Oral health inequality among Indonesian workers in South Korea: role of health insurance and discrimination factors

Background

The health of migrant workers is becoming an important public health issue. Although there are an increasing number of migrant workers in Korea, the health status in migrant populations remains unknown. The aims of this study were (1) to evaluate the association between income and self-rated oral health (SROH), and (2) to assess the role of health insurance and self-perceived discrimination in the association between income and SROH among Indonesian migrant workers in Korea.

Methods

Information about self-reported income, SROH, coverage/utilization of health insurance (HI), living difficulties related to oral health (LDROH), oral health literacy (OHL), and discrimination were obtained from Indonesian migrant workers in Korea (n = 248). The main explanatory variable was income, and SROH was an outcome variable. Logistic regression analyses were performed controlling for age, gender, HI, LDROH, OHL, and discrimination. The paths from income to SROH were analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM).

Results

Among Indonesian migrant workers, the lower income group had the highest probability of a poor SROH compared to the higher income group. The variables showing a high explanatory power were discrimination among the low income group and HI among the middle income group. In PLS-SEM, the variables such as HI, LDROH, OHL, and discrimination contributed 11% to explaining the association between income and SROH.

Conclusion

A monotonic gradient was revealed among migrant workers according to the association between income and SROH. Discrimination and HI contributed to oral health inequalities.

Validation of self-reported oral health among Indonesian adolescents

Background and aim

With the recognition of health as a subjective state, self-reported oral health has been applied in many epidemiological studies. However, the validity of self-reports may vary across different age groups and socio-cultural backgrounds and by using different tools. This study aimed to assess the validity of self-reported oral health of 15-year-old Indonesian adolescents.

Materials and methods

This study used data from the Indonesian National Oral Health Survey, a part of the Indonesian Basic Health Survey 2018. The study included 572 15-year-old Indonesian adolescents. We compared the presence of clinically assessed dental caries, tooth loss, and fillings following the World Health Organization Basic Health Survey method and questionnaire-based self-reported oral conditions using McNemar test. The sensitivity (Sn), specificity (Sp), and likelihood ratios (LRs) of self-reports were calculated using clinical assessment as the reference standard. The overall accuracy of self-reports in identifying the clinical condition was assessed using the area under the curve (AUC) of a receiver operating characteristic curve.

Results

Self-reports significantly underestimated the clinical presence of caries (39.3% and 67.1%) and overestimated the clinical presence of tooth loss (9.3% and 4.2%) and filling (4.7% and 2.4%, p < 0.05). All self-reported conditions had higher Sp (at least 70.3%) than Sn (max 54.2%) and the AUC for all self-reported conditions were < 0.7. Self-reporting the presence of fillings had the highest LR+  = 11.

Conclusions

Self-reporting oral health in Indonesian adolescents had low accuracy. Further studies of other methods of self-reporting are needed before they can be used to assess adolescents’ oral health in epidemiological surveys.

Inequalities in Unmet Oral Health Care Need Among Adults in East Iran, a Cross Sectional Population-Based Study

Statement of the Problem:

Need assessment is considered as a key element of health care planning. Subjective measures can be useful tools in epidemiologic surveillances.

Purpose:

The aim of study was to evaluate inequality in perceived unmet oral health need (PUOHN) in adults in east of Iran.

Materials and Method:

In this cross-sectional population-based study, the target population included adult residents in the Mashhad and Kerman city. Data was collected through telephone interviews using a validated structured questionnaire. Phone numbers were obtained from telecommunication company. Participants were selected by stratified random sampling. Predisposing and enabling variables associated with PUOHN were included gender, age, educational level, job, insurance coverage, dental insurance, type of insurance, residential location, household size, and family economic indicators. Logistic regression was used to examine association of PUOHN and predisposing and enabling factors.

Results:

1475 individuals participated in the study (response rate of 63%). 52% of participants stated that their dental needs have not been met during the past year. The mean ages of respondents were 39 years old and 69.8% were female. Logistic regression analyses indicated living in rental house [OR=2 (95% CI 1.25-3.21), p Value=0.004] and higher household size [OR=1.19(95% CI 1.003-1.43), p= 0.04] significantly associated with PUOHN.

Conclusion:

The results of this study indicated high PUOHN in the adult population of East Iran. Effective strategies must be implemented to provide accessible dental services regardless of socioeconomic status.

Dental Caries and the Erosive Tooth Wear Status of 12-Year-Old Children in Jakarta, Indonesia

Background: Indonesia has the largest population of all countries in southeast Asia. However, little information is available on the oral health status of Indonesian children. The aims of this study were to assess dental caries and erosive tooth wear in 12-year-old children in Jakarta, Indonesia and to investigate the associated risk factors. Methods: Samples were selected using cluster sampling. Parents were asked to complete a self-administered questionnaire regarding their oral health knowledge, demographic information, their child’s dietary habits, and oral health-related behaviors. Experience of caries and erosive tooth wear were recorded using the Decayed, Missing (due to caries), and Filled Teeth (DMFT) index and the Basic Erosive Wear Examination (BEWE) index, respectively. Results: Of 779 children invited, 696 participated in the survey. Of these, 61% had experienced caries, and the mean DMFT score was 1.58. Almost all decay was untreated. Children who were female, who had a high frequency of soft drink intake, and whose father’s educational level was low were more likely to have dental caries. Most children had at least one lesion of erosive tooth wear. Children whose mother’s educational level was low were more likely to have erosive tooth wear. Conclusions: The prevalence of dental caries and erosive tooth wear was high in 12-year-old children in Jakarta. Their dietary habits and parental level of education were associated with the presence of these dental conditions.

Validity of Self-perceived and Clinically Diagnosed Gingival Status among 12-15-year-old Children in Indonesia

A few studies have revealed the self-perceived gingival status using questionnaires among children. Perceived health is a crucial factor that has an impact on quality of life. The objective of the study was to assess self-perceived and clinically diagnosed gingival status among children in Indonesia. This was a cross-sectional study of 494 schoolchildren (aged 12-15 years). Periodontal status was recorded using the gingival index (GI) and plaque index (PI) based on the World Health Organization standards. Data were collected through a brief visual, non-invasive clinical oral examination and a self-administered questionnaire. The sensitivity and specificity of self-perceived assessment were calculated using normative assessment as the gold standard. This study showed that self-perceived need for dental treatment showed the highest sensitivity (86% using PI and 85% using GI) and self-perceived swollen gums showed the highest specificity (89% using PI and 88% using GI) for clinically diagnosed plaque (PI cut-off value: 0.74) and gingival problems (GI cut-off value: 0.51). In conclusion, both self-perceived variables showed significant discordance between their respective sensitivity and specificity. Self-perceived information is at a higher-level unawareness that does not reflect the current gingival status. Thus, public health strategies are needed to improve the awareness of better oral health among children by promoting, empowering, and advocating.

An assessment of the impacts of child oral health in Indonesia and associations with self-esteem, school performance and perceived employability

Background

Previous surveys have indicated that a majority of Indonesian children have poor oral health. However, little detailed information is available on underlying causation and none that examine impacts of oral health on child self-esteem, school performance and perceived employability. The aim of this study was to determine levels of child oral health in primary school children in Indonesia, the prevalence of key causal factors; and, to determine relationships between oral health, self-esteem and school academic performance.

Methods

Cross-sectional epidemiological study in a sample (n = 984) of children aged 6–7 and 10–11 years old attending three public schools in Indonesia. A dental visual impact study was conducted, in which teachers reported their perceptions of the impact of child oral health on school academic performance. Oral health behaviors, self-esteem, and school performance were assessed. The children were clinically examined to measure dental caries and oral cleanliness.

Results

Teachers believe that children with visually poor oral health and impaired smiles are more likely to perform poorly at school, be socially excluded and have lower job prospects than their peers with visually good oral health and healthy smiles. The percentages of children with decayed teeth were 94 and 90% in the 6-7- and 10–11-year age groups, respectively. Families reported high levels of child consumption of sugar-containing foods and drinks; many had irregular use of fluoride toothpaste. Children with substantial plaque on their teeth achieved significantly lower levels of school performance than their peers with clean teeth. Significant associations were found between school performance and self-esteem for these children.

Conclusions

The study findings highlight the need for preventive care programs to improve the oral health of children in Indonesia and prospective determination of associations between child oral health; self-esteem and school academic performance.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-017-0358-5) contains supplementary material, which is available to authorized users.

Gaps in need, demand, and effective demand for dental care utilization among residents of Krishna district, Andhra Pradesh, India

AIMS

To identify the relation between need, demand, and effective demand for dental services in Andhra Pradesh, India.

MATERIALS AND METHODS

This is a cross-sectional study performed among populations residing in the rural and urban areas of Krishna district, Andhra Pradesh, India. Data were collected from 3102 individuals who were selected through multiphase random sampling. Data regarding self-perceived dental need, dental service utilization, and barriers for utilization were collected through s pretested questionnaire followed by type-III clinical examination to assess the normative need of the individuals. Chi-square test was used to compare independent and dependent variables, and further comparison was done with multivariate logistic regression analysis for significant variables.

RESULTS

Less than half (40%) of the participants perceived a need for dental care. Among the people who perceived need for care, only 21.4% utilized dental care and 78.6% of them had unmet dental needs. The two main reasons for not seeking dental care was lack of money, i.e., unaffordable dental treatment (48%) and having the perception that they do not have any dental problem (19.4%).

CONCLUSIONS

There is an enormous difference between normative need, demand, and actual utilization rates in dental care, and hindrances for effective demand need to be addressed to improve dental care delivery system.

Determinantes da utilização de serviços odontológicos entre adultos: um estudo de base populacional em Florianópolis, Santa Catarina, Brasil

Objetivou-se estimar a prevalência da utilização dos serviços odontológicos entre adultos e os fatores associados. Realizou-se um estudo transversal, de base populacional, com 1.720 adultos de Florianópolis, Santa Catarina, Brasil, em 2009. A associação entre a utilização de serviços odontológicos e fatores predisponentes, facilitadores e de necessidade, em nível individual, foi testada. A análise multivariável deu-se por meio de regressão de Poisson e estratificou-se por local da última consulta. A prevalência do uso de serviços odontológicos foi de 66% (IC95%: 62,9-70,7). A prevalência de consulta odontológica foi 20% maior entre as mulheres e 72% entre os mais escolarizados; estes, também foram a maioria nos serviços público e privado. A proporção de pessoas que tinham plano de saúde e utilizaram o serviço foi 13% maior do que as que não tinham. Em Florianópolis, o uso de serviços odontológicos é essencialmente privado e a escolaridade é a variável mais importante. Sugere-se um monitoramento dos fatores associados para que se obtenha uma utilização equitativa dos serviços.