Dental dissatisfaction factors in Korean elderly patients according Socio-economic characteristics

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1 , pp Dental dissatisfaction factors in Korean elderly patients according Socio-economic characteristics Min-Kyung Lee 1, Min-Kyoung Park 2, Hye-Jung Jin 1* 1 Department of Dental Hygiene, Dong-Eui University, Busan, , Korea 2 Department of Dental Hygiene, Kyung-Woon University, Gumi, Gyeongbuk, , Korea, * corresponding author: jinhj@deu.ac.kr Abstract. Unmet dental need for health care is a critical indicator of access problems. This study was to examine the possible reasons of unmet dental need, considering the relationship between the socioeconomic and oral health status in Korea elderly. Analysis included 1,174 subjects over 65 years old who participated in the 5 th Korea National Health and Nutrition was used to assess the periodontal status. The percentage of unmet dental care needs among older people accounted for 37.5%. Compared with men (35.1%), women (64.9%) showed higher unmet dental care needs. Female, low-level income and low-level educated, chewing difficulty and non-worker demonstrated higher unmet dental care needs, also have their financial problems as the main reason. A combined public policy that addresses financial and nonfinancial barriers to care is required to reduce unmet dental need for oral care. Key Words: Korea elderly, socioeconomic status, unmet dental need 1 Introduction Recently in Korea, average life span has been continuously increased due to advances in public medical technologies, expansion of medical facilities and health insurance in parallel with consistent economic growth hence resulting increase in elderly population. The entry into the aging society without sufficient and non-established social system, may raise concerns for social problems with regards to elderly population thus, various welfare policies are being pursued [1]. The quality of elderly life and their health issues have been being focused as important social interests and to note, oral health is closely related to the health of whole body. Therefore in the present study, we analyzed causes of dental dissatisfaction in Korean elderly patients utilizing the 5 th Korean National Health and Nutrition Examination Survey (KNHANES) in order to seek plans for better accessibility of dental treatments. ISSN: ASTL Copyright 2014 SERSC

2 2 Subjects and Method Amongst all subjects of the database, a total of 1,174 elderly patients who are older than 65 years old and completed both questionnaires and dental examinations were included for the study. The health questionnaires of KNHANES were done in mobile medical care centers and were based on the national criterion of oral health status checkup, released in Questionnaire items possibly affected by examination results were directly asked via interview by a dentist in advance to performance of dental examinations. All of the analyses were performed by complex sampling analysis of SPSS TM 19.0 software (SPSS Inc., Chicago, IL, USA). 3 Results 3.1. General characteristics of the participants In the study, female subjects (64.9%) had higher dental dissatisfaction compared to those of male subjects (35.1%). The group with low monthly income had higher dental dissatisfaction than the group with higher monthly income (30.3% vs 17.8%). When it comes to education level, the level of dissatisfaction was shown to be the highest in the subjects went elementary schools (76.8%) followed by middle schools (9.1%), high schools (10.7%), and colleges or higher degree (3.4%). < Table 1> Dental dissatisfaction factors according oral health status In the speaking ability, the percentage of dental dissatisfaction was highest in the group with satisfactory speaking ability (65.4%), and lowest in the group with normal speaking ability (12.3%); 22.3 % of the group with non-satisfactory speaking ability were reporting dental dissatisfaction (p<0.023). The group with non-satisfactory chewing ability represented the highest dissatisfaction, followed by the group with satisfactory chewing ability (25.2%), and with normal chewing ability (17.2%, p<0.001)<table 2>. 4 Discussion With socioeconomical developments and advances in medicines, average life span has been increased and general awareness of the significance of oral health management in regards to life quality improvement has been changing. As aging, numbers of lost teeth are increasing thus most Korean elderly patients experience difficulties in basal food intake which is regarded as fundamental for vital functions thereby emphasizing the importance of oral health issues than any other health issues [2,3]. However it is not very common for elderly patients to visit dental clinics and receive preventive Copyright 2014 SERSC 13

3 measurements in order to minimize scope of treatments [4]. A total of 486 subjects responded that they are not satisfying with their chewing ability which confirms that it is one of the most common oral health issues in Korean elderly population. Despite of discomfort in chewing, and multiple lost teeth, a number of patients were not able to utilize dental clinics indicating that there is a presence of considerable economic barrier which overwhelmed their oral health problems. In the study, we demonstrated that elderly patients were not able to undergo dental treatments even with their discomforts in chewing; these results show that economic burdensome makes access to dental treatments and overwhelms their oral health problems. References 1. Korean National Statistics Office. Korean Statistical Information Service(KOSIS)- Population projection: Seoul:Statistics, pp , (2011) 2. B. Shin, and S. Jung, Socio-economic inequalities in tooth loss and chewing difficulty in the Korean elderly, J Korean Acad Dent Health, Vol. 36, pp , (2002) 3. M. Iwasaki, G. Taylor, M. Manz, A. Yoshihara, M. Sato, K. Muramatsu, R. Watanabe, H. Miyazaki. Oral health status: relationship to nutrient and food intake among 80-year-old Japanese adults, Community Dent Oral Epidemiol, Vol. 42. No. 5, pp , (2014) 4. M. Baldani, J. Antunes. Inequalities in access and utilization of dental services: a crosssectional study in an area covered by the Family Health Strategy Cad Saude Publica Vol. 27, No. 2, pp , (2011) 14 Copyright 2014 SERSC

4 Table 1. General characteristics of study subject Total Unmet dental need N % N % Gender Male Female Age Income High Mid high Mid low Low Education level Elementary Middle High school College Residence Dong Eup, Myeon Economic activity Activity None Welfare recipients Yes No Smoking Current No-smoker Perceived general health Good Moderate Copyright 2014 SERSC 15

5 Poor Table 2. Unmet dental need according to oral health status Unmet dental need Yes No p-value Missing tooth 0 21(5.4) 68(7.0) (33.4) 262(32.1) (27.2) 170(21.8) (34.0) 304(39.1) Pronunciation ability Dissatisfaction 84(22.3) 109(15.9) Moderate 52(12.3) 90(10.4) Satisfaction 233(65.4) 598(73.7) Chewing ability <0.001 Dissatisfaction 212(57.7) 269(36.2) Moderate 63(17.2) 142(17.2) Satisfaction 95(25.2) 391(46.6) The data were analysed by Complex Samples Crosstabs. 16 Copyright 2014 SERSC