ | |||
2010 | 449,542 | 342,800 | 1,017,067 | 8.4 | 0.34 | 106,742 | 445,414 | 6.0 | 0.24 | <0.001 |
2011 | 436,845 | 328,542 | 977,258 | 8.4 | 0.34 | 108,303 | 426,094 | 6.4 | 0.25 | <0.001 |
2012 | 424,946 | 318,288 | 945,605 | 8.4 | 0.34 | 106,658 | 413,324 | 6.5 | 0.26 | <0.001 |