Factors Affecting Preventive Dental Treatment of Adolescents in Korea
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Dependent Variables
2.3. Individual-Level Variables
2.4. Regional-Level Variables
2.5. Statistical Analysis
3. Results
3.1. Annual Professional Fluoride Application and Scaling Experience Rate
3.2. Relationship Between Personal Characteristics, Annual Professional Fluoride Application, and Scaling Experience
3.3. Multilevel Analysis of Annual Professional Fluoride Application Experience
3.4. Multilevel Analysis of Annual Scaling Experience
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Total | Professional Fluoride Application | Scaling | ||||
---|---|---|---|---|---|---|---|
N (wt %) | N (wt %) | p-Value | N (wt %) | p-Value | |||
Total | 72,435 (100.0) | 10,036 (12.3) | 15,250 (21.5) | ||||
Demographic factors | Sex | Boy | 36,655 (52.3) | 4924 (11.8) | 0.113 | 7085 (19.8) | <0.001 |
Girl | 35,780 (47.7) | 5112 (12.9) | 8165 (23.4) | ||||
School type | Boys’ school | 12,512 (17.6) | 1626 (13.1) | 0.475 | 2662 (21.3) | 0.367 | |
Girls’ school | 12,695 (17.0) | 1812 (12.9) | 2670 (21.0) | ||||
Co-ed school | 47,228 (65.4) | 6598 (11.9) | 9918 (21.7) | ||||
School year | 3rd in high school | 12,012 (17.2) | 973 (7.2) | <0.001 | 2666 (22.6) | <0.001 | |
2nd in high school | 11,865 (16.9) | 1173 (9.0) | 2761 (23.6) | ||||
1st in high school | 12,028 (17.1) | 1324 (9.9) | 2574 (21.6) | ||||
3rd in middle school | 12,218 (16.5) | 1733 (12.2) | 2462 (20.8) | ||||
2nd in middle school | 12,133 (16.0) | 2068 (15.5) | 2516 (21.3) | ||||
1st in middle school | 12,199 (16.2) | 2765 (20.7) | 2271 (19.1) | ||||
Grade | Low | 27,292 (37.3) | 3423 (11.0) | <0.001 | 5142 (19.2) | <0.001 | |
Middle | 20,148 (28.1) | 2751 (12.1) | 4161 (21.0) | ||||
High | 24,995 (34.6) | 3862 (13.9) | 5947 (24.4) | ||||
Socio-economic factors | Fathers’ education level | Less than high school graduate | 26,686 (43.5) | 3667 (11.6) | 0.010 | 5070 (19.3) | <0.001 |
More than college graduate | 31,362 (26.5) | 4242 (12.6) | 7755 (25.0) | ||||
Family affluence scale | Low | 8541 (11.3) | 973 (9.4) | <0.001 | 1210 (14.6) | <0.001 | |
Middle | 37,767 (51.7) | 4749 (10.9) | 7300 (19.8) | ||||
High | 26,127 (37.0) | 4314 (15.2) | 6740 (26.1) | ||||
Weekly allowance | <10,000 | 23,218 (32.0) | 3443 (13.1) | <0.001 | 4625 (20.5) | <0.001 | |
10,000–19,999 | 18,995 (26.0) | 2637 (12.3) | 3796 (20.5) | ||||
≥20,000 | 30,222 (42.0) | 3956 (11.7) | 6829 (22.9) | ||||
Oral health behavior factors | Snack consumption | Less twice a week | 43,999 (61.2) | 5792 (11.6) | <0.001 | 8891 (20.7) | <0.001 |
3 or more times a week | 28,436 (38.8) | 4244 (13.5) | 6359 (22.8) | ||||
Tooth brushing after lunch | Sometimes/No | 29,893 (43.6) | 3564 (11.0) | <0.001 | 5751 (19.7) | <0.001 | |
Always/Almost always | 42,542 (56.4) | 6472 (13.3) | 9499 (22.9) | ||||
Perceived oral health status | Healthy | 57,312 (79.3) | 7985 (12.4) | 0.347 | 11,807 (21.1) | <0.001 | |
Poor | 15,123 (20.7) | 2051 (12.1) | 3443 (23.1) | ||||
Oral symptoms experience | No | 27,322 (37.9) | 3622 (11.7) | <0.001 | 4686 (17.6) | <0.001 | |
1 or more | 45,113 (62.1) | 6414 (12.7) | 10,564 (23.9) | ||||
Troubled by tooth fracture | No | 63,253 (87.6) | 8644 (12.2) | 0.007 | 13,032 (21.1) | <0.001 | |
Yes | 9182 (12.4) | 1392 (13.2) | 2218 (24.5) | ||||
Toothache while eating foods | No | 44,884 (62.0) | 6062 (11.9) | <0.001 | 8538 (19.5) | <0.001 | |
Yes | 27,551 (38.0) | 3974 (12.9) | 6712 (24.8) | ||||
Teeth ache all the time | No | 52,532 (72.6) | 7166 (12.1) | 0.006 | 10,162 (19.8) | <0.001 | |
Yes | 19,903 (27.4) | 2870 (12.9) | 5086 (26.0) | ||||
Bleeding gum | No | 58,173 (80.5) | 7867 (12.0) | <0.001 | 11,432 (20.1) | <0.001 | |
Yes | 14,262 (19.5) | 2169 (13.7) | 3818 (27.4) | ||||
Aching inside of the mouth or tongue | No | 63,964 (88.2) | 8669 (12.0) | <0.001 | 12,899 (20.6) | <0.001 | |
Yes | 8471 (11.8) | 1367 (14.8) | 2351 (28.3) | ||||
Bad breath | No | 56,185 (77.6) | 7692 (12.1) | 0.004 | 11,337 (20.6) | <0.001 | |
Yes | 16,250 (22.4) | 2344 (13.0) | 3913 (24.7) |
Variable | Professional Fluoride Application | Scaling | ||||
---|---|---|---|---|---|---|
OR (95% CI) | p-Value | OR (95% CI) | p-Value | |||
Demographic factors | Sex | Boy | – | – | Ref | |
Girl | – | – | 1.15 (1.09–1.21) | <0.001 | ||
School type | Boys’ school | – | – | – | ||
Girls’ school | – | – | – | – | ||
Co–ed school | – | – | – | – | ||
School year | 3rd in high school | Ref | Ref | |||
2nd in high school | 1.34 (1.20–1.48) | <0.001 | 1.08 (1.01–1.16) | 0.022 | ||
1st in high school | 1.57 (1.34–1.83) | <0.001 | 0.97 (0.91–1.04) | 0.420 | ||
3rd in middle school | 2.06 (1.68–2.53) | <0.001 | 0.90 (0.84–0.97) | 0.007 | ||
2nd in middle school | 2.86 (2.36–3.47) | <0.001 | 0.96 (0.89–1.04) | 0.320 | ||
1st in middle school | 4.00 (3.33–4.81) | <0.001 | 0.85 (0.78–0.92) | <0.001 | ||
Grade | Low | Ref | Ref | |||
Middle | 1.08 (1.00–1.15) | <0.001 | 1.08 (1.03–1.14) | 0.004 | ||
High | 1.18 (1.10–1.26) | 0.040 | 1.24 (1.18–1.30) | <0.001 | ||
Socio–economic factors | Fathers’ education level | Less than high school graduate | Ref | Ref | ||
More than college graduate | 0.94 (0.88–1.01) | 0.080 | 1.28 (1.22–1.34) | <0.001 | ||
Family affluence scale | Low | Ref | Ref | |||
Middle | 1.18 (1.07–1.31) | 0.002 | 1.37 (1.27–1.48) | <0.001 | ||
High | 1.50 (1.35–1.67) | <0.001 | 1.90 (1.75–2.06) | <0.001 | ||
Weekly allowance (won) | <10,000 | Ref | Ref | |||
10,000–19,999 | 1.08 (1.01–1.16) | 0.026 | 0.98 (0.93–1.03) | 0.429 | ||
≥20,000 | 1.11 (1.04–1.19) | 0.002 | 1.06 (1.01–1.11) | 0.025 | ||
Oral health behavior factors | Snack consumption | Less twice a week | Ref | Ref | ||
3 or more times a week | 1.13 (1.07–1.20) | <0.001 | 1.06 (1.02–1.11) | 0.006 | ||
Tooth brushing after lunch | Sometimes/No | Ref | Ref | |||
Always/Almost always | 1.49 (1.34–1.66) | <0.001 | 1.11 (1.06–1.16) | <0.001 | ||
Perceived oral health status | Healthy | – | – | Ref | ||
Poor | – | – | 1.01 (0.95–1.06) | 0.812 | ||
Oral symptoms experience | No | Ref | Ref | |||
1 or more | 1.06 (0.97–1.16) | 0.177 | 1.13 (1.06–1.21) | <0.001 | ||
Troubled by tooth fracture | No | Ref | Ref | |||
Yes | 1.04 (0.96–1.13) | 0.379 | 1.15 (1.08–1.22) | <0.001 | ||
Toothache while eating foods | No | Ref | Ref | |||
Yes | 1.04 (0.97–1.12) | 0.280 | 1.09 (1.04–1.15) | 0.001 | ||
Teeth ache all the time | No | Ref | Ref | |||
Yes | 1.04 (0.98–1.11) | 0.226 | 1.10 (1.05–1.16) | <0.001 | ||
Bleeding gum | No | Ref | Ref | |||
Yes | 1.15 (1.07–1.22) | <0.001 | 1.25 (1.19–1.32) | <0.001 | ||
Aching inside of the mouth or tongue | No | Ref | Ref | |||
Yes | 1.13 (1.05–1.22) | 0.002 | 1.14 (1.07–1.21) | <0.001 | ||
Bad breath | No | Ref | Ref | |||
Yes | 1.08 (1.01–1.15) | 0.019 | 1.09 (1.04–1.15) | 0.001 |
Model Parameter | Model 1 Null Model | Model 2 Unconditional Slope Model | Model 3 Final Model | ||||
---|---|---|---|---|---|---|---|
Odds Ratio (95% CI) | p-Value | Odds Ratio (95% CI) | p-Value | Odds Ratio (95% CI) | p-Value | ||
Fixed effect | |||||||
level 1 | Intercept γ00 | 0.18 (0.13–0.25) | <0.001 | 0.09 (0.06–0.13) | <0.001 | 0.07 (0.05–0.09) | <0.001 |
Sex (girl vs. boy) | 1.01 (0.95–1.08) | 0.712 | 1.02 (0.98–1.06) | 0.293 | |||
School type (girls’ school vs. boys’ school) | – | – | – | – | |||
School type (co-ed school vs. boys’ school) | – | – | – | – | |||
School year (2nd in high school vs. 3rd in high school) | 1.20 (1.06–1.37) | 0.008 | 1.19 (1.04–1.37) | 0.016 | |||
School year (1st in high school vs. 3rd in high school) | 1.46 (1.23–1.73) | <0.001 | 1.45 (1.22–1.72) | <0.001 | |||
School year (3rd in middle school vs. 3rd in high school) | 2.08 (1.52–2.86) | <0.001 | 2.29 (1.66–3.15) | <0.001 | |||
School year (2nd in middle school vs. 3rd in high school) | 2.39 (1.75–3.24) | <0.001 | 2.69 (1.97–3.68) | <0.001 | |||
School year (1st in middle school vs. 3rd in high school) | 3.10 (2.23–4.31) | <0.001 | 3.71 (2.67–5.17) | <0.001 | |||
Grade (middle vs. low) | 1.08 (1.00–1.17) | 0.049 | 1.09 (1.01–1.18) | 0.036 | |||
Grade (high vs. low) | 1.17 (1.07–1.28) | 0.002 | 1.21 (1.11–1.33) | <0.001 | |||
Fathers’ education level (More than college graduates vs. Less than high school graduate) | – | – | – | – | |||
Family affluence scale (middle vs. low) | 0.95 (0.84–1.07) | 0.382 | 0.97 (0.86–1.09) | 0.588 | |||
Family affluence scale (high vs. low) | 1.04 (0.88–1.22) | 0.650 | 1.10 (0.93–1.29) | 0.240 | |||
Weekly allowance (10,000–19,999 vs. <10,000 won) | 1.01 (0.96–1.07) | 0.678 | – | – | |||
Weekly allowance (≥20,000 vs. <10,000 won) | 1.01 (0.95–1.08) | 0.721 | – | – | |||
Snack consumption (3 or more times a week vs. less than twice a week) | 1.05 (0.97–1.13) | 0.221 | – | – | |||
Tooth brushing after lunch (always/almost always vs. sometimes/no) | 1.32 (1.22–1.43) | <0.001 | 1.37 (1.26–1.49) | <0.001 | |||
Perceived oral health status (poor vs. healthy) | – | – | – | – | |||
oral symptoms Experience (1 or more vs. no) | – | – | – | – | |||
Teeth ache all the time (yes vs. no) | – | – | – | – | |||
Bleeding gums (yes vs. no) | 1.12 (1.05–1.19) | 0.001 | 1.19 (1.14–1.24) | <0.001 | |||
level 2 | Number of dental clinics per 10,000 population | 0.91 (0.77–1.09) | 0.268 | ||||
Rate of receiving school-based oral health education by region | 1.04 (1.02–1.06) | 0.003 | |||||
Deprivation index | 1.04 (0.83–1.32) | 0.699 | |||||
Number of private educational institutes per 1000 population | 0.64 (0.42–0.97) | 0.039 | |||||
Random effect | |||||||
τ00 = var (u0j) intercept variance | 0.38 | <0.001 | 0.37 | <0.001 | 0.22 | <0.001 | |
Intra–Class Correlation (ICC) | 0.104 | 0.101 | 0.063 | ||||
Deviance | 198,038.68 | 170,844.48 | 178,160.92 | ||||
Reliability | 0.993 | 0.830 | 0.779 |
Model Parameter | Model 1 Null Model | Model 2 Unconditional Slope Model | Model 3 Final Model | ||||
---|---|---|---|---|---|---|---|
Odds Ratio (95% CI) | p-Value | Odds Ratio (95% CI) | p-Value | Odds Ratio (95% CI) | p-Value | ||
Fixed effect | |||||||
level 1 | Intercept γ00 | 0.25 (0.23–0.28) | <0.001 | 0.09 (0.08–0.11) | <0.001 | 0.09 (0.08–0.10) | <0.001 |
Sex (girl vs. boy) | 1.11 (1.05–1.18) | 0.001 | 1.13 (1.08–1.18) | <0.001 | |||
School type (girls’ school vs. boys’ school) | – | – | – | – | |||
School type (co-ed school vs. boys’ school) | – | – | – | – | |||
School year (2nd in high school vs. 3rd in high school) | 1.05 (0.97–1.15) | 0.215 | 1.06 (0.99–1.13) | 0.092 | |||
School year (1st in high school vs. 3rd in high school) | 0.98 (0.89–1.08) | 0.713 | 0.98 (0.91–1.04) | 0.481 | |||
School year (3rd in middle school vs. 3rd in high school) | 0.88 (0.80–0.98) | 0.019 | 0.90 (0.84–0.96) | 0.002 | |||
School year (2nd in middle school vs. 3rd in high school) | 0.96 (0.87–1.07) | 0.459 | 0.97 (0.90–1.04) | 0.399 | |||
School year (1st in middle school vs. 3rd in high school) | 0.86 (0.78–0.95) | 0.006 | 0.85 (0.79–0.92) | <0.001 | |||
Grade (middle vs. low) | 1.05 (0.99–1.13) | 0.118 | 1.07 (1.01–1.12) | 0.017 | |||
Grade (high vs. low) | 1.19 (1.12–1.27) | <0.001 | 1.21 (1.15–1.27) | <0.001 | |||
Fathers’ education level (More than college graduates vs. Less than high school graduate) | 1.23 (1.16–1.31) | <0.001 | 1.24 (1.19–1.29) | <0.001 | |||
Family affluence scale (middle vs. low) | 1.38 (1.22–1.56) | <0.001 | 1.40 (1.29–1.52) | <0.001 | |||
Family affluence scale (high vs. low) | 1.94 (1.72–2.19) | <0.001 | 1.96 (1.80–2.13) | <0.001 | |||
Weekly allowance (10,000–19,999 vs. <10,000 won) | 0.99 (0.91–1.08) | 0.831 | 0.98 (0.93–1.04) | 0.544 | |||
Weekly allowance (≥20,000 vs. <10,000 won) | 1.07 (1.01–1.14) | 0.028 | 1.07 (1.02–1.13) | 0.004 | |||
Snack consumption (3 or more times a week vs. less than twice a week) | 1.08 (1.02–1.13) | 0.009 | 1.09 (1.04–1.13) | <0.001 | |||
Tooth brushing after lunch (always/almost always vs. sometimes/no) | 1.18 (1.09–1.28) | <0.001 | 1.17 (1.08–1.26) | <0.001 | |||
Perceived oral health status (poor vs. healthy) | – | – | – | – | |||
oral symptoms Experience (1 or more vs. no) | 1.37 (1.28–1.46) | <0.001 | 1.34 (1.28–1.41) | <0.001 | |||
Teeth ache all the time (yes vs. no) | – | – | – | – | |||
Bleeding gums (yes vs. no) | 1.27 (1.19–1.36) | <0.001 | 1.29 (1.22–1.36) | <0.001 | |||
level 2 | Number of dentists per 10,000 population | 1.14 (1.04–1.25) | 0.008 | ||||
Rate of receiving school-based oral health education by region | 1.01 (1.00–1.02) | 0.106 | |||||
Deprivation index | 0.88 (0.80–0.98) | 0.024 | |||||
Number of private educational institutes per 1000 population | 1.02 (0.86–1.22) | 0.788 | |||||
Random effect | |||||||
τ00 = var (u0j) intercept variance | 0.03 | <0.01 | 0.02 | 0.233 | 0.004 | 0.022 | |
Intra–Class Correlation (ICC) | 0.009 | 0.006 | 0.001 | ||||
Deviance | 207,474.60 | 160,982.88 | 165,244.34 | ||||
Reliability | 0.935 | 0.276 | 0.371 |
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Kwak, S.-H.; Bae, S.-M.; Shin, S.-J.; Shin, B.-M. Factors Affecting Preventive Dental Treatment of Adolescents in Korea. Int. J. Environ. Res. Public Health 2020, 17, 4948. https://doi.org/10.3390/ijerph17144948
Kwak S-H, Bae S-M, Shin S-J, Shin B-M. Factors Affecting Preventive Dental Treatment of Adolescents in Korea. International Journal of Environmental Research and Public Health. 2020; 17(14):4948. https://doi.org/10.3390/ijerph17144948
Chicago/Turabian StyleKwak, Seon-Hui, Soo-Myoung Bae, Sun-Jung Shin, and Bo-Mi Shin. 2020. "Factors Affecting Preventive Dental Treatment of Adolescents in Korea" International Journal of Environmental Research and Public Health 17, no. 14: 4948. https://doi.org/10.3390/ijerph17144948