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According to data from the Korean National Health Insurance (KNHI) that has provided the entire South Korean population with health care coverage since 1989, periodontal diseases have ranked among the top 10 diseases that were most seen in outpatient care over the years. In 2014, Korea Centers for Disease Control and Prevention conducted the Korean National Health and Nutrition Examination Survey (KNHNES) and reported that the prevalence of severe periodontitis was 27.7% among adults aged over 19 years. However, despite the well-known benefits of regular dental checkups and consistent supportive periodontal therapy, most Koreans have been found to lack in receiving sufficient periodontal care. This phenomenon is well portraited in a longitudinal population-based study (https://doi.org/10.1111/jcpe.12056) by Professor Peter Meisel at the University of Greifswald in Germany. He stated that low socioeconomic status shows strong correlations with having more prevalent and more severe periodontal disease.
Given these circumstances, the Korean government has recently decided to extend dental care benefits under the KNHI to cover preventive scaling for adults hoping to improve access to periodontal healthcare, irrespective of socioeconomic backgrounds. To measure the effect of this policy change, we analyzed data from KNHNES 2010–2014 with a total of approximately 12,000 subjects and reported the results last year (https://doi.org/10.5051/jpis.2016.46.6.405). Unfortunately, we were only to find out that even this policy change had disproportionately benefited certain groups and that high income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits.
With our full understanding of the substantial influence of national healthcare system on measures of periodontal health, we are delighted to feature a very intriguing research paper that analyzed 12 years' worth of KNHI service data as the cover article of this issue. For those of you who wish to learn the reasons behind the steady increase in incidence of tooth extraction despite dental healthcare policies to expand public health insurance coverage, reading the paper will serve you as an opportunity to broaden insights on what future endeavors are needed to maximize the effects of dental care coverage expansion.
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