Journal of dental hygiene science (치위생과학회지)

The Korean Society of Dental Hygiene Science (한국치위생과학회)
권호 표지
DOI QR코드

DOI QR Code

Impact of Periodontal Treatment and Demographic and Socioeconomic Factors on Tooth Loss in Persons with Disabilities: An Analysis of Korean National Health Insurance Claims Data

  • Bo-Ra Kim (Department of Dental Hygiene, Namseoul University)
  • Received : 2023.09.06
  • Accepted : 2023.09.13
  • Published : 2023.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: This study aimed to analyze the effects of periodontal treatment and individual- and tooth-related factors on tooth extraction in people with disabilities. Methods: The Korea National Health Insurance claims data of individuals with disabilities aged 40~64 years with chronic periodontitis in 2008 were obtained. Of these, data on the disabled who underwent scaling/root plaining, subgingival curettage/periodontal surgery, or non-periodontal treatments, and data on their teeth were selected. The extraction of 716,688 teeth from 39,097 patients was tracked until 2018, and the patient- and tooth-level factors related to tooth loss were identified using a mixed-effect logistic regression analysis. Results: Data from approximately 17% of the teeth were extracted during a follow-up period of approximately 11 years. Among the tooth-level variables, scaling/root planing treatment at baseline and periodontal treatment during the follow-up period were associated with a lower risk of tooth loss (odds ratio=0.692 and 0.769, respectively, p<0.001). Non-vital teeth increased the risk of tooth loss by 3.159 times (p<0.001). Among the patient-level variables, females were less likely to have lost their teeth than males, and those with orthopedic impairment or brain lesions/mental disabilities, a higher age group, lower income level, or residents in medium/small cities or rural areas were more likely to have lost their teeth (p<0.001). Conclusion: Through approximately 11 years of follow-up, scaling or root planing, experience with periodontal treatment at least once, female sex, older age, lower income, smaller residential areas, type of disability, and pulp vitality were found to be associated with tooth loss in individuals with disabilities aged 40~64 years with chronic periodontitis. To prevent tooth loss in individuals with disabilities, it is necessary to establish a dental treatment plan that considers the timing of periodontal treatment and the characteristics of the patient and teeth.

Keywords

Acknowledgement

The author thanks professor Hosung Shin for advice on statistical analysis.

References

  1. Gerritsen AE, Allen PF, Witter DJ, Bronkhorst EM, Creugers NH: Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes 8: 126, 2010. https://doi.org/10.1186/1477-7525-8-126 
  2. Yin Z, Yang J, Huang C, Sun H, Wu Y: Eating and communication difficulties as mediators of the relationship between tooth loss and functional disability in middle-aged and older adults. J Dent 96: 103331, 2020. https://doi.org/10.1016/j.jdent.2020.103331 
  3. Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W: Global burden of severe tooth loss: a systematic review and meta-analysis. J Dent Res 93(7 Suppl): 20S-28S, 2014. https://doi.org/10.1177/0022034514537828 
  4. Huh J, Lee HG, Cheong J, Lee B, Jung HI: The current status and the future directions of dental services for disabled people. J Korean Acad Adv Gen Dent 9: 71-76, 2020. https://doi.org/10.23034/jkaagd.2020.9.3.71 
  5. Robbins MR: Dental management of special needs patients who have epilepsy. Dent Clin North Am 53: 295-309, ix, 2009. https://doi.org/10.1016/j.cden.2008.12.014 
  6. Devinsky O, Boyce D, Robbins M, Pressler M: Dental health in persons with disability. Epilepsy Behav 110: 107174, 2020. https://doi.org/10.1016/j.yebeh.2020.107174
  7. Kim JY, Kang MW, Seo WY, Lee JW: Chronic diseases, health behaviors, and mortality in persons with disabilities: an analysis of the National Health Insurance Service-Health Screening (NHIS-HEALS) database. Health Soc Welf Rev 40: 121-150, 2020. https://doi.org/10.15709/hswr.2020.40.2.121 
  8. Falcao A, Bullon P: A review of the influence of periodontal treatment in systemic diseases. Periodontol 2000 79: 117-128, 2019. https://doi.org/10.1111/prd.12249 
  9. Petersen PE, Ogawa H: The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol 2000 60: 15-39, 2012. https://doi.org/10.1111/j.1600-0757.2011.00425.x 
  10. Wilson NJ, Lin Z, Villarosa A, George A: Oral health status and reported oral health problems in people with intellectual disability: a literature review. J Intellect Dev Disabil 44: 292-304, 2019. https://doi.org/10.3109/13668250.2017.1409596 
  11. Gabre P, Martinsson T, Gahnberg L: Incidence of, and reasons for, tooth mortality among mentally retarded adults during a 10-year period. Acta Odontol Scand 57: 55-61, 1999. https://doi.org/10.1080/000163599429110 
  12. Park HJ, Lee JH, Park S, Kim TI: Trends in the utilization of dental outpatient services affected by the expansion of health care benefits in South Korea to include scaling: a 6-year interrupted time-series study. J Periodontal Implant Sci 48: 3-11, 2018. https://doi.org/10.5051/jpis.2018.48.1.3 
  13. Jeon JE, Ryu JI: Scaling and sealants service utilization of the disabled people in National Health Insurance, South Korea. J Korean Acad Dent Insur 9: 1-10, 2019.
  14. Jin HJ: Survey of unmet dental treatment needs among adult disabled. J Korea Acad-Ind Cooper Soc 16: 7501-7507, 2015. https://doi.org/10.5762/KAIS.2015.16.11.7501 
  15. Jeong SH, Kim JY, Park JH, Choi YH, Song KB, Kim YJ: Dental caries status and related factors among disabled children and adolescent in Korea. J Korean Acad Pediatr Dent 35: 102-109,
  16. Lee HS, Kim HJ, Nam SH, Kim MS, You HS, Baek SH: The mobile oral health survey of the disabled in facilities in Seoul. J Korea Assos Disabil Oral Health 8: 1-9, 2012. https://doi.org/10.12655/jkdoh.2012.8.1.001 
  17. Ryu JI, Jeong HR: The analysis of dental treatments among the disabled in a charity dental clinic, Cheongju city. J Korean Acad Oral Health 46: 78-84, 2022. https://doi.org/10.11149/jkaoh.2022.46.2.78 
  18. Park SH, Kim HJ, Jeong JY, et al.: Comparative analysis of accessibility for dental care utilization of people with disabilities. Korean Public Health Res 47: 33-45, 2021. https://doi.org/10.22900/kphr.2021.47.1.004 
  19. Park BY, Cho HA, Shin H: Disparity in access for people with disabilities to outpatient dental care services: a retrospective cohort study. BMC Oral Health 23: 213, 2023. https://doi.org/10.1186/s12903-023-02948-6 
  20. Shim SH, Lee W, Choi B: The status and improvement course of dental treatment for the disabled in Korea. J Korean Dent Assoc 48: 280-287, 2010.  https://doi.org/10.22974/jkda.2010.48.4.004
  21. Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W: Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res 93: 1045-1053, 2014. https://doi.org/10.1177/0022034514552491 
  22. Korean Statistical Information Service: Medical expenses by age and frequent diseases of disabled persons. Retrieved March 23, 2023, from https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117102_A041&conn_path=I3. 
  23. Ministry of Health and Welfare: Laws and regulations related to disability registration review 2023. Retrieved September 9, 2023, from https://www.mohw.go.kr/react/jb/sjb0406vw.jsp?PAR_MENU_ID=03&MENU_ID=030406&page=2&CONT_SEQ=375912 (2023, April 20). 
  24. Health Insurance Review and Assessment Service: Expenses covered by Dental Health Insurance 2023. Retrieved September 9, 2023, from https://www.hira.or.kr/ebooksc/ebook_720/ebook_720_202303101037526946.pdf (2023). 
  25. Heitz-Mayfield LJ, Trombelli L, Heitz F, Needleman I, Moles D: A systematic review of the effect of surgical debridement vs non-surgical debridement for the treatment of chronic periodontitis. J Clin Periodontol 29 Suppl 3: 92-102; discussion 160-162, 2002. https://doi.org/10.1034/j.1600-051x.29.s3.5.x 
  26. Graziani F, Karapetsa D, Mardas N, Leow N, Donos N: Surgical treatment of the residual periodontal pocket. Periodontol 2000 76: 150-163, 2018. https://doi.org/10.1111/prd.12156 
  27. Ong G: Periodontal disease and tooth loss. Int Dent J 48(3 Suppl 1): 233-238, 1998. https://doi.org/10.1111/j.1875-595x.1998.tb00711.x 
  28. Al-Shammari KF, Al-Khabbaz AK, Al-Ansari JM, Neiva R, Wang HL: Risk indicators for tooth loss due to periodontal disease. J Periodontol 76: 1910-1918, 2005. https://doi.org/10.1902/jop.2005.76.11.1910 
  29. Toure B, Faye B, Kane AW, Lo CM, Niang B, Boucher Y: Analysis of reasons for extraction of endodontically treated teeth: a prospective study. J Endod 37: 1512-1515, 2011. https://doi.org/10.1016/j.joen.2011.07.002 
  30. Ng YL, Mann V, Gulabivala K: A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J 44: 610-625, 2011. https://doi.org/10.1111/j.1365-2591.2011.01873.x 
  31. Kim S: Findings and implications of disability survey 2017. Korea Institute for Health and Social Affairs, Sejong, pp.1-55, 2018. 
  32. Lumley PJ, Lucarotti PS, Burke FJ: Ten-year outcome of root fillings in the General Dental Services in England and Wales. Int Endod J 41: 577-585, 2008. https://doi.org/10.1111/j.1365-2591.2008.01402.x 
  33. Chang J: How to establish dental treatment plans for the patients with severe disabilities. J Korean Dent Assoc 53: 770-778, 2015.  https://doi.org/10.22974/jkda.2015.53.11.001
  34. Sim KH, Lee CJ, Kim NJ: The questionnaire study on the oral health status for disabled people in Korea. Int J Clin Prev Dent 12: 237-242, 2016. https://doi.org/10.15236/ijcpd.2016.12.4.237 
  35. Korean Statistical Information Service: Current status of oral examination subjects for the disabled and number of examinees. Retrieved August 7, 2023, from https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117102_A016&conn_path=I3. 
  36. Shin HS, Lee SH: Factors affecting spatial distance to outpatient health services. Korean J Health Policy Adm 21: 23-43, 2011. https://doi.org/10.4332/KJHPA.2011.21.1.023 
  37. Jeon BY, Choi SM, Kim CY: Socioeconomic equity in regional distribution of health care resources in Korea. Korean J Health Policy Adm 22: 85-108, 2012. https://doi.org/10.4332/KJHPA.2012.22.1.085 
  38. Choi KH, Kim M, Choi YJ, et al.: Current status of unmet health care needs in the disabled in Korea. Health Soc Welf Rev 41: 160-176, 2021. https://doi.org/10.15709/hswr.2021.41.3.160 
  39. da Rosa SV, Moyses SJ, Theis LC, et al.: Barriers in access to dental services hindering the treatment of people with disabilities: a systematic review. Int J Dent 2020: 9074618, 2020. https://doi.org/10.1155/2020/9074618 
  40. Brown LF, Ford PJ, Symons AL: Periodontal disease and the special needs patient. Periodontol 2000 74: 182-193, 2017. https://doi.org/10.1111/prd.12198 
  41. Chang J: Treatment barriers of special needs patients- part 1. Consideration from the perspectives of special care dentists. J Korea Assos Disabil Oral Health 15: 7-13, 2019. https://doi.org/10.12655/KADH.2019.15.1.7 
  42. Pradhan A, Slade GD, Spencer AJ: Factors influencing caries experience among adults with physical and intellectual disabilities. Community Dent Oral Epidemiol 37: 143-154, 2009. https://doi.org/10.1111/j.1600-0528.2008.00455.x 
  43. Cho Y, Han E, Jeon B, Lee H: Comparison of the medical costs by diagnostic code between people with disabilities and general population: focusing on visual, hearing, and intellectually disabled people. Korean J Health Econ Policy 28: 1-24, 2022. 
  44. Kwak EJ: Dental treatment and oral hygiene management for the disabled. J Korean Dent Assoc 59: 63-71, 2021. https://doi.org/10.22974/jkda.2020.59.1.007 
  45. Baelum V, van Palenstein Helderman W, Hugoson A, Yee R, Fejerskov O: A global perspective on changes in the burden of caries and periodontitis: implications for dentistry. J Oral Rehabil 34: 872-906; discussion 940, 2007. https://doi.org/10.1111/j.1365-2842.2007.01799.x