Skip to main content
Top
Published in: BMC Oral Health 1/2020

Open Access 01-12-2020 | Caries | Research article

Changes in oral health indicators due to implementation of the National Health Insurance Services coverage for first molar dental sealant for children and adolescents in South Korea

Authors: Jin-Sun Choi, Deuk-Sang Ma

Published in: BMC Oral Health | Issue 1/2020

Login to get access

Abstract

Background

In South Korea, dental sealant was included in the National Health Insurance Services (NHIS) coverage for the first molar for ages 6–14 in December 2009. The second molar was included in 2012, and the age of insurance coverage was extended to under 18 in 2013. This study aimed to verify the effectiveness of an NHIS dental sealant coverage policy for children and adolescents by comparing the changes in first molar oral health indicators before and after policy implementation.

Methods

The Korea National Health and Nutrition Examination Survey data were analyzed; the fourth period (2007–2009) provided data for before and the sixth period (2013–2015) provided data for after policy implementation. The proportion of individuals with first-molar sealant, decay-missing-filled first molar permanent teeth, and single crowns in the group aged 11–20 years were calculated. Data were analyzed using chi-square for complex samples and the complex samples general linear model. In addition, complex-sample logistic regression analysis was performed to confirm the association between factors.
Results: Compared with non-beneficiaries, among policy beneficiaries, sealant ownership increased by 7.7% (from 27.8 to 35.5, P < 0.001), and the number of permanent teeth with sealant per capita increased by approximately 0.4 to 0.8 (P < 0.001). The proportion of individuals with decay-missing-filled permanent teeth decreased by 9.1% (from 68.4 to 59.3, P < 0.001), and the average decay-missing-filled permanent teeth index per person decreased by approximately 2.0 to 1.5 (P < 0.001). The rate of single-crown holders decreased by 2.7% (from 8.7 to 6.0, P > 0.05), and the average single-crown index decreased by approximately 0.11 to 0.08 per person(P > 0.05). The number of sealants increased with age and household income (P < 0.001). The mother’s education level affected sealant experience (P < 0.05). The caries rate was higher in females and older respondents (P < 0.001).

Conclusions

The sealant covered by NHIS contributed to decreasing dental caries in Korea. However, policies that can reduce oral health inequality should also be considered, and a follow-up study is required for long-term sealant maintenance in Korea.
Literature
1.
go back to reference Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, Murray CJL, Marcenes W, GBD 2015 Oral health collaborators. Global, regional, and National Prevalence, incidence, and disability-adjusted life years for Oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380–7.CrossRef Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, Murray CJL, Marcenes W, GBD 2015 Oral health collaborators. Global, regional, and National Prevalence, incidence, and disability-adjusted life years for Oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380–7.CrossRef
2.
go back to reference Müller A, Hussein K. Meta-analysis of teeth from European populations before and after the 18th century reveals a shift towards increased prevalence of caries and tooth loss. Arch Oral Biol. 2017;73:7–15.CrossRef Müller A, Hussein K. Meta-analysis of teeth from European populations before and after the 18th century reveals a shift towards increased prevalence of caries and tooth loss. Arch Oral Biol. 2017;73:7–15.CrossRef
3.
go back to reference Petersen PE. The world Oral health report 2003: continuous improvement of oral health in the 21st century--the approach of the WHO global Oral health Programme. Community Dent Oral Epidemiol. 2003;1:3–23.CrossRef Petersen PE. The world Oral health report 2003: continuous improvement of oral health in the 21st century--the approach of the WHO global Oral health Programme. Community Dent Oral Epidemiol. 2003;1:3–23.CrossRef
4.
go back to reference GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–858. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–858.
5.
go back to reference Korean Dental Association, Health Policy Institute. Oral health status and determinants. In 2014 Yearbook of the Korean Dentistry. Seoul, South Korea: Korean Dental Association, Health Policy Institute; 2015. Korean Dental Association, Health Policy Institute. Oral health status and determinants. In 2014 Yearbook of the Korean Dentistry. Seoul, South Korea: Korean Dental Association, Health Policy Institute; 2015.
6.
go back to reference Korean Dental Association, Health Policy Institute. Oral health status and determinants. In: 2018 Yearbook of the Korean dentistry. Seoul: Korean Dental Association, Health Policy Institute; 2019. Korean Dental Association, Health Policy Institute. Oral health status and determinants. In: 2018 Yearbook of the Korean dentistry. Seoul: Korean Dental Association, Health Policy Institute; 2019.
9.
go back to reference Choi JS, Park DY, Jung SH. 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). J Korean Acad Oral Health. 2017;41(2):116–21.CrossRef Choi JS, Park DY, Jung SH. 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). J Korean Acad Oral Health. 2017;41(2):116–21.CrossRef
10.
go back to reference Choi JS, Park DY. The impact of national health insurance coverage on pit and fissure sealing experience. Rural Remote Health. 2018;18(4):4804.PubMed Choi JS, Park DY. The impact of national health insurance coverage on pit and fissure sealing experience. Rural Remote Health. 2018;18(4):4804.PubMed
11.
go back to reference Ministry of Health & Welfare. 2010 Oral health services manual. Seoul: Ministry of Health & Welfare; 2010. . Ministry of Health & Welfare. 2010 Oral health services manual. Seoul: Ministry of Health & Welfare; 2010. .
12.
go back to reference Ministry of Health & Welfare. 2015 Korean Children's Oral Health Survey. Sejong·Cheongju: Ministry of Health & Welfare; 2015. Ministry of Health & Welfare. 2015 Korean Children's Oral Health Survey. Sejong·Cheongju: Ministry of Health & Welfare; 2015.
13.
go back to reference Ministry of Health & Welfare. 2018 Korean Children's Oral Health Survey, vol. 114. Sejong·Cheongju: Ministry of Health & Welfare; 2018. Ministry of Health & Welfare. 2018 Korean Children's Oral Health Survey, vol. 114. Sejong·Cheongju: Ministry of Health & Welfare; 2018.
16.
go back to reference Korea Centers for Disease Control and Prevention. Standardization for Oral Health Survey in KNHANES. Sejong·Cheongju: South Korea: Korea Centers for Disease Control and Prevention; 2014. Korea Centers for Disease Control and Prevention. Standardization for Oral Health Survey in KNHANES. Sejong·Cheongju: South Korea: Korea Centers for Disease Control and Prevention; 2014.
17.
go back to reference Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2007); 2008. Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2007); 2008.
18.
go back to reference Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2008); 2009. Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2008); 2009.
19.
go back to reference Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2009); 2010. Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2009); 2010.
20.
go back to reference Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2013); 2014. Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2013); 2014.
21.
go back to reference Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2014); 2014. Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2014); 2014.
22.
go back to reference Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2015); 2015. Korea Centers for Disease Control & Prevention. Standardization for Oral health survey in KNHANES (2015); 2015.
23.
go back to reference Ministry of Health & Welfare, Korea Centers for Disease Control and Prevention. The sixth (2013–2015) Instructions for Use of Raw Data. Sejong·Cheongju: Ministry of Health & Welfare, Korea Centers for Disease Control and Prevention; 2015. Ministry of Health & Welfare, Korea Centers for Disease Control and Prevention. The sixth (2013–2015) Instructions for Use of Raw Data. Sejong·Cheongju: Ministry of Health & Welfare, Korea Centers for Disease Control and Prevention; 2015.
24.
go back to reference Ekstrand KR, Martignon S, Christiansen ME. Frequency and distribution patterns of sealants among 15-year-olds in Denmark in 2003. Community Dent Health. 2007;24(1):26–30.PubMed Ekstrand KR, Martignon S, Christiansen ME. Frequency and distribution patterns of sealants among 15-year-olds in Denmark in 2003. Community Dent Health. 2007;24(1):26–30.PubMed
25.
go back to reference 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(1):69–77.CrossRef 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(1):69–77.CrossRef
26.
go back to reference Al Agili DE, Griffin SO. Effect of family income on the relationship between parental education and sealant prevalence, National Health and nutrition examination survey, 2005-2010. Prev Chronic Dis. 2015;12:E138. Al Agili DE, Griffin SO. Effect of family income on the relationship between parental education and sealant prevalence, National Health and nutrition examination survey, 2005-2010. Prev Chronic Dis. 2015;12:E138.
27.
go back to reference Paglia L. Oral prevention starts with the mother. Eur J Paediatr Dent. 2019;20(3):173. Paglia L. Oral prevention starts with the mother. Eur J Paediatr Dent. 2019;20(3):173.
28.
go back to reference Abiola Adeniyi A, Eyitope Ogunbodede O, Sonny Jeboda O, Morenike FO. Do maternal factors influence the dental health status of Nigerian pre-school children? Int J Paediatr Dent. 2009;19(6):448–54. Abiola Adeniyi A, Eyitope Ogunbodede O, Sonny Jeboda O, Morenike FO. Do maternal factors influence the dental health status of Nigerian pre-school children? Int J Paediatr Dent. 2009;19(6):448–54.
29.
go back to reference Oulis CJ, Berdouses ED, Mamai-Homata E, Polychronopoulou A. Prevalence of sealants in relation to dental caries on the permanent molars of 12 and 15-year-old Greek adolescents. A national pathfinder survey. BMC Public Health. 2011;11:100. Oulis CJ, Berdouses ED, Mamai-Homata E, Polychronopoulou A. Prevalence of sealants in relation to dental caries on the permanent molars of 12 and 15-year-old Greek adolescents. A national pathfinder survey. BMC Public Health. 2011;11:100.
30.
go back to reference Jung SH. Chpater 10 Oral health policy and program on Korea: New Dental Public Health. 1st ed. Seoul: Kommonsa Publications Inc.; 2012. p. 191–238. Jung SH. Chpater 10 Oral health policy and program on Korea: New Dental Public Health. 1st ed. Seoul: Kommonsa Publications Inc.; 2012. p. 191–238.
31.
go back to reference Choi YS, Chun KH, Baek KW, Kim MS, Lee SJ. The relationship of pit and fissure sealant in children and mother’s socioeconomic status, mother’s oral-health screening. J Korean Acad Oral Health. 2012;36:124–30. Choi YS, Chun KH, Baek KW, Kim MS, Lee SJ. The relationship of pit and fissure sealant in children and mother’s socioeconomic status, mother’s oral-health screening. J Korean Acad Oral Health. 2012;36:124–30.
33.
go back to reference Korea Institute for Health and Social Affairs. Social Security in Major Countries - Sweden-. Korea Institute for Health and Social Affairs. Sejong·Cheongju: Korea Institute for Health and Social Affairs; 2012. Korea Institute for Health and Social Affairs. Social Security in Major Countries - Sweden-. Korea Institute for Health and Social Affairs. Sejong·Cheongju: Korea Institute for Health and Social Affairs; 2012.
34.
go back to reference The Seoul institute. Policy evaluation of family dentist system for students and children of low-income households and its suggestions. Seoul: The Seoul institute; 2016. p. 4. The Seoul institute. Policy evaluation of family dentist system for students and children of low-income households and its suggestions. Seoul: The Seoul institute; 2016. p. 4.
36.
go back to reference The Seoul institute. Policy evaluation of family dentist system for students and children of low-income households and its suggestions. Seoul: The Seoul Institute; 2016. p. 110. The Seoul institute. Policy evaluation of family dentist system for students and children of low-income households and its suggestions. Seoul: The Seoul Institute; 2016. p. 110.
37.
go back to reference Ministry of Health & Welfare. 2000 Korean National Oral Health Survey. Ministry of Health & welfare. Seoul. South Korea: Ministry of Health & Welfare; 2001. Ministry of Health & Welfare. 2000 Korean National Oral Health Survey. Ministry of Health & welfare. Seoul. South Korea: Ministry of Health & Welfare; 2001.
38.
go back to reference Kervanto-Seppälä S, Pietilä I, Meurman JH, Kerosuo E. Pit and fissure sealants in dental public health: application criteria and general policy in Finland. BMC Oral Health. 2009;9:5. Kervanto-Seppälä S, Pietilä I, Meurman JH, Kerosuo E. Pit and fissure sealants in dental public health: application criteria and general policy in Finland. BMC Oral Health. 2009;9:5.
40.
go back to reference Going RE, Haugh LD, Grainger DA, Conti AJ. Four-year clinical evaluation of a pit and fissure sealant. J Am Dent Assoc. 1977;95:972–81.CrossRef Going RE, Haugh LD, Grainger DA, Conti AJ. Four-year clinical evaluation of a pit and fissure sealant. J Am Dent Assoc. 1977;95:972–81.CrossRef
41.
go back to reference Kühnisch J, Mansmann U, Heinrich-Weltzien R, Hickel R. Longevity of materials for pit and fissure sealing--results from a meta-analysis. Dent Mater. 2012;28(3):298–303.CrossRef Kühnisch J, Mansmann U, Heinrich-Weltzien R, Hickel R. Longevity of materials for pit and fissure sealing--results from a meta-analysis. Dent Mater. 2012;28(3):298–303.CrossRef
42.
go back to reference Choi JS, Park DY. 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. J Korean Acad Oral Health. 2016;40(3):171–7.CrossRef Choi JS, Park DY. 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. J Korean Acad Oral Health. 2016;40(3):171–7.CrossRef
43.
go back to reference Jung YS, Jeong SH, Kang NK, Choi YH, Song KB. The characteristics of high caries risk group for 12-years children in Korea. J Korean Acad Oral Health. 2013;37:47–52.CrossRef Jung YS, Jeong SH, Kang NK, Choi YH, Song KB. The characteristics of high caries risk group for 12-years children in Korea. J Korean Acad Oral Health. 2013;37:47–52.CrossRef
44.
go back to reference Kwon JH, Choi BJ, Lee JH, Kim SO, Son HK, Choi HJ. Eruption time and sequence of permanent teeth in students from elementary school. J Korean Acad Pediatr Dent. 2009;36:253–61. Kwon JH, Choi BJ, Lee JH, Kim SO, Son HK, Choi HJ. Eruption time and sequence of permanent teeth in students from elementary school. J Korean Acad Pediatr Dent. 2009;36:253–61.
45.
go back to reference Zaborskis A, Lagunaite R, Busha R, Lubiene J. Trend in eating habits among Lithuanian school-aged children in context of social inequality: three cross-sectional surveys 2002, 2006 and 2010. BMC Public Health. 2012;12:52.CrossRef Zaborskis A, Lagunaite R, Busha R, Lubiene J. Trend in eating habits among Lithuanian school-aged children in context of social inequality: three cross-sectional surveys 2002, 2006 and 2010. BMC Public Health. 2012;12:52.CrossRef
46.
go back to reference Lee YC, Huang YT, Tsai YW, Huang SM, Kuo KN, McKee M, Nolte E. The impact of universal National Health Insurance on population health: the experience of Taiwan. BMC Health Serv Res. 2010;10:225.CrossRef Lee YC, Huang YT, Tsai YW, Huang SM, Kuo KN, McKee M, Nolte E. The impact of universal National Health Insurance on population health: the experience of Taiwan. BMC Health Serv Res. 2010;10:225.CrossRef
47.
go back to reference Chu TB, Liu TC, Chen CS, Tsai YW, Chiu WT. Household out-of-pocket medical expenditures and national health insurance in Taiwan: income and regional inequality. BMC Health Serv Res. 2005;5:60.CrossRef Chu TB, Liu TC, Chen CS, Tsai YW, Chiu WT. Household out-of-pocket medical expenditures and national health insurance in Taiwan: income and regional inequality. BMC Health Serv Res. 2005;5:60.CrossRef
Metadata
Title
Changes in oral health indicators due to implementation of the National Health Insurance Services coverage for first molar dental sealant for children and adolescents in South Korea
Authors
Jin-Sun Choi
Deuk-Sang Ma
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Caries
Published in
BMC Oral Health / Issue 1/2020
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-020-01201-8

Other articles of this Issue 1/2020

BMC Oral Health 1/2020 Go to the issue