Journal List > J Korean Acad Oral Health > v.40(3) > 1057691

Choi and Park: Comparison of supplied amount of pit and fissure sealing on the first permanent molars by age and disparity of dental accessibility using National Health Insurance data

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.

References

1. Brudevold F. Aasenden R. Bakhos Y. A Preliminary Study of Posteruptive Maturation of Teeth in situ. Caries Res. 1982; 16:243–348.
2. Lee YH, Kwon HK, Kim BI. The dental caries experience of Korean in 2000 by tooth and surface type. J Korean Acad Oral Health. 2004; 28:315–323.
3. Ministry of Health and Welfare. Advanced Analysis of Korean National Oral Health Survey. Seoul: Ministry of Health & Welfare;2011. p. 226.
4. Ministry of Health and Welfare. 2012 Korean National Oral Health Survey. Seoul: Ministry of Health & Welfare;2012. p. 68.
5. Han SY, Sung SH, Kim DK. A study on the analysis of caries preventive effectiveness on occlusal pit and fissure sealing. J Korean Acad Oral Health. 1995; 19:51–64.
6. Lee SH, Ju HJ, Park SY, Oh HW, Lee HS. Dental health capacity of the first permanent molars among children and adolescents in Korea for the year 2010. J Korean Acad Oral Health. 2013; 37:103–109.
crossref
7. Kho CH, Moon HS, Paik DI, Kim JB. Two-year study of the need and retention rates of pit and fissure sealant on first molars in primary school children. J Korean Acad Oral Health. 2002; 26:484–494.
8. Kim DJ, Kim JY, Park YJ, Shin HS. Study on Horizontal inequity in health care utilization in Korea. Sejong: Korea Institute for Health and Social Affairs;2011. p. 09–30.
9. Yeo JY, Jeong HS. Determinants Of Dental Screening and Unmet Dental Needs:Interaction effect between geographical accessibility and economic affordability. Korean Health Economic Review. 2012; 18:109–126.
10. Kim NH, Jeon JE, Chung WG, Kim DK. Social determinants related to the regional difference of unmet dental need in Korea. J Korean Acad Oral Health. 2014; 38:165–169.
11. Lee HJ, Bae KH. A change in the regional disparity based on the national insurance coverage of dental sealant in Korea. J Korean Acad Oral Health. 2014; 38:165–169.
crossref
12. Choi JS, Ma DS, Jung SH, Cho EP, Park DY. Changes in the amount of pit and fissure sealants supplied in Korea after inclusion in the National Health Insurance coverage. J Korean Acad Oral Health. 2015; 39:69–77.
crossref
13. National Health Insurance CorporationㆍKorean dental association. Strategy for increasing national health insurance benefit in dental expenditure in Korea. Seoul: National health insurance serviceㆍ Korean dental association;2013.
14. Ministry of Government Administration and Home Affairs. Statistics of resident registration population. [Internet]. [cited 2015 Nov 03]. Available from:http://rcps.egov.go.kr:8081/jsp/stat/ppl_stat_jf.jsp.
15. Statistics Korea. Situation of country. [Internet]. [cited 2015 Feb 02]. Available from:http://www.index.go.kr/potal/main/EachDtlPage-Detail.do?idx_cd=2728.
16. Kwon HK, Kim DK, Kim BI, Kim YN, MA DS, Park DY, et al. chapter 6. Topical fluoride therapy. JO YS. Primary preventive dentistry. 6th ed.Daehannaraepublishing, Inc.;2004. p. 190.
17. Cheon GT, Song HJ, Lyoo YJ, Kim IS, Shin SC, Cho JW. The supplies of pit and fissure sealants for Korean children and adolescents in 2003. J Korean Acad Oral Health. 2006; 30:204–211.
18. Dye Bruce A., Thornton-Evans Gina, Li Xianfen, Iafolla Timothy J.Dental Caries and Sealant Prevalence in Children and Adolescents in the United States, 2011-2012. NCHS Data Brief. 2015; 191.
19. Park KH, Shin SC. A Clinical study on the retention rate of pit & fissure sealing. J Korean Acad Oral Health. 1993; 17:53–68.
20. Makhija SK, Childers NK, Lauten J, Dorantes CE, Chafin T, Dasanay-ake AP. Evaluation of initial caries score and caries incidence in a public health sealant program: a retrospective study. Pediatr Dent. 2006; 28:420–424.
21. Korea Health Industry Development Institute. Uiryoseobiseu iyong mich Gonggeub deuongy deunge daehan uiryogwong seoljeong yeonggu(A Study on medical service area on medical service use and supply). Cheongju: Korea Health Industry Development Institute;2011. p. 17–30.
22. Korea Institute for Health and Social Affairs. Urinara bogenuiryo jawonsugeubui monjejeomgwa jungchaekbanghyang(The problem and direction of policy on resource demand and supply of health and medical treatment in South Korea). Sejong: Korea Institute for Health and Social Affairs;2013. p. 1–22.
23. Park SK, Kim CB, Chung WG, Ahn YHE, Kim NH. The Utilization of Oral Health Services in Community Health Centers in Korea: A Study Using Data from the 2011-2012 Community Health Survey. J Korean Acad Oral Health. 2014; 38:154–164.
crossref
24. Xue Y, Lin W, Jie L, Qing D. Caries status of the first permanent molar among 7- to 9-year-old children in Tangshan city and their correlation. Hua Xi Kou Qiang Yi Xue Za Zhi. 2015; 33:54–57.
25. Douglass JM, Wei Y, Zhang BX, Tinanoff N. Caries prevalence and patterns in 3-6-year-old Beijing children. Community Dent Oral Epidemiol. 1995; 23:340–343.
crossref
26. Kim MK, Kim YW, Song JF, Lee MJ, Seong MG. Perception of parents on pit & fissure sealant for preschool children and its National Health Insurance Coverage. J Korean Soc Dent Hygiene. 2013; 15:33–44.
27. Kim SJ, Lee HJ, Kim YS, Jeon JK, Chang KW. The recognition and attitude of student’s parents of elementary school on the sealant and its operation by dental hygienists. J Korean Acad Oral Health. 2012; 36:323–332.
crossref

Table 1.
Characteristics of National Health Insurance data
Variables Data contents
Year 2010, 2011, 2012
Target ages 6- to 12-year-olds
Target tooth First permanent molars
Data unit Frequency of Pit and fissure sealing, PFS (Excluding resealing)
Areas Seoul, Busan, Daegu, Incheon, Gwangju, Daejeon, Ulsan, Gyeonggi, Gangwon, Chungbuk, Chungnam(Including Sejong),

Jeonbuk, Jeonnam, Gyeongbuk, Gyeongnam, Jeju

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

*Population (age of 6-12) ÷ Extent of the area [1 km

2 ]. †Number of Dental institutions ÷ Extent of the area [1 km

2 ].

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

* PFS: Frequency of supplied amount of PFS.

RT: Rate of sealed first permanent molars=PFS/(Population×4)×100.

NT: Frequency first permanent molar sealing per Person=PFS/Population.

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

* PFS: Frequency of supplied amount of PFS.

RT: Rate of sealed first permanent molars=PFS/(Population×4)×100.

NT: Frequency first permanent molar sealing per Person = PFS/Population.

§ The data were analysed by chi-square test.

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

* PFS: Frequency of supplied amount of PFS.

RT: Rate of sealed first permanent molars=PFS/(Population×4)×100.

NTmax: Estimated frequency of PFS per Person at maximum=PFS/Population.

§ The data were analysed by chi-square test.

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