Table 1 shows the characteristics of the participants, including the number of non-beneficiaries and beneficiaries based on gender, age, region, household income, and father and mother’s education levels.
Table 1. Characteristics of Subjects
Classification
|
Non-beneficiaries
(2007-2009 year)
|
Beneficiaries
(2013-2015 year)
|
N
|
Wt(%)a
|
N
|
Wt(%)a
|
Gender
|
Male
|
1,574
|
51.9
|
1,333
|
51.8
|
|
Female
|
1,518
|
48.1
|
1,258
|
48.2
|
Age
|
11-15 years
|
1,902
|
53.9
|
1,420
|
46.6
|
|
16-20 years
|
1,190
|
46.1
|
1,171
|
53.4
|
Region
|
Urban
|
2,516
|
83.8
|
2,201
|
85.2
|
|
Rural
|
576
|
16.2
|
390
|
14.8
|
Household income
|
I(lower)
|
386
|
13.7
|
327
|
13.6
|
II(Lower-middle)
|
711
|
23.6
|
669
|
27.4
|
III(Upper-middle)
|
956
|
31.8
|
817
|
30.9
|
IV(Upper)
|
958
|
30.9
|
753
|
28.1
|
Father’s education level
|
Less than high school
|
200
|
71.7
|
192
|
57.9
|
More than college
|
90
|
28.3
|
145
|
42.1
|
Mother’s education level
|
Less than high school
|
245
|
87.1
|
227
|
67.1
|
More than college
|
44
|
12.9
|
115
|
32.9
|
a Weighted value.
Table 2 shows the application of sealant reimbursement among Korean children and adolescents, and the differences in sealant treatment according to sociodemographic characteristics.
Compared with the non-beneficiaries, the sealant rate among the beneficiaries of the reimbursement policy increased by 7.7% (27.8% to 35.5%). The number of sealant permanent per capita doubled, 0.45 in non-beneficiaries and 0.83 in beneficiaries, and the difference between the two groups was significant (P<0.001). Sealant retention (rate and index) was higher in women, younger age groups, for those whose father had higher education, and those with higher household income. Age and household income were significant factors (P<0.001). Mothers’ education levels were higher in the lower level of education among non-beneficiaries, and were not statistically significant. For the beneficiaries, the higher the mother’s education level, the higher the sealant retention; this association was found to be significant (P<0.05).
Table 2. The application of dental sealant reimbursement among Korean children and adolescents, and the differences in sealant treatment according to sociodemographic characteristics
Classification
|
Sealant ratea (%)
|
Sealant indexb (Mean±SEd)
|
Non-beneficiaries
|
Beneficiaries
|
Non-beneficiaries
|
Beneficiaries
|
Total
|
27.8
|
|
35.5
|
***c
|
0.45±0.05
|
|
0.83±0.03
|
***c
|
Gender
|
Male
|
26.7
|
NS
|
35.1
|
NS
|
0.62±0.03
|
NS
|
0.87±0.05
|
NS
|
Female
|
29.1
|
|
35.9
|
|
0.58±0.04
|
|
0.78±0.05
|
|
Age
|
11-15 years
|
34.9
|
***
|
43.3
|
***
|
0.82±0.04
|
***
|
1.13±0.05
|
***
|
16-20 years
|
19.5
|
|
28.3
|
|
0.35±0.03
|
|
0.55±0.05
|
|
Region
|
Urban
|
27.9
|
NS
|
35.5
|
NS
|
0.60±0.03
|
NS
|
0.84±0.04
|
NS
|
Rural
|
27.6
|
|
35.5
|
|
0.61±0.08
|
|
0.76±0.09
|
|
Household income
|
I(lower)
|
17.6
|
***
|
26.5
|
***
|
0.35±0.05
|
***
|
0.60±0.09
|
*
|
II(Lower-middle)
|
22.4
|
|
32.1
|
|
0.50±0.06
|
|
0.78±0.07
|
|
III(Upper-middle)
|
27.7
|
|
36.3
|
|
0.57±0.04
|
|
0.80±0.06
|
|
IV(Upper)
|
37.0
|
|
42.2
|
|
0.83±0.05
|
|
1.00±0.07
|
|
Father’s education level
|
Less than high school
|
14.3
|
NS
|
18.8
|
NS
|
0.20±0.05
|
NS
|
0.29±0.06
|
NS
|
More than college
|
24.7
|
|
23.2
|
|
0.39±0.10
|
|
0.48±0.11
|
|
Mother’s education level
|
Less than high school
|
18.2
|
NS
|
15.9
|
*
|
0.26±0.05
|
NS
|
0.33±0.06
|
NS
|
More than college
|
12.8
|
|
30.5
|
|
0.24±0.13
|
|
0.53±0.11
|
|
aThe data were analyzed by Complex samples chi-square test.
bThe data were analyzed by Complex samples general linear model.
c The difference between Non-beneficiaries and Beneficiaries (by Complex samples chi-square test and general linear model).
dStandard error
***p<0.001, **p<0.01, *p<0.05, NSp>0.05
Table 3 shows the application of sealant reimbursement among Korean children and adolescents, and the differences in decay-missing-filled permanent teeth index according to sociodemographic characteristics.
Compared with the non-beneficiaries, the DMFT rate among the beneficiaries decreased by 9.1% (68.4% vs. 59.3%). The DMFT index per person was 2.09 for the non-beneficiaries and 1.57 for the beneficiaries; this indicates a decrease of about a quarter, which was significant (P<0.001). The decay-missing-filled permanent teeth retention (DMF rate, DMFT index) was higher in women (P<0.001), in the older age group, those living in the urban area, and those whose father’s education was lower. In the non-beneficiaries, the association was significant for gender and age group (P<0.001), and in the beneficiaries, for father's education (P<0.05).
Table 3. The application of dental sealant reimbursement among Korean children and adolescents, and the differences in decay-missing-filled permanent teeth retention according to sociodemographic characteristics
Classification
|
DMF ratea (%)
|
DMFT indexb (Mean±SEd)
|
Non-beneficiaries
|
Beneficiaries
|
Non-beneficiaries
|
Beneficiaries
|
Total
|
68.4
|
|
59.3
|
*** c
|
2.09±0.10
|
|
1.57±0.04
|
*** c
|
Gender
|
Male
|
62.2
|
***
|
54.9
|
***
|
1.74±0.05
|
***
|
1.38±0.05
|
***
|
Female
|
75.1
|
|
64.0
|
|
2.19±0.05
|
|
1.77±0.06
|
|
Age
|
11-15 years
|
60.3
|
***
|
50.1
|
***
|
1.64±0.04
|
***
|
1.26±0.05
|
***
|
16-20 years
|
77.9
|
|
67.5
|
|
2.32±0.05
|
|
1.84±0.06
|
|
Region
|
Urban
|
68.5
|
NS
|
59.6
|
NS
|
1.97±0.04
|
NS
|
1.57±0.05
|
NS
|
Rural
|
67.6
|
|
57.3
|
|
1.88±0.08
|
|
1.53±0.11
|
|
Household income
|
I(lower)
|
68.4
|
NS
|
62.3
|
NS
|
2.03±0.10
|
NS
|
1.95±0.12
|
NS
|
II(Lower-middle)
|
69.7
|
|
60.3
|
|
2.01±0.07
|
|
1.93±0.15
|
|
III(Upper-middle)
|
69.2
|
|
61.4
|
|
1.98±0.07
|
|
1.95±0.12
|
|
IV(Upper)
|
66.8
|
|
54.8
|
|
1.85±0.06
|
|
1.98±0.16
|
|
Father’s education level
|
Less than high school
|
81.9
|
NS
|
73.3
|
NS
|
2.47±0.11
|
NS
|
1.70±0.12
|
*
|
More than college
|
79.8
|
|
68.6
|
|
2.28±0.17
|
|
1.63±0.09
|
|
Mother’s education level
|
Less than high school
|
81.6
|
NS
|
72.0
|
NS
|
2.39±0.10
|
NS
|
1.63±0.07
|
NS
|
More than college
|
83.4
|
|
71.3
|
|
2.70±0.26
|
|
1.38±0.07
|
|
aThe data were analyzed by Complex samples chi-square test.
bThe dat
a were analyzed by Complex samples general linear model.
c The difference between Non-beneficiaries and Beneficiaries (by Complex samples chi-square test and general linear model).
dStandard error
***p<0.001, **p<0.01, *p<0.05, NSp>0.05
Table 4 shows the application of sealant reimbursement among Korean children and adolescents, and the differences in single-crown treatment according to sociodemographic characteristics.
Compared with the non-beneficiaries, the Crown rate fell by 2.7% (8.7% vs 6.0%). The Crown index per person decreased by 0.03, with 0.11 for the non-beneficiaries and 0.08 for the beneficiaries, but the difference was not significant. Single-crown holdings were higher in females (P<0.05), those in the higher age group(P<0.001), and those with a higher level of father’s education (P<0.05).
Table 4. The application of dental sealant reimbursement among Korean children and adolescents, and the differences in Single-crown permanent teeth retention according to sociodemographic characteristics
Classification
|
Crown ratea (%)
|
Crown indexb (Mean±SEd)
|
Non-beneficiaries
|
Beneficiaries
|
Non-beneficiaries
|
Beneficiaries
|
Total
|
8.7
|
|
6.0
|
NS c
|
0.11±0.02
|
|
0.08±0.00
|
NS c
|
Gender
|
Male
|
7.5
|
NS
|
5.7
|
NS
|
0.10±0.01
|
*
|
0.07±0.01
|
NS
|
Female
|
9.9
|
|
6.3
|
|
0.14±0.01
|
|
0.09±0.01
|
|
Age Group
|
11-15 years
|
4.5
|
***
|
3.2
|
***
|
0.06±0.00
|
***
|
0.04±0.00
|
***
|
16-20 years
|
13.6
|
|
8.5
|
|
0.19±0.01
|
|
0.12±0.01
|
|
Region
|
Urban
|
9.0
|
NS
|
5.8
|
NS
|
0.12±0.01
|
NS
|
0.08±0.01
|
NS
|
Rural
|
7.1
|
|
7.0
|
|
0.10±0.02
|
|
0.10±0.02
|
|
Household income
|
I(lower)
|
7.0
|
NS
|
6.4
|
NS
|
0.11±0.02
|
NS
|
0.08±0.02
|
NS
|
II(Lower-middle)
|
11.1
|
|
6.7
|
|
0.17±0.02
|
|
0.10±0.02
|
|
III(Upper-middle)
|
8.2
|
|
6.5
|
|
0.10±0.01
|
|
0.09±0.01
|
|
IV(Upper)
|
8.5
|
|
4.9
|
|
0.11±0.01
|
|
0.05±0.01
|
|
Father’s education level
|
Less than high school
|
11.5
|
NS
|
11.8
|
NS
|
0.18±0.04
|
NS
|
0.17±0.04
|
NS
|
More than college
|
15.0
|
|
16.7
|
|
0.18±0.57
|
|
0.21±0.05
|
|
Mother’s education level
|
Less than high school
|
12.4
|
NS
|
14.6
|
NS
|
0.20±0.03
|
NS
|
0.21±0.04
|
NS
|
More than college
|
9.3
|
|
16.6
|
|
0.09±0.06
|
|
0.21±0.05
|
|
aThe data were analyzed by Complex samples chi-square test.
bThe data were analyzed by Complex samples general linear model.
c The difference between Non-beneficiaries and Beneficiaries (by Complex samples chi-square test and general linear model)
dStandard error
***p<0.001, **p<0.01, *p<0.05, NSp>0.05
Table 5 shows the results of the analysis of the association using a Complex samples logistic regression model between the sealant rate, household income, and mother’s education level.
In Model 1, for both non-beneficiaries (ORs=I:0.37, II:0.49, III:0.64, P<0.001, P<0.01) and beneficiaries (ORs=I:0.55, II:0.67, III:0.75, P <0.01, P <0.05), the lower the household income, the lower the sealant rate, with the statistical significance maintained. In Model 2, the gap between the odds ratios of the beneficiaries (ORs=I:0.84, II:0.72, III:0.62, P>0.05) decreased more compared to the non-beneficiaries (ORs=I:0.98, II:0.60, III:0.91, P>0.05); however, inequality still existed without statistical significance (P>0.05). Further, in Model 2, ORs of the sealant experience was higher for non-beneficiaries when the mother's education level was low (ORs=3.11, P<0.05); however, it was higher for beneficiaries when the mother's education level was high (ORs=0.39, P <0.05).
Table 5. Odds ratios of sealant rate among the groups categorized by household income and mother’s education level (95% CI)
Classification
|
Non-beneficiaries
|
Beneficiaries
|
Model 1 a
|
Model 2 b
|
Model 1 a
|
Model 2 b
|
Sealant
|
|
|
|
|
Household income
|
|
|
|
|
I(lower)
|
0.379 (0.264-0.544) ***
|
0. 982(0.318-3.029)
|
0.552(0.373-0.818) **
|
0.845(0.287-2.487)
|
II(Lower-middle)
|
0.493(0.364-0.666) ***
|
0.604(0.230-1.582)
|
0.671(0.503-0.896) **
|
0.729(0.324-1.640)
|
III(Upper-middle)
|
0.648 (0.495-0.847) **
|
0.913 (0.379-2.199)
|
0.751(0.570-0.991) *
|
0.626(0.274-1.427)
|
IV(Upper)
|
Ref. 1.000
|
Ref. 1.000
|
Ref. 1.000
|
Ref. 1.000
|
Mother’s education level
|
Less than high school
|
1.579(0.583-4.275)
|
3.115(1.060-9.150) *
|
0.439(0.226-0.851)**
|
0.393(0.177-0.871) *
|
More than college
|
Ref. 1.000
|
Ref. 1.000
|
Ref. 1.000
|
Ref. 1.000
|
The data were analyzed by Complex Samples Logistic Regression.
a Adjusted for age
b Adjusted for gender, age, region, father’s education level, mother’s education level, household income
***p<0.001, **p<0.01, *p<0.05, NSp>0.05