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Borgeat M, Espinoza I, Navarro K, Carvajal C, Carvajal P. Inequalities by sex on remaining teeth in adults: A decomposition analysis. Community Dent Oral Epidemiol 2023. [PMID: 37235482 DOI: 10.1111/cdoe.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 05/06/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To identify which social determinants of health explain the gap in the remaining teeth between men and women. METHODS A secondary analysis of data from the Chilean National Health Survey (CNHS) 2016-2017 was performed on the number of remaining teeth in adults. The explanatory variables were organized into structural and intermediate social determinants of health according to the WHO framework. The contribution of both groups and the contribution of each individual explanatory variable to the remaining teeth gap was estimated using the Blinder-Oaxaca decomposition analysis. RESULTS The predicted average number of remaining teeth for men was 23.4 and 21.0 for women, thus a mean difference of 2.4 teeth. 49.8% of the inequality between men and women was due to the different distribution (endowments) of the predictors in the model. Among them, structural determinants of health, namely education level (15.8%) and employment status (17.8%), contributed the most. Intermediate determinants had no relevant contribution to explain the gap. CONCLUSIONS Results revealed that the difference in the mean number of remaining teeth between men and women was mainly explained by two structural determinants: education level and employment status. The lack of explanatory power of intermediate determinants and the large explanatory power of structural determinants means that tackling oral health inequity in Chile requires strong political commitment. The role of intersectoral and intersectional public policies to address gender inequalities in oral health in Chile is discussed.
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Affiliation(s)
- Marjorie Borgeat
- Interdisciplinary Center for Health Studies, Faculty of Dentistry, University of Valparaíso, Valparaíso, Chile
- Interuniversity Center for Healthy Aging, Chile
| | - Iris Espinoza
- Interuniversity Center for Healthy Aging, Chile
- Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Santiago, Chile
| | - Karina Navarro
- Department of Sociology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | - Claudia Carvajal
- Department of Oral Health, Division of Prevention and Control of Diseases, Ministry of Health, Santiago, Chile
| | - Paola Carvajal
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
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Kim BR, Cho HA, Shin H. The effects of orthodontic treatment on personal dental expenditures in South Korea: a follow-up study using Korean health panel survey. BMC Health Serv Res 2022; 22:1598. [PMID: 36585698 PMCID: PMC9805093 DOI: 10.1186/s12913-022-09009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This study aimed to investigate the effects of orthodontic treatment on cumulative out-of-pocket (OOP) expenditures for up to 8 years and the factors contributing to changes in individual OOP dental expenses. METHODS The data of adults aged ≥19 years, 218 with experience of orthodontic treatment (OT group) and 654 without experience of orthodontic treatment (non-OT group) were extracted from the Korea Health Panel Survey between 2009 and 2017 using the propensity score matching method. The total personal OOP expenditure for dental care incurred after orthodontic treatment in the OT group and that incurred in the matched non-OT group were calculated. Since dependent variables, cumulative dental expenditures, were continuous with excess zeros, Tweedie compound Poisson linear models were used to explore the influence of orthodontic treatment experience and demographic and socioeconomic factors, including private insurance, on per capita OOP dental expenditures. RESULTS The OT group had socioeconomic characteristics distinct from those of general dental patients. The Box-Cox transformed per capita OOP expenditures for dental care in the OT group were lower than those in the non-OT group (P < 0.05). When all covariates were held constant, the non-OT group spent 1.4-times more on OOP dental expenditures, but this was not statistically significant (P > 0.1). The data from those with higher incomes revealed the opposite trend (P < 0.05), while the other covariates were not statistically significant. CONCLUSIONS Orthodontic treatment had no positive or negative effect on future oral care use. This finding is similar to the inconsistent results of previous clinical studies on oral health and orthodontic treatment.
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Affiliation(s)
- Bo-Ra Kim
- grid.443736.10000 0004 0647 1428Department of Dental Hygiene, Namseoul University, Cheonan-si, South Korea
| | - Han-A Cho
- grid.496515.a0000 0004 0371 6987Department of Dental Hygiene, Shinhan University, Uijeongbu-si, South Korea
| | - Hosung Shin
- grid.410899.d0000 0004 0533 4755Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, 460 Iksan-daero, Iksan-si, 54538 South Korea
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Kim SY, Kim NH. Trends in Self-Rated Poor Oral Health Among all Age Populations in Korea from 2007 to 2015: Monitoring Expansion of Dental Insurance. Int Dent J 2021; 71:76-84. [PMID: 33616056 PMCID: PMC9275200 DOI: 10.1111/idj.12608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES This study explored trends in self-rated poor oral health (SRPOH) from 2007 to 2015 among all age groups to monitor changes after the expansion of dental insurance. METHODS Repeated cross-sectional data from 2007 to 2015 Korea National Health and Nutrition Examination Surveys were collected and analysed. The respondents (n = 20,199) were categorised into four age groups: 0-19, 20-44, 45-64, and ≥65 years. The outcome variable was SRPOH, with independent variables being socioeconomic factors, sex, household income, and education. The age-sex standardised prevalence rate was calculated to determine trends, and complex samples logistic regression analysis was performed to confirm the factors affecting SRPOH. RESULTS Self-rated poor oral health prevalence decreased significantly from 2007 to 2009 (25%) to 2013 to 2015 (14%) in the age groups of 0-19 and 20-44 years (P < 0.05), whereas the SRPOH prevalence in the age groups of 45-64 and ≥65 years did not undergo any significant changes. Although the prevalence decreased by 6% among older adults, over 40% older women still experienced SRPOH. A sex gap increased with age but did not change over time. SRPOH was strongly associated with sex, income, and education across all age groups; the association did not notably change from 2007 to 2015. CONCLUSIONS Self-rated poor oral health improved among younger people in Korea. The gender gap in the prevalence increased with age and persisted over time. However, income was the strongest determinant of SRPOH among all age groups, regardless of dental insurance expansion. Further studies should aim to draw causal inferences to explore the policy impact of dental insurance benefits.
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Affiliation(s)
- Song-Yi Kim
- Department of Dental Hygiene, The Graduate School, Yonsei University, Seoul, South Korea
| | - Nam-Hee Kim
- Department of Dental Hygiene, Wonju College of Medicine, Yonsei University, Wonju, South Korea.
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Islas-Granillo H, Casanova-Rosado JF, de la Rosa-Santillana R, Casanova-Rosado AJ, Islas-Zarazúa R, Márquez-Corona MDL, Rueda-Ibarra V, Jiménez-Gayosso SI, Navarrete-Hernández JDJ, Medina-Solís CE. Self-reported oral hygiene practices with emphasis on frequency of tooth brushing: A cross-sectional study of Mexican older adults aged 60 years or above. Medicine (Baltimore) 2020; 99:e21622. [PMID: 32898997 PMCID: PMC7478503 DOI: 10.1097/md.0000000000021622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The objective of the study was to characterize self-reported oral hygiene practices among Mexican older adults aged ≥60 years, and to measure the association between frequency of tooth brushing and a set of sociodemographic, socioeconomic, and dental variables.We conducted a cross-sectional study of 139 older adults aged ≥60 years in Pachuca, Mexico. A questionnaire and a clinical dental examination were administered to identify specific variables. We determined frequency of tooth brushing (or cleaning of dentures or prostheses) and use of toothpaste, mouthwash, and dental floss among respondents. Non-parametric testing was performed for statistical analysis and a multivariate logistic regression model was generated with Stata 11 software to determine frequency of tooth brushing.In our study sample, 53.2% of participants reported brushing their teeth at least once a day, 50.4% always using toothpaste, 16.5% using mouthwash and 3.6% using floss for their oral hygiene. In general, younger and female respondents used oral hygiene aids more than the others. Our multivariate model yielded an association (P < .05) between tooth brushing at least once daily and the following variables: having functional dentition (OR = 12.60), lacking health insurance (OR = 3.72), being retired/pensioned (OR = 4.50), and suffering from a chronic disease (OR = 0.43).The older adults in our sample exhibited deficient oral hygiene behaviors. The results suggest certain socioeconomic inequalities in oral health. The findings of this study should be considered when designing dental care instructions for older adults.
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Affiliation(s)
- Horacio Islas-Granillo
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca
| | | | | | | | - Rosalina Islas-Zarazúa
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca
| | | | - Vicente Rueda-Ibarra
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca
| | | | | | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca
- Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry at Autonomous University State of Mexico, Toluca, Mexico
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Medina-Solís CE, Ávila-Burgos L, Márquez-Corona MDL, Medina-Solís JJ, Lucas-Rincón SE, Borges-Yañez SA, Fernández-Barrera MÁ, Pontigo-Loyola AP, Maupomé G. Out-Of-Pocket Expenditures on Dental Care for Schoolchildren Aged 6 to 12 Years: A Cross-Sectional Estimate in a Less-Developed Country Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111997. [PMID: 31195612 PMCID: PMC6603907 DOI: 10.3390/ijerph16111997] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 12/20/2022]
Abstract
Aim: The objective of this study was to estimate the Out-Of-Pocket Expenditures (OOPEs) incurred by households on dental care, as well as to analyze the sociodemographic, economic, and oral health factors associated with such expenditures. Method: A cross-sectional study was conducted among 763 schoolchildren in Mexico. A questionnaire was distributed to parents to determine the variables related to OOPEs on dental care. The amounts were updated in 2017 in Mexican pesos and later converted to 2017 international dollars (purchasing power parities-PPP US $). Multivariate models were created: a linear regression model (which modeled the amount of OOPEs), and a logistic regression model (which modeled the likelihood of incurring OOPEs). Results: The OOPEs on dental care for the 763 schoolchildren were PPP US $53,578, averaging a PPP of US $70.2 ± 123.7 per child. Disbursements for treatment were the principal item within the OOPEs. The factors associated with OOPEs were the child's age, number of dental visits, previous dental pain, main reason for dental visit, educational level of mother, type of health insurance, household car ownership, and socioeconomic position. Conclusions: The average cost of dental care was PPP US $70.2 ± 123.7. Our study shows that households with higher school-aged children exhibiting the highest report of dental morbidity-as well as those without insurance-face the highest OOPEs. An array of variables were associated with higher expenditures. In general, higher-income households spent more on dental care. However, the present study did not estimate unmet needs across the socioeconomic gradient, and thus, future research is needed to fully ascertain disease burden.
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Affiliation(s)
- Carlo Eduardo Medina-Solís
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
- The Center for Advanced Studies and Research in Dentistry "Keisaburo Miyata", Faculty of Dentistry, the Autonomous University of the State of Mexico, Toluca 50000, Mexico.
| | - Leticia Ávila-Burgos
- The Center for Health Systems Research, the National Institute of Public Health, Cuernavaca 62100, Mexico.
| | - María de Lourdes Márquez-Corona
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
| | - June Janette Medina-Solís
- Ministry of Education of Campeche, Sub-secretary of Educational Coordination, Direction of Coordination and Budgetary Management, Campeche 24095, Mexico.
| | - Salvador Eduardo Lucas-Rincón
- The Center for Advanced Studies and Research in Dentistry "Keisaburo Miyata", Faculty of Dentistry, the Autonomous University of the State of Mexico, Toluca 50000, Mexico.
- School of Dentistry, the Ixtlahuaca University Centre, Ixtlahuaca 50080, Mexico.
| | | | - Miguel Ángel Fernández-Barrera
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
| | - América Patricia Pontigo-Loyola
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University in Indianapolis, Indianapolis, IN 46202, USA.
- The Indiana University Network Science Institute, Bloomington, IN 47408, USA.
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