The relationship between pit and fissure sealant (PFS) experience and the socio-economic factors of adolescents before and after coverage by National Health Insurance (NHI)

Jin-Sun Choi; Deok-Young Park; Se-Hwan Jung

doi:10.11149/jkaoh.2017.41.2.116

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Choi, Park, and Jung: The relationship between pit and fissure sealant (PFS) experience and the socio-economic factors of adolescents before and after coverage by National Health Insurance (NHI)

Original Article

J Korean Acad Oral Health 2017;41(2):116-121.

Published online: 15 June 2017

DOI: https://doi.org/10.11149/jkaoh.2017.41.2.116

The relationship between pit and fissure sealant (PFS) experience and the socio-economic factors of adolescents before and after coverage by National Health Insurance (NHI)

Jin-Sun Choi, Deok-Young Park, Se-Hwan Jung

Department of Preventive and Public Health Dentistry, College of Dentistry, Gangneung-Wonju National University, Research Institute of Oral Science, Gangneung, Korea

Corresponding Author: Jin-Sun Choi Department of Preventive and Public Health Dentistry, College of Dentistry, Gangneung-Wonju National University, Research Institute of Oral Science, 7 Jukheon-gil, Gangneung 25457, Korea Tel: +82-33-640-2794 Fax: +82-33-640-6410 E-mail: jjcjsa@naver.com

Received 13 March 2017 Revised 17 April 2017 Accepted 23 April 2017

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to review the relationship between pit and fissure sealant (PFS) experience and the socio-economic factors of adolescents before and after coverage by National Health Insurance (NHI).

Methods

Our sources were the Korea Youth Risk Behavior Web-based Surveys from 2008 and 2014. The variables used were PFS experience, demographic factors, socio-economic factors, and oral health-related behaviors.

Results

PFS experience was higher in 2014 than in 2008. The relationship between PFS experience and socio-economic factors was significant in both 2008 and 2014. Although the inequity of PFS experience among adolescents was reduced as PFS was included in NHI coverage, a disparity still exists.

Conclusions

Even after NHI coverage included PFS, the policies to reduce the inequity of PFS experiences among adolescents should be further devised. In addition, a longitudinal study is recommended to determine the relationship between PFS experience and various socio-economic or behavioral factors.

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Keywords: Korea youth risk behavior web-based survey, National Health Insurance, Pit and fissure sealant, Socio-economic factors

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Table 1.

The variables in this study

Classification	Categories	Variables
Dependent variable	Dental care utilization factors	Experienced pit and fissure sealing during recent one year	Yes, No
Independent variable	Demographic factors	Gender	Male, Female
		Grade	1st-3rd graders of middle school,
		Grade	1st-3rd graders of high school
	Socio-economic factors	Father’s education status	≥College, High school,
		Mother’s education status	≤Middle school, Don’t know,
			No response
		Subjective households-economic status	High, Middle, Low
	Oral health related behaviors factors	Daily tooth brushing frequency	≥3, 1-2, No
	Oral health related behaviors factors	Oral health education experience in school	Yes, No

Table 2.

The distribution of subjects who have experienced pit and fissure sealing (PFS) during recent one year in 2008 and 2014 year

Classification	2008 year				2014 year
	N	Subjects experienced PFS			N	Subjects experienced PFS
	N	N	Wt%^†	P-value	N	N	Wt%^†	P-value
Total	75,238	16,001	21.5		72,060	19,487	26.9
Demographic factors
Gender				<0.001				<0.001
Male	39,278	7,563	19.5		36,470	8,780	24.1
Female	35,960	8,438	23.7		35,590	10,707	30.0
Grade				<0.001				<0.001
1st graders of Middle school	13,037	3,259	25.6		11,661	3,640	31.5
2nd graders of Middle school	13,056	3,259	21.1		12,275	3,528	29.2
3rd graders of Middle school	12,850	2,743	22.0		12,220	3,340	27.2
1st graders of High school	12,720	2,718	21.3		11,824	3,112	26.3
2nd graders of High school	12,375	2,436	19.9		12,152	3,028	24.5
3rd graders of High school	11,200	2,006	17.4		11,928	2,839	23.5
Socio-economic factors
Father’s education status
≥College	27,838	6,698	24.2	<0.001	33,794	9,963	29.3	<0.001
High school	28,435	5,797	20.5		21,483	5,551	25.6
≤Middle school	5,496	990	17.2		2,118	507	23.2
Don't know	8,035	1,443	17.9		11,630	2,706	23.1
No response	5,434	1,073	20.2		3,035	760	24.4
Mother’s education status				<0.001				<0.001
≥College	19,341	4,838	25.3		28,668	8,536	29.6
High school	36,511	7,647	21.1		27,391	7,223	26.1
≤Middle school	5,628	989	17.0		1,845	449	24.6
Don't know	8,746	1,609	18.7		11,200	2,603	22.9
No response	5,012	918	18.3		2,956	676	22.3
Subjective households-economic status				<0.001				<0.001
High	20,801	5,264	25.7		23,945	7,197	30.0
Middle	35,770	7,433	20.9		35,040	9,221	26.0
Low	18,667	3,304	17.5		13,075	3,069	23.1
Oral health related behaviors factors
Daily toothbrushing frequencies				<0.001				<0.001
≥3	61,819	13,828	22.5		37,152	10,591	28.3
1-2	12,652	2,062	16.5		34,219	8,750	25.5
No	767	111	15.5		689	146	21.6
Oral health education experience in school				<0.001				<0.001
Yes	15,754	4,412	28.2		17,314	6,010	34.7
No	59,484	11,589	19.8		54,746	13,477	24.5

The data were analysed by Chi-square test or Fisher’s exact test.

^† Weighted value.

Table 3.

Odds ratios of PFS experience during recent one year among groups categorized by socio-economic factors OR (95% CI)

Classification	Model 1			Model 2
Classification		2008 year	2014 year	2008 year	2014 year
Father’s education status	≥College	Ref. 1.000
	High	0.821	0.849	0.824	0.847
		(0.783-0.860)^‡	(0.812-0.886)^‡	(0.786-0.865)^‡	(0.811-0.886)^‡
	≤Middle	0.693	0.776	0.705	0.774
		(0.632-0.758)^‡	(0.685-0.878)^‡	(0.643-0.773)^‡	(0.683-0.877)^‡
Mother’s education status	≥College	Ref. 1.000
	High	0.818	0.862	0.821	0.866
		(0.778-0.860)^‡	(0.828-0.898)^‡	(0.781-0.863)^‡	(0.831-0.902)^‡
	≤Middle	0.656	0.819	0.671	0.821
		(0.601-0.716)^‡	(0.714-0.940)^†	(0.614-0.734)^‡	(0.715-0.944)^†
Subjective households-economic status	High			Ref. 1.000
	Middle	0.767	0.833	0.776	0.843
		(0.735-0.801)^‡	(0.801-0.866)^‡	(0.743-0.810)^‡	(0.811-0.877)^‡
	Low	0.629	0.730	0.654	0.742
		(0.593-0.668)^‡	(0.694-0.768)^‡	(0.615-0.695)^‡	(0.705-0.780)^‡

The data were analysed by Complex Samples Logistic Regression. *P<0.05,

^† P<0.01,

^‡ P<0.001. Model 1: Adjusting for Gender and Grade. Model 2: Adjusting for Gender, Grade, Daily toothbrushing, Oral health education experience in school.

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