• Journal of Korean society of Dental Hygiene
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• v.22 no.5
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• pp.417-424
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• 2022

Objectives: This study aimed to find a way to solve oral health inequality in old age by understanding the effect of the socioeconomic level of the elderly on oral health. Methods: We used data from the 7th Korea National Health and Nutrition Examination Survey. A chi-square test was performed to investigate differences in oral health according to socioeconomic status and demographic and oral health-related factors. Socioeconomic status and oral health inequality were analyzed using multiple logistic regression. Results: The average number of teeth in the elderly was 17.20, which is insufficient for the minimum number of teeth required for mastication. In the analysis of the correlation between socioeconomic status and oral health inequality, education level, income level, and home ownership were factors influencing the oral health of the elderly; education level was found to have the strongest effect. Conclusions: Oral health inequality according to socioeconomic status was confirmed, and it is necessary to measure the level of oral health inequality with active efforts at the government level to resolve the gap in oral health by social class.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.439-445
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• 2018

This study was conducted to investigate the status of oral health behavior according to economic inequality in Korea. Raw data for the 3rd year (2015) of the 6th national health and nutrition survey were analyzed. Among surveyed individuals, adults over the age of 19 were designated as research subjects. The results indicated that a smaller 'house income' was associated with a higher supply and demand experience for basic living and a higher DMFT. Additionally, a higher DMFT was associated with a lower 'house income', lower 'education level', and the 'experience of basic living security received'. Oral health behavior inequality was caused by economic inequality. Overall, these results indicate that it is necessary for the oral health service of vulnerable groups to strengthen preventive activities through comprehensive arbitration policies regarding the social decision factors of public health projects.

• Journal of dental hygiene science
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• v.23 no.3
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• pp.185-192
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• 2023

Background: The establishment of a strategy for the reduction and prevention of oral disease, a global pervasive disease, is considered one of the important national health policy strategies. In Korea, the 5th Comprehensive National Health Promotion Plan is currently in progress, but there is insufficient research on the transition process or improvement direction in the field of oral health. Methods: Changes in Comprehensive National Health Promotion Plan's Oral health sector in three countries were compared, and the direction of the three countries (Korea, the United States, and Canada) in accordance with the recent Oral health paradigm was confirmed. In this study, we reviewed the existing literature using the narrative review method to draw implications for strategies and directions for oral health promotion in Korea. Results: In Korea, the oral health promotion strategy is included in the 5th Comprehensive National Health Promotion Plan, and the project is being led by the government. The United States prepared a national-led oral health promotion strategy and suggested multi-disciplinary cooperation to improve overall oral health and reduce the oral health inequality. For more active intervention, Canada established an oral health-related department and assigned experts, while emphasizing cooperation between the government and the private sector. Conclusion: As a result of this study, Korea is also making efforts to improve oral health, but more active government intervention is needed to reduce the inequality in oral health by population group. To this end, it is necessary to establish a strong multi-sectoral cooperation system and prepare a strategy for implementation.

• Journal of Korean society of Dental Hygiene
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• v.19 no.4
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• pp.565-575
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• 2019

Objectives: In this study, both subjective and objective levels of oral health were used to identify the relationship between oral health inequalities. Methods: Korean National Health and Nutritional Examination Survey data from 2013 to 2015 were combined to create an analysis plan. Oral health questions categorized as subjective oral health conditions and oral health-related diseases used dental tissue disease status as data measured by the Community Periodical Index(CPI) and decayed, missing, filled teeth(DMFT) experience. Other data on oral health behaviors such as toothache experience, the frequency of toothbrush use, chewing problems, oral examination status, and unmet dental care needs were classified and analyzed according to the socioeconomic level. Data were analyzed using frequency and cross analyses, and the statistical significance level was set at 0.05. Results: It was found that higher the economic and educational level, better was the subjective oral health, lower the CPI, lower the experience of toothache, higher the frequency of toothbrush use, lower the number of people having chewing problems, and higher the frequency of oral checkups. Conclusions: Oral health inequality exists among social classes. It is suggested that continuous research and efforts be carried out to promote oral health while considering socioeconomic and educational levels. Further, active government efforts will be needed to address polarization by social class.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.2 no.1
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• pp.17-30
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• 2006

Federal disability law has evolved from several laws geared to protect people with disabilities since the late 1960s and early 1970s. When U.S. Congress passed the Americans with Disabilities Act (ADA) in 1990, no federal statute prohibited the majority of employers, program administrators, owners and managers of places of public accommodation and others from discriminating against people with disabilities. Toward the ends to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with the disabilities, the ADA pursues three major strategies: Title I addresses inequality in employment, Title II, inequality in public services, and Title III, inequality in services and accommodations offered by private entities. The purposes of the study were to analyze the impact of the ADA on health care for persons with disabilities and to review the ongoing health policy reforms at the federal and state governments. Essential remedies that the ADA contemplates are based on two principles, simple discrimination and reasonable accommodation, which significantly improved access to quality care, especially long-term care, by persons with disabilities. However, the ongoing Medicaid policy reforms to control rising health care costs in the U.S. could threaten the access to care by persons with disabilities in optional groups and to optional care services by persons with disabilities in mandatory groups.

• Journal of Preventive Medicine and Public Health
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• v.50 no.5
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• pp.303-310
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• 2017

Objectives: The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. Methods: This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. Results: The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents' education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). Conclusions: An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.

• Journal of the Korea Convergence Society
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• v.8 no.9
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• pp.49-57
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• 2017

The purpose of this study was to investigate factors affecting perceived oral health status according to socioeconomic status and community periodontal index(CPI) and decayed, missing, and filled teeth(DMFT) using the 6th Korean national health and nutritional examination survey(KNHANES VI) and provide a basic data for plan of policy. The higher the age, the lower the household income and education level, the worse the subjective oral health had better oral health and there was a tendency that the respondents who had no oral exam within 1 year and experienced CPI or DMFT estimated their own health as worse. It is needed to make policy development to resolve the inequality of oral health.

• Journal of Korean society of Dental Hygiene
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• v.18 no.6
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• pp.921-932
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• 2018

Objectives: The aim of this study was to investigate the number of existing permanent teeth and the denture usage status in elderly adults aged 65 years and above living in metropolitan cities and to confirm the degree of oral health inequality caused by the differences in oral conditions in each metropolitan city using the Lorenz curve and the Gini coefficient. Methods: The raw data for the analysis were obtained from the dataset of the sixth Korea National Health and Nutrition Examination Survey conducted between 2013 and 2015. The subjects included 1,764 people who underwent oral examination and answered questions. The complex samples general linear model was used to analyze the number of existing permanent teeth adjusted for age and monthly household income. The proportion of edentulousness and the denture status was analyzed using complex samples crosstabs. Results: The number of existing permanent teeth in the elderly adults aged 65 years and above was lowest in Ulsan (15.41) and highest in Gwangju (20.44). The proportion of edentulousness was highest in Busan (14.5%) and lowest in Daejeon (4.0%). With regard to the proportion of denture users, Busan had the highest tendency for denture usage (50.4%) and Gwangju had the lowest tendency (34.9) (p=0.172). The Gini's coefficient for the number of existing teeth was lowest in Busan (0.332). Oral health inequality was most severe in metropolitan cities. Conclusions: We found that oral health inequality exists among elderly adults living in the metropolitan cities of Korea using the Lorenz curve and Gini's coefficient.

• The Journal of Korean Society for School & Community Health Education
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• v.16 no.3
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• pp.41-50
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• 2015

Objectives: The purpose of this study was to apply an effective oral health promotion program and effect for underprivileged lower grade students. This study attempted to resolve some oral health inequality issues by providing underprivileged children with an oral health action program designed to promote positive oral health maintenance habits. Methods: This study was carried from May to August of 2009 with 77(control group 27 subjects, experimental group 36 subjects) elementary school students selected among first to third graders attending regional welfare center's after school program in Seoul. To the control group, conventional education methods were applied. To the experimental group, newly designed program was conducted by three project experts(1 expert, 1 dentist, 1 dental hygienist). It consisted of 5 sessions and progressed with various activities. It was focused on achieving target knowledge and changing oral health behavior. In order to evaluate the designed educational program, learners' achievement was evaluated with implementing the questionnaire and one-on-one interviews. And also the oral health improvement was evaluated based on change of Patient Hygiene Performance(PHP) index. Results: Based on the results of learners' achievement, the experimental group showed the significant increment of the oral health knowledge by the relapsed time, and it maintained after finished the program(p<0.001). The patient hygiene performance index showed not significant changed(p>0.05), but 1 month later the control group showed an increment of the PHP score, but the experimental group showed a decrement of it. Conclusions: Oral health promotion program by project approach could give a long-lasting educational effect to the children and encouraged proper oral hygiene behavioral changes.

• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.136-144
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• 2018

Objectives: The aim of this study is to analyze the differences in factors related to the incidence of dental caries between children in fluoridated and non-fluoridated areas and compared the DMFT and DMFS scores to confirm the effect of water fluoridation program (WFP) in Geoje and Changwon. Methods: The oral health examination and questionnaire survey were conducted in fluoridated and non-fluoridated areas. The number of surveyed children aged 8, 10, and 12 years in the fluoridated and non-fluoridated area of two cities was 1,524 and 1,383, respectively. Self-recorded questionnaires included self-perception of their own dental health, daily toothbrushing frequency, intake frequency of cariogenic sweet snacks and beverages, experience of gingival bleeding, experience of unmet dental treatment, and use of oral hygiene device except for toothbrush and toothpaste. The prevalence of caries and fissure-sealant status were surveyed. The logistic regression analysis was used to analyze the difference in children's self-rated oral health status between the fluoridated and non-fluoridated area. The mean number of sealed teeth and surfaces, marginal means of the DMFT and DMFS scores adjusted for the difference in the samples' sex distribution, and region were compared between the fluoridated and non-fluoridated areas. Results: In the fluoridated area, the experience rate of unmet dental treatments was higher among children aged 10 years, intake frequency of cariogenic sweet snacks and beverages were higher among the whole sample, and experience rate of professional fluoride application were lower than in the non-fluoridated area. The DMFT score for permanent dentition adjusted for differences in sex, region, and mean number of fissure-sealed teeth in the fluoridated area was significantly lower among whole samples and 8-, 10-, and 12-year-olds alone than in the non-fluoridated area. Conclusions: WFP can alleviate oral health inequality because it is effective in reducing the incidence of caries among children is disadvantaged demographic, socioeconomic, and cultural contexts.