Association between unmet needs for dental treatment and the DMFT index among Korean adults

Sun-Young Chung; Ja-Won Cho; Yun-Sook Jung; Hye-Young Kim; Ji-Young Kim; Youn-Hee Choi; Keun-Bae Song

doi:10.11149/jkaoh.2017.41.4.267

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Chung, Cho, Jung, Kim, Kim, Choi, and Song: Association between unmet needs for dental treatment and the DMFT index among Korean adults

Original Article

J Korean Acad Oral Health 2017;41(4):267-273.

Published online: 15 December 2017

DOI: https://doi.org/10.11149/jkaoh.2017.41.4.267

Association between unmet needs for dental treatment and the DMFT index among Korean adults

Sun-Young Chung¹, Ja-Won Cho¹, Yun-Sook Jung², Hye-Young Kim³, Ji-Young Kim⁴, Youn-Hee Choi², Keun-Bae Song^2,

¹Department of Preventive Dentistry, Dankook University Dental Hospital, Cheonan, Korea

²Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea

³Department Dental Hygiene, Kangwon National University, Samcheok, Korea

⁴Department of Dental Hygiene, Ulsan College, Ulsan, Korea

Corresponding Author: Keun-Bae Song Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, 2217 Dalgubeoldae-ro, Jung-gu, Daegu 41940, Korea Tel: +82-53-660-6870 Fax: +82-53-423-2947 E-mail: kbsong@knu.ac.kr

Received 18 October 2017 Revised 11 December 2017 Accepted 12 December 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

Unmet needs for dental treatment are one of the potential contributing factors to poor oral health because oral health problems worsen if left untreated. This study aimed to demonstrate the prevalence of and the causes for unmet dental needs, and to evaluate the association between unmet needs for dental treatment and oral health status.

Methods

Data on 3,883 subjects aged ≥18 years from the Korean National Oral Health Survey 2006 were analyzed. Information regarding unmet needs for dental treatment was obtained using standardized questionnaires. Eight trained dentists examined decayed, missing, or filled teeth (DMFT). Multiple regression models were built to assess the association between unmet needs for dental treatment and the DMFT scores.

Results

The prevalence of perceived unmet needs for dental treatment was 34.7% among the adult Korean population. Economic constraints were the main cause (38.6%) for unmet dental needs. The average DMFT scores were higher in the subjects with unmet needs for dental treatment than in those without. In individuals with unmet needs for dental treatment within the past 1 year, the number of decayed teeth after adjusting for confounders was likely to be greater by 0.58 and that of missing teeth by 0.27 compared to that in their counterparts with no unmet dental needs in the past 1 year.

Conclusions

Perceived unmet needs for dental treatment were significantly associated with poor oral health status among the adult Korean population. Further studies are needed to clarify the direct and indirect effects of unmet needs for dental treatment on an individual's oral health status by investigating critical variables of the causal pathways among perceived dental needs, dental care utilization, and oral health status.

Keywords: Dental care, Dental health surveys, DMF index, Health services needs and demand, Oral health

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Fig. 1.

The reasons for unmet dental needs (n=1,378; weighted percent).

Table 1.

Characteristics of subjects with or without unmet needs for dental care utilization

	Total (n=3,883)	Unmet dental needs (n=1,378)	Met dental needs (n=2,505)	P-value
Biological factor
Age group				0.47
18-29	467 (23.0)	163 (22.5)	304 (23.2)
30-39	925 (25.2)	339 (26.5)	586 (24.5)
40-49	722 (21.2)	256 (21.1)	466 (21.3)
50-59	610 (14.5)	230 (15.2)	380 (14.2)
60-69	635 (10.0)	209 (8.8)	153 (10.6)
≥70	524 (6.1)	181 (5.9)	343 (6.2)
Sex				0.06
Male	1,410 (47.1)	471 (44.7)	939 (48.4)
Female	2,473 (52.9)	907 (55.3)	1,566 (51.6)
Socioeconomic factor
Education (years)				0.61
None	322 (4.4)	118 (4.1)	204 (4.6)
1-9	735 (12.0)	260 (11.9)	475 (12.1)
10-12	1,750 (46.3)	631 (47.6)	1,119 (45.5)
>12	1,076 (37.3)	369 (36.4)	707 (37.8)
Monthly household income^†				0.01*
Low	966 (18.8)	361 (19.6)	605 (18.3)
Middle-low	971 (26.2)	368 (28.7)	603 (24.9)
Middle-high	975 (28.8)	358 (29.9)	617 (28.2)
High	971 (26.2)	291 (21.8)	680 (28.6)
Residence				0.01*
Metropolis	1,545 (48.2)	542 (48.4)	1,003 (48.1)
City	1,839 (36.6)	690 (38.9)	1,149 (35.3)
Rural	499 (15.2)	146 (12.7)	353 (16.6)
Oral health-related behaviors
Frequency of tooth brushing (times/day)				0.19
0	48 (0.8)	16 (0.8)	32 (0.8)
1	456 (10.2)	167 (10.8)	289 (9.8)
2	1,937 (50.1)	714 (52.0)	1,223 (49.1)
3+	1,442 (38.9)	481 (36.3)	961 (40.3)
Experience with smoking				0.03*
Yes	729 (25.1)	279 (27.7)	450 (23.7)
No	3,154(74.9)	1,099 (72.3)	2,055 (76.3)
Use of dental care service
Recent dental checkups (years)				0.01*
<1	1,570 (40.9)	426 (31.6)	1,144 (46.0)
1-2	830 (21.5)	341 (26.0)	489 (19.0)
>2	1,483 (37.6)	611 (42.4)	872 (35.0)
Purpose of the recent dental visit (n=1,445)				0.01*
Prevention	263 (20.5)	50 (14.0)	213 (23.0)
Treatment	1,182 (79.5)	352 (96.0)	830 (77.0)

n (%) n=unweighted number, %=weighted percent, *significant P-values.

^† Cutoff points for low ($1,090), middle-low ($2,246), and middle-high ($3,575), $1 United States dollar=925.8 Korean Won in 2006.

Table 2.

Oral health status of the participants with or without unmet dental needs

	Total (n=3,883)	Unmet dental needs (n=1,378)	Met dental needs (n=2,505)	P-value
DMFT	7.31±0.10	7.57±0.17	7.17±0.13	0.05*
DT	0.60±0.02	1.00±0.06	0.39±0.02	<0.01*
MT	2.30±0.06	2.43±0.10	2.23±0.08	0.23
FT	4.40±0.08	4.13±0.14	4.54±0.10	0.01*

Data are presented as weighted mean±standard deviation, *significant P-values, DMFT, decayed, missing, or filled teeth; DT, decayed teeth; MT, missing teeth; FT, filled teeth.

Table 3.

Oral health status of the study population depending on the reason for unmet dental needs

	Total (n=1,335)	Low priority (n=260)	Economic problem (n=621)	Restriction due to personal factors^† (n=277)	Restriction due to social factors^‡ (n=177)	P-value
DMFT	7.27±0.22	6.30±0.32	9.07±0.30	6.48±0.31	7.29±0.50	<0.01*
DT	1.01±0.11	0.68±0.09	0.98±0.09	1.17±0.14	1.27±0.21	0.02*
MT	2.17±0.18	1.57±0.15	3.83±0.20	1.47±0.14	1.95±0.26	<0.01*
FT	4.09±0.30	4.04±0.29	4.25±0.23	3.84±0.27	4.06±0.42	0.73

Data are presented as weighted mean±standard deviation, *significant P-values, DMFT, decayed, missing, or filled teeth; DT, decayed teeth; MT, missing teeth; FT, filled teeth.

^† Restrictions on personal factors included difficulty in mobility, childcare, and fear.

^‡ Restrictions on social factors included living far from the dental clinic and the inability to take time off from work.

Table 4.

Regression coefficients for an association between unmet dental needs and the DMFT scores

	Model 1		Model 2		Model 3		Model 4
	b (SE)	P-value	b (SE)	P-value	b (SE)	P-value	b (SE)	P-value
DMFT	0.39 (0.21)	0.07	0.42 (0.21)	0.04*	0.43 (0.21)	0.04*	0.59 (0.21)	0.01*
DT	0.61(0.06)	0.01*	0.60 (0.06)	0.01*	0.58 (0.06)	0.01*	0.58 (0.06)	0.01*
MT	0.19 (0.13)	0.14	0.24 (0.11)	0.02*	0.24 (0.10)	0.02*	0.27 (0.10)	0.01*
FT	―0.40 (0.17)	0.02*	―0.42 (0.17)	0.01*	―0.39 (0.17)	0.02*	―0.26 (0.17)	0.14

b, estimated regression coefficient; SE, standard error; *significant P-values, DMFT, decayed, missing, or filled teeth. Model 1: crude association. Model 2: adjusted for age. Model 3: adjusted for age, education level, and income. Model 4: adjusted for age, education level, income, the frequency of daily tooth brushing, and the timing of the recent dental visit.

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