A comparative study of the utility of oral health indicators in adults

In-Ja Kim; Hyun-Jeong Ju; Hyo-Won Oh; Heung-Soo Lee

doi:10.11149/jkaoh.2017.41.3.165

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Kim, Ju, Oh, and Lee: A comparative study of the utility of oral health indicators in adults

Original Article

J Korean Acad Oral Health 2017;41(3):165-172.

Published online: 15 September 2017

DOI: https://doi.org/10.11149/jkaoh.2017.41.3.165

A comparative study of the utility of oral health indicators in adults

In-Ja Kim, Hyun-Jeong Ju, Hyo-Won Oh, Heung-Soo Lee

Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, Iksan, Korea

Corresponding Author: Heung-Soo Lee Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Korea Tel: +82-63-850-6851 Fax: +82-63-850-6851 E-mail: smagn@wonkwang.ac.kr

Received 19 January 2017 Revised 4 May 2017 Accepted 19 June 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 compare the value and utility of certain oral health indicators in adults.

Methods

The data used for analysis was obtained from the 6^th Korean National Health and Nutrition Examination Survey (2013-2014). The study subjects were 7,729 adults aged between 20 and 64 years. The oral health indicators used for the analysis were T-Health (tissue health index), FS-T (functioning teeth index), and DHC of 1st molar (dental health capacity of the first molars). Descriptive statistical indices for oral health indicators were obtained (mean, skewness and kurtosis, and coefficient of variation). The correlation among oral health indicators, DMF, and sound tooth structure was analyzed.

Results

The oral health indicator scores had an abnormal distribution. DHC of 1st molar is found to be the most reliable indicator because it most accurately reflects the oral health decline that occurs as a result of aging. In all ages, DHC of 1st molar marked the lowest value in skewness and kurtosis. However, the skewness and kurtosis values of T-Health in adults younger than 44 years old were found to be the lowest among all age groups. FS-T is believed to most accurately reflect oral health status as it has a high correlation with sound tooth structure and sound tooth surfaces. T-Health is evaluated to most accurately reflect oral disease indicators as it appears to have a high correlation with DMF and high caries risk.

Conclusions

The oral health indicators T-Health, DHC of 1st molar, and FS-T have distinct characteristics that can serve as different health indices. Therefore, they can each be utilized in various fields of oral epidemiology.

Keywords: Adult, Epidemiologic measurements, Indicator, Molar, Oral health, Tooth

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Fig. 1.

Scatter plot of indicators. T-Health: tissue health index, DHC of 1st molar: dental health capacity of the first permanent molars. FST: functioning teeth index.

Table 1.

Test of normality* (Kolmogorov-Smirnova)

Index	Statistics	df	P
T-Health	.127	7729	.000
FS-T	.275	7729	.000
DHC of 1st molars	.220	7729	.000

*Kolmogorov-Smirnova test. T-Health: tissue health index, FS-T: functioning teeth index. DHC of 1st molars: dental health capacity of the first permanent molars.

Table 2.

Change of dental health index scores

Age (N)	T-Health					FS-T					DHC of 1st molars
Age (N)	Mean	SE	S	K	CV	Mean	SE	S	K	CV	Mean	SE	S	K	CV
20-24 (569)	99.6327	.38049	―.628	.303	9.10965	27.2109	.06479	―2.455	7.847	5.67968	36.8348	.15224	―3.461	19.648	9.85908
25-29 (545)	97.6110	.41670	―.858	2.231	9.96615	27.0073	.08480	―3.255	15.947	7.33009	35.3404	.23553	―2.743	10.218	15.55850
30-34 (860)	96.7547	.33388	―.518	.435	10.11955	26.7640	.08092	―3.587	20.755	8.86635	34.8942	.19328	―2.233	6.586	16.24382
35-44 (1,998)	99.0010	.21470	―.817	1.508	9.69356	26.3589	.06651	―3.203	15.105	11.27918	34.7167	.15037	―2.137	5.169	19.36014
45-54 (1,881)	98.1861	.27372	―1.874	7.720	12.09090	24.6720	.11085	―2.509	7.877	19.48610	33.2419	.19783	―1.709	2.673	25.81058
55-64 (1,876)	92.8630	.43207	―1.813	4.256	20.15262	20.7383	.18185	―1.214	.523	37.97967	29.6892	.26767	―1.154	.313	39.05021
Total (7,729)	97.0114	.14940	―2.088	8.352	13.53875	24.7376	.06217	―2.550	6.935	22.09321	33.3572	.09788	―1.947	3.639	25.79560

T-Health: tissue health index, FS-T: functioning teeth index. DHC of 1st molar: dental health capacity of the first permanent molars. S, skewness; K, kurtosis; CV, coefficient of variation.

Table 3.

Correlation between oral health indicators and sound tooth (surface)

Age	Oral health indicator	Sound surface	Sound tooth
20-24	T-Health	.701**	.326**
	FS-T	.635**	.801**
	DHC of 1st molars	.590**	.512**
25-29	T-Health	.744**	.495**
	FS-T	.707**	.823**
	DHC of 1st molars	.617**	.610**
30-34	T-Health	.790**	.604**
	FS-T	.707**	.788**
	DHC of 1st molars	.636**	.624**
35-44	T-Health	.720**	.535**
	FS-T	.783**	.862**
	DHC of 1st molars	.633**	.603**
45-54	T-Health	.637**	.541**
	FS-T	.871**	.917**
	DHC of 1st molars	.572**	.538**
55-64	T-Health	.605**	.574**
	FS-T	.927**	.946**
	DHC of 1st molars	.545**	.523**
Total	T-Health	.645**	.557**
	FS-T	.897**	.935**
	DHC of 1st molars	.611**	.585**

Pearson’s correlation, **P<0.01. T-Health: tissue health index, FS-T: functioning teeth index. DHC of 1st molars: dental health capacity of the first permanent molars.

Table 4.

Correlation between oral health indicators

Oral health indicator	T-Health	FS-T
T-Health
FS-T	.453**
DHC of 1st molars	.736**	.526**

Pearson’s correlation, **P<0.01. T-Health: tissue health index, FS-T: functioning teeth index. DHC of 1st molars : dental health capacity of the first permanent molars.

Table 5.

Correlation between oral health indicators and oral diseases indicators

Age	Oral health indicator	DS	DT	FS	FT	MS	MT	DMFT	DMFS
20-24	T-Health	―.343**	―.364**	―.738**	―.820**	―.325**	―.335**	―.977**	―.864**
	FS-T	―.230**	―.134**	.005	.041	―.487**	―.483**	―.073	―.195**
	DHC of 1st molars	―.394**	―.283**	―.447**	―.334**	―.642**	―.630**	―.513**	―.700**
25-29	T-Health	―.308**	―.334**	―.692**	―.739**	―.478**	―.478**	―.963**	―.877**
	FS-T	―.277**	―.199**	―.040	.059	―.640**	―.639**	―.181**	―.395**
	DHC of 1st molars	―.240**	―.216**	―.346**	―.193**	―.737**	―.717**	―.452**	―.681**
30-34	T-Health	―.313**	―.318**	―.683**	―.733**	―.480**	―.481**	―.962**	―.870**
	FS-T	―.253**	―.142**	―.065	.006	―.760**	―.763**	―.251**	―.422**
	DHC of 1st molars	―.280**	―.214**	―.303**	―.197**	―.697**	―.682**	―.454**	―.613**
35-44	T-Health	―.283**	―.293**	―.669**	―.730**	―.567**	―.567**	―.955**	―.889**
	FS-T	―.256**	―.161**	.013	.088**	―.672**	―.674**	―.177**	―.367**
	DHC of 1st molars	―.243**	―.169**	―.301**	―.204**	―.760**	―.746**	―.480**	―.669**
45-54	T-Health	―.335**	―.346**	―.524**	―.527**	―.755**	―.754**	―.942**	―.935**
	FS-T	―.208**	―.172**	.103**	.177**	―.589**	―.589**	―.213**	―.362**
	DHC of 1st molars	―.164**	―.162**	―.244**	―.154**	―.767**	―.753**	―.572**	―.705**
55-64	T-Health	―.257**	―.262**	―.262**	―.232**	―.913**	―.913**	―.951**	―.959**
	FS-T	―.125**	―.097**	.210**	.297**	―.619**	―.618**	―.334**	―.434**
	DHC of 1st molars	―.160**	―.150**	―.127**	―.058*	―.823**	―.807**	―.727**	―.793**
Total	T-Health	―.286**	―.282**	―.462**	―.451**	―.783**	―.783**	―.932**	―.928**
	FS-T	―.158**	―.090**	.092**	.216**	―.671**	―.670**	―.245**	―.460**
	DHC of 1st molars	―.186**	―.146**	―.219**	―.087**	―.788**	―.773**	―.580**	―.752**

Pearson’s correlation, *P<0.05, **P<0.01. T-Health: tissue health index, FS-T: functioning teeth index. DHC of 1st molars: dental health capacity of the first permanent molars.

Table 6.

Relationship between high caries risk group and oral health indicatorsUnit : N (%)

Age	high cariesrisk group	T-Health level				FS-T level				DHC of 1st molars level
Age	high cariesrisk group	Low	High	ø	P	Low	High	ø	P	Low	High	ø	P
20-24	No	10 (2.7)	361 (97.3)	0.616	<0.001	107 (28.8)	264 (71.2)	0.010	0.811	61 (16.4)	310 (83.6)	0.428	<0.001
	Yes	152 (76.8)	46 (23.2)			59 (29.8)	139 (70.2)			125 (63.1)	73 (36.9)
25-29	No	9 (2.4)	361 (97.6)	0.650	<0.001	104 (28.1)	266 (71.9)	0.150	<0.001	59 (15.9)	311 (84.1)	0.357	<0.001
	Yes	150 (85.7)	25 (14.3)			76 (43.4)	99 (56.6)			92 (52.6)	83 (47.4)
30-34	No	20 (3.5)	556 (96.5)	0.599	<0.001	114 (19.8)	462 (80.2)	0.162	<0.001	116 (20.1)	460 (79.9)	0.281	<0.001
	Yes	210 (73.9)	74 (26.1)			99 (34.9)	185 (65.1)			138 (48.6)	146 (51.4)
35-44	No	36 (2.7)	1,281 (97.3)	0.581	<0.001	271 (20.6)	1,046 (79.4)	0.128	<0.001	217 (16.5)	1,100 (83.5)	0.333	<0.001
	Yes	463 (68.0)	218 (32.0)			220 (32.3)	461 (67.7)			340 (49.9)	341 (50.1)
45-54	No	74 (5.7)	1,226 (94.3)	0.600	<0.001	291 (22.4)	1,009 (77.6)	0.132	<0.001	252 (19.4)	1,048 (80.6)	0.314	<0.001
	Yes	458 (78.8)	123 (21.2)			204 (35.1)	377 (64.9)			302 (52.0)	279 (48.0)
55-64	No	55 (4.3)	1,219 (95.7)	0.628	<0.001	252 (19.8)	1,022 (80.2)	0.270	<0.001	169 (13.3)	1,105 (86.7)	0.465	<0.001
	Yes	502 (83.4)	100 (16.6)			282 (46.8)	1,342 (71.5)			390 (64.8)	212 (35.2)

*P-value determined by chi-square test. T-Health: tissue health index, FS-T: functioning teeth index. DHC of 1st molars: dental health capacity of the first permanent molars.

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