• Title/Summary/Keyword: preventive dentistry

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Changes in dental care access upon health care benefit expansion to include scaling

  • Park, Hee-Jung;Lee, Jun Hyup;Park, Sujin;Kim, Tae-Il
    • Journal of Periodontal and Implant Science
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    • v.46 no.6
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    • pp.405-414
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    • 2016
  • Purpose: This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. Methods: A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Results: Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. Conclusions: The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

How to Improve Influenza Vaccination Rates in the U.S.

  • Yoo, Byung-Kwang
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.4
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    • pp.141-148
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    • 2011
  • Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities. This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.

THE CHARACTERISTICS ON THE DENTAL EMERGENCY PATIENTS OF WONJU CHRISTIAN HOSPITAL FOR LAST 10 YEARS (원주기독병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구)

  • Moon, Won-Kyu;Jung, Young-Soo;Lee, Eui-Wung;Kwon, Ho-Keun;Yoo, Jae-Ha
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.34-42
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    • 2004
  • The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

CONTRALATERAL NECK LYMPH NODE METASTASIS OF EARLY TONGUE CANCER : A CASE REPORT (반대측 경부 림프절로 전이된 초기 설암의 치험례)

  • Kwon, Myung-Hee;Kim, Sung-Il;Kim, Pyoung-Soo;Leem, Dae-Ho;Shin, Hyo-Keun;Ko, Seung-O
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.5
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    • pp.376-379
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    • 2009
  • Likely to be the most common oral cancer, squamous cell carcinoma(SCC) of the tongue accounts for about 20% of all oral and pharyngeal cancers. SCC of the tongue frequently arises in the lateral border, and if it metastasize, it occurs on submandibular gland and neck lymph nodes. Location of the primary lesions and neck lymph node metastasis affect the prognosis and decrease survival rate of patients with carcinoma of the tongue. The authors experienced the patient with contralateral neck lymph node metastasis of SCC of the tongue. The patient came to our department with chief complaint of elevated lesion on left lateral border of the tongue. The mass was diagnosed as $T_2N_0M_0$, Stage II invasive SCC of oral tongue. Computed tomography(CT) & magnetic resonance imaging(MRI) which were taken before the operation showed no significant finding of metastasis. Surgical mass removal and preventive neck dissection on the left side were done. While follow up PET/CT, contralateral neck lymph node metastasis(right side, level II) was detected, and re-operation(Rt. side RND) was done. There are few studies concerning the contralateral neck lymph node metastasis related with SCC of the tongue. The purpose of this report is to introduce the uncommon case of contralateral neck lymph node metastasis occurred in the $T_2$-stage of SCC of the tongue treated by surgical resection.

Association of Poly (ADP-Ribose) Polymerase 1 Variants with Oral Squamous Cell Carcinoma Susceptibility in a South Indian Population

  • Anil, Sukumaran;Gopikrishnan, PB;Basheer, Ashik Bin;Vidyullatha, BG;Alogaibi, Yahya A;Chalisserry, Elna P;Javed, Fawad;Dalati, MHN;Vellappally, Sajith;Hashem, Mohamed Ibrahim;Divakar, Darshan Devang
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4107-4111
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    • 2016
  • Background: Oral cancers account for approximately 2% of all cancers diagnosed each year; however, the vast majority (80%) of the affected individuals are smokers whose risk of developing a lesion is five to nine times greater than that of non-smokers. Tobacco smoke contains numerous carcinogens that cause DNA damage, including oxidative lesions that are removed effectively by the base-excision repair (BER) pathway, in which poly (ADP-ribose) polymerase 1 (PARP-1), plays key roles. Genetic variations in the genes encoding DNA repair enzymes may alter their functions. Several studies reported mixed effects on the association between PARP-1 variants and the risk of cancer development. Till now no reported studies have investigated the association between PARP-1 variants and oral squamous cell carcinoma (OSCC) risk in an Indian population. Materials and Methods: In the present case control study 100 OSCC patients and 100 matched controls were genotyped using PARP1 single nucleotide peptides (SNP's) rs1136410 and rs3219090 using TaqMan assays. Results: The results indicated significantly higher risk with PARP1 rs1136410 minor allele "C" (OR=1.909; p=0.02942; CI, 1.060-3.439). SNP rs1136410 also showed significantly increased risk in patients with smoking habit at C/C genotype and at minor allele C. Conclusions: The PAPR-1 Ala762Val polymorphism may play a role in progression of OSCC. Larger studies with a greater number of samples are needed to verify these findings.

Cognition of registered nurse on emergency treatment for oral and maxillofacial injury in Jeju province (제주 지역 간호사의 구강 악안면 영역 손상에 대한 응급 처치 인식도)

  • Lee, Byoung-Jin;Song, Hyo-Jeong;Lim, Gil-Chai;Kahm, Se-Hoon;Kim, Sung-Joon
    • The Journal of the Korean dental association
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    • v.50 no.12
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    • pp.763-770
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    • 2012
  • The purposes of this work were to assess the cognition of the registered nurse(RN) on oral and maxillofacial emergency treatment and to compare cognition of the RN with that of the 119 emergency medical technician(EMT). 450 RNs who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. Independent sample t-test and chi-square test were used to assess the state of RN on dental emergency treatment and to compare RN with EMT. The question 'education time on dentistry in formal education' that marked '0 hour' and '1-3 hours' were 73.3% and 20.0%, respectively. The question 'refresher training class on dentistry' that marked '0 hour' and '1-3 hours' were 92.9% and 6.7%, aggregately 99.6%. The results showed low score in the question 'reduction of temporo-mandibular joint(TMJ)'($1.67{\pm}0.857$), 'fixation of dislocated TMJ'($1.70{\pm}0.853$) and 'post-avulsed tooth treatment'($1.78{\pm}0.774$) by 5-point Likert scale. Likewise, the scores were $2.02{\pm}0.806$ in the question 'treatment of maxillofacial trauma', $2.76{\pm}1.061$ in the question 'emergent care of avulsed tooth', $2.70{\pm}1.095$ in the question 'treatment time of avulsed tooth' and $2.79{\pm}1.056$ in the question 'mouth guard', respectively. Compared to EMT, results of RN showed a statistically lower figure(p<0.05) in all items compared except the question 'medicine control', and the question 'doctor care in emergency room' was borderline(p=0.069). From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial emergency treatment for the initial management of injuries. Authors suggest further co-study and nation-wide research with nursing care.

Effects of National Dental Screening on Dental Caries Experience, Treatment, and Cost in Children (국가 구강검진이 어린이의 치아우식 경험, 치료 및 비용에 미치는 영향)

  • Lee, Jonghyung;Lee, Hangil;Son, Donghyun;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.3
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    • pp.248-256
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    • 2020
  • This study aimed to evaluate the effects of national dental screening for children in Korea in the aspects of prevention of dental caries, the number of treatments related to dental caries, and cost of dental care. The study used the national cohort data on children health screening provided by National Health Insurance Service, and analyzed 32,937 1st dental screening, 22,608 2nd dental screening, 13,708 3rd dental screening, and 241,043 cases from the dental care of 27,944 children born in year 2008 and 2009. The decayed-filled teeth index and decayed-filled person rate, calculated from the results of the 2nd and 3rd dental screening, decreased as the number of preceding dental screening increased. Glass ionomer and amalgam restoration, pulp treatment of primary teeth and extraction of primary canine and molar were shown to decrease as the number of examined dental screening increased, and the total cost of dental care covered by national health insurance also decreased as the number of dental screening increased. In conclusion, national dental screening for children is an efficient and economical oral health care method that prevents dental caries and lowers the possibility of dental caries related treatment, thereby reducing cost of dental care.

Characteristics and Risk Factors of High Caries Risk Group in 12-year-old Children Using Data from the 2015 Children's Oral Health Survey (2015년 아동구강건강실태조사 자료를 이용한 12세 아동의 치아우식증 고위험군의 특성과 위험 요인 분석)

  • Kim, Kayoung;Kim, Ah-Hyeon;An, So-Youn
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.3
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    • pp.327-336
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    • 2020
  • The purpose of this study was to examine the characteristics of the high caries risk group of 12-year-old children in Korea. Oral health status and interview data were collected from 23,089 children aged 12 years who participated in the 2015 Korean Children's Oral Health Survey. Subjects were classified into high-risk and low-risk groups according to the Significant caries (SiC) index, and the influence of each variable was analyzed. As a result of the study, the SiC index of the high-risk group was 5.08, which was about 9.6 times higher than the low-risk group. The risk factors associated with the high-risk group were in the order of the number of sealant teeth, dental treatment demand for the past year, perceived oral health status, gender, region, frequency of snack intake per day, and use of oral hygiene aids. In order to improve the oral health of children, appropriate preventive treatment and oral health education should be carried out with reference to the items indicated as risk factors in the high-risk group of dental caries.

Safety and Efficacy of Submucosal Midazolam When Combined with Oral Chloral Hydrate, Hydroxyzine and Nitrous Oxide Sedation by using Houpt's Scale (Midazolam을 구강 점막 하로 병용 투여한 진정법의 안정성과 Houpt Scale을 이용한 진정효과에 대한 연구)

  • Park, Mi-Koung;Kim, Yun-Hee;Jung, Sang-Hyuk;Beak, Kwang-Woo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.6 no.2 s.11
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    • pp.103-112
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    • 2006
  • Background: The purpose of this study was to compare the clinical safety and effect with and without additional submucosal midazolam to oral chloral hydrate and hydroxyzine when used for pediatric conscious sedation in a clinical dental environment. Methods: Thirty one cases of pediatric conscious sedations were performed in this study. Selection criteria included good health (ASA I), under 6 years old, 20 kg of body weight, uncooperative behavior and the need for sedation to receive dental treatment including anesthesia and restorative or surgical procedure for at least two teeth. In each visit, patients were randomly assigned into one of two groups; CH group: chloral hydrate (60 mg/kg), hydroxyzine (1 mg/kg), CH-M group: chloral hydrate (60 mg/kg). hydroxyzine (1 mg/kg) and submucoal midazolam (0.1 mg/kg). 50% nitrous oxide-oxygen was maintained during the sedation period Sedations were monitored using a pulse oximeter for estimating pulse rate (PR) and percutaneous oxygen saturation ($SpO_2$). Behavior response rated using Houpt's scale and need of restraint was assessed every 2 minutes through 30 minutes of operative procedure reviewing the videotape recording. Evaluation of overall behavior success was performed using modified overall behavior rate of Houpt's scale. Data was analyzed using t-test. Results: PR and $SpO_2$ for both groups remained within the normal values. The mean scores for sleep and movement of CH-M group were higher than those of CH group (P < 0.05). There were no significant difference in mean score for crying between two groups. The mean scores of overall behavior of CH-M group was higher than those of CH group (P < 0.01). Reinstraint of CH-M group was less required than that of CH group (P < 0.05). Conclusions: Oral chloral hydrate (60 mg/kg) and hydroxyzine (1 mg/kg) combined with submucosal injection of midazolam was safer and showed more improved sedation effect than oral chloral hydrate (60 mg/kg) and hydroxyzine (1 mg/kg) without midazolam for sedation of pediatric dental patients.

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Retirement attitude of korean dental technicians (한국 치과기공사의 은퇴태도)

  • Lee, Sun-Kyoung;Hwang, Kyung-Sook;Hwang, Seong-Sig;Park, Yong-Duk;Seong, Jeong-Min
    • Journal of Technologic Dentistry
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    • v.37 no.4
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    • pp.253-259
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    • 2015
  • Purpose: The purpose of the study is to investigate the need for the retirement attitude of korean dental technicians. Retirement attitude is important in the study of retirement planning. Methods: A total of 778 dental technicians were selected by proportional stratified by region compared to extraction sampling from a list of korea dental technician association in 2012. The final sample size was 386. Questionnaires consisted of 10 questions general characteristics, 9 questions for the current life satisfaction and retirement preparation, and 4 questions about retirement attitudes on a Likert 5 scale. Cronbach's alpha was 0.812 in the study. All statistical analyzed were performed using SPSS 14.0(Statistical Packages for Social Science Ver. 14.0. Chicago, IL, USA). Results: An average of $3.01{\pm}0.8$ dental technicians were retirement attitude. To affect retirement attitude marital status, age, subjective health status, assets satisfaction, job type, job satisfaction and the economic outlook was living after retirement (p <0.05). Conclusion: This study suggested that retirement attitude of korean dental technicians was very important and the preparation must be connected with the social welfare policy.