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Abstract : Objectives: The aim of this study was to develop policy tasks and approaches for the integration of oral health care systems in South and North Korea on the basis of a literature research, and to verify their validity through a Delphi survey of an expert panel. Methods: Twelve policy tasks and 11 approaches for South-North Korea integration were developed by a comparative model of oral health care systems. Two rounds of Delphi surveys were conducted via e-mail on May 20 and June 16, 2020, targeting 10 experts with experience in inter-Korean oral health care exchange and cooperation or related research. The mean, coefficient of variation (CV), and content validity ration (CVR) were calculated for each item. The validity of each item was judged based on the CVR. Results: The five policy tasks that meet the consensus of experts are: the integration of dental college education, the integration of activity qualifications and supply/demand for general dentists, the integration of education and training for auxiliary dental personnel, the integration of activity qualifications and supply/demand for auxiliary dental personnel, and the integration of oral health care financing. The nine approaches of the consensus of experts are: sharing the philosophy, values, and strategies, guaranteeing geographic access for residents, standardized oral health care delivery, an integrated performance management system, an integrated computerized information system, an integrated governance structure, the installation and operation of an integrated organization, the re-education and re-qualification of active oral health care personnel, and integrated goals for oral health outcomes. Conclusions: The expert panel showed a relatively high degree of agreement with policy tasks and approaches for the integration of the South-North Korea oral health care systems. It is necessary to develop more realistic contents based on more reliable North Korean data in the future.
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Abstract : Objectives: The purpose of this study is to analyze the trend of inequality in dental caries, deep periodontal pockets, and severe tooth loss according to the income level of adults using data from the Korea National Health and Nutrition Examination Survey (KNHANES).Methods: The raw data from the 4th wave (2007-2009) to the 7th wave (2016-2018) were downloaded from the KNHANES website. The analytical subjects were 19 years of age or older who completed oral examinations and were classified differently according to the prevalence characteristics of each clinical indicator. The prevalence of permanent tooth caries (19 years +), deep periodontal pockets (30 years +), total tooth loss (50 years +), and 20 teeth and over (70 years +) were estimated according to the guidebook for data users. The absolute difference (AD) between the lowest and highest income levels and the prevalence ratio (PR) were calculated. All statistical analyses were performed with STATA version 13.Results: The prevalence of permanent tooth caries decreased by 6.7%, but the AD increased by 3.4% and the PR was statistically significant. The prevalence of deep periodontal pockets was 6-10%, but the AD increased by 1.7%, and the PR of 7th wave rapidly increased. The prevalence of total tooth loss decreased by 1.5%, but in the 7th wave, the AD and the PR rapidly increased. The prevalence of 20 teeth and over increased by 10.9%, but the AD increased by ―4.3%, and the PR was statistically significant in the first and second quantiles of all waves.Conclusions: In Korean adults, overall oral health status has improved over the past decade, but oral health inequality according to income level has generally worsened. Therefore, policy development including intervention in social determinants is needed to reduce the oral health inequality identified in this study.
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Abstract : Objectives: This study aimed to evaluate the effect of silver fluoride (AgF) on the formation of cariogenic biofilm and surface of dentin in vitro.Methods: Bovine dentin specimens with artificial caries were prepared and divided into 3 groups: untreated control, AgF-treated, and silver diamine fluoride (SDF)-treated. Streptococcus mutans cultured in brain heart infusion (BHI) broth was used to induce biofilm. The specimens were placed in a well plate containing BHI broth and S. mutans bacterial suspension, and incubated under aerobic conditions supplemented with 5% CO2 at 37℃ for 24 hours. After the incubation, the specimens were washed twice with phosphate-buffered saline (PBS) and sonicated to obtain a bacterial suspension. The diluted bacterial suspension was then smeared on a blood agar plate and cultured for 72 hours at 5% CO2 and 37℃. Following this, the number of bacterial colony forming units (CFUs) was counted and converted into logarithms for analysis. Additional specimens of each group were observed by scanning electron microscope (SEM). Energy dispersive X-ray spectroscopy (EDS) was also performed for component analysis of the dentin surface.Results: The number of S. mutans bacterial CFUs was significantly lower in the AgF and SDF groups than in the untreated control group. It was shown that SDF inhibited biofilm formation more than AgF; however, there was no statistical significance. The SEM images showed particles formed after AgF and SDF application were deposited on the dentin. It is confirmed through EDS analysis that the particles contained silver and fluoride ions.Conclusions: This study confirmed that AgF application effectively inhibited the formation of the early S. mutans biofilm. It is suggested that AgF solution may be effectively used in the clinical setting to prevent caries without occurrence of gingival irritation or bad odors.
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Abstract : Objectives: Disabled people experience difficulties in accessing dental services. Some of them tend to rely on charity dental services due to financial reasons. The purpose of this study is to identify some of the treatment statuses of disabled people to aid in planning oral health policies.Methods: This study analyzed the dental records of 141 patients from 2014 to 2019 in a charity dental clinic in Cheongju City. The demographic characteristics such as gender, age, area, social security, and type of disability of the patients were analyzed. Chi-square test and logistic regression analyses were performed to investigate the sociodemographic factors related to dental treatments.Results: Within the study population, 63.1% were men and 66.0% were older, over 40 years old. The type of disabilities showed significant differences in the possibilities of having periodontal treatments. The older people showed almost four times a higher risk of experiencing dental extractions than those who were younger, even after adjustments with sociodemographic factors.Conclusions: Among disabled people, an older age corresponds to a much higher probability of extraction, making chewing difficult and leading to the deterioration of general health. It is therefore necessary to conduct a detailed and extended national oral health survey on people with disabilities to allow for the provision of systematic support.
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Abstract : Objectives: Oral streptococci play a significant role in the development of dental caries. Among them, Streptococcus mutans and Streptococcus sobrinus are the principal causative agents of dental caries. Rheum palmatum is a flowering plant of the family Polygonaceae with several known medicinal properties. However, its effects on oral streptococci have yet to be established. Therefore, we investigated the effects of Rheum palmatum for its potential use as an anticaries agent in inhibiting the growth of streptococci and preventing biofilm formation.Methods: Rheum palmatum extract was diluted with sterile distilled water to obtain various extract concentrations. Several strains of oral bacteria, including S. mutans and S. sobrinus , were treated with the varying concentrations. The effects of the extract on bacterial growth was examined using the viable cell count method. Glucan synthesis was measured using a spectrophotometer at 650 nm optical density. Crystal violet staining was also carried out to observe the effect of the extract on biofilm formation.Results: The growth of S. mutans and S. sobrinus was significantly inhibited by the Rheum palmatum solution at concentrations of 0.3% or more compared to the control group. The viable cell count results indicated that the number of bacterial colonies decreased 1.2-fold and 1.7-fold at concentrations of 1.25% and 2.5%, respectively, compared to the control group. Biofilm formation by S. mutans and S. sobrinus was suppressed more than 20-fold compared to the control group at extract concentrations of 1.25% or more.Conclusions: The extract inhibited the growth of caries-causing bacteria, namely S. mutans and S. sobrinus . Furthermore, the extract inhibited the synthesis of glucan and biofilm formation by S. mutans and S. sobrinus . Therefore, this study suggests that the extract is a potential candidate as a therapeutic agent for controlling dental caries.
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Abstract : Objectives: This study aimed to analyze the trends of the gap in toothbrushing and dental care according to the household income level of all people using the Korea National Health and Nutrition Examination Survey (the KNHANES) data.Methods: Data from 2007-2020 were downloaded from the KNHANES website. Data integration and analysis were conducted for each wave. The prevalence of toothbrushing less than twice a day, toothbrushing after lunch, unmet dental care needs, regular dental check-ups, and preventive dental services use were each estimated based on the data users’ guidebook. The absolute difference (AD) between the lowest and highest income level and the prevalence ratio (PR) were calculated.Results: The prevalence of toothbrushing less than twice a day and toothbrushing after lunch improved by 5.3% and 13.6%, respectively. However, AD decreased by 4.5% and 2.4%, respectively. The step-wise social gradient in the PR of these indicators was maintained. The prevalence of unmet dental care needs improved substantially from 38.7% in Wave 4 to 21.0% in Wave 7. However, AD and PR were the poorest in Wave 7. The prevalence of regular dental check-ups and preventive dental service use improved steadily by Wave 8 to 45.0% and 37.0%, respectively. However, AD in Wave 8 was ―16.8% for the prevalence of regular dental check-ups and ―12.2% for preventive dental service use. The social gradient in the PR was maintained.Conclusions: While toothbrushing and dental care use have improved over the past decade, disparity by income level has not been noticeably reduced. This study’s results also reflected the achievements and limitations of the Korean government’s policies and projects for toothbrushing and dental hygiene habits.
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Abstract : Objectives: International students attending Korean universities are sometimes not able to receive timely dental treatment, despite the need for dental treatment owing to various oral health problems. The purpose of the study was to identify various barriers to the regular use of dental services by international students in a metropolitan area of Korea.Methods: Questionnaires, both online and offline, were sent to 500 foreign university students enrolled in five selected universities located in Daegu city and nearby areas, with a total of 19 valid responses received. The questionnaire consisted of 41 items, including demographic characteristics, oral hygiene-related behavior, barriers to dental services access, and Oral Health Impact Profile (OHIP-14). The internal validity of each factor was 0.8 or higher (Cronbach Alpha α=0.86), confirming the reliability. All data were analyzed using IBM SPSS for Windows ver. 25.0 was used for analysis, and the statistical significance level was set to 0.05%.Results: Among the international student participants, 69.5% did not visit the dentist during their stay in Korea, and those with low prevalence of gum bleeding and plaque were more likely to visit the dentist regularly. Financial problems and lack of knowledge and interest in oral health were significantly associated with the use of dental services. The revised model’s explanatory power was 20.3%.Conclusions: In order to improve the oral and general health of international students residing in Korea, university level oral health education programs, oral health care centers, and governmental support programs should be implemented.
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Abstract : Objectives: This study aimed to assess the antibacterial, bactericidal, and mouth freshener effects of lysozyme hydrochloride 0.01%, sodium fluoride 0.02%, and cetylpyridinium chloride 0.05%.Methods: Eight oral disease-related bacteria were cultivated anaerobically. Four samples were prepared with or without 0.5% cetylpyridinium chloride, 0.2% sodium fluoride, and 0.1% lysozyme hydrochloride. Antimicrobial activity was tested in 96-well microplates. After assessing the bacterial count, the bacterial suspension was mixed with samples and spread on agar. The bactericidal rate was calculated by counting and comparing treated and untreated colonies.Results: Lysozyme hydrochloride 0.01%, sodium fluoride 0.02%, and cetylpyridinium chloride 0.05% mouth fresheners sterilized 99.99% of 8 oral bacteria, including Streprococcus mutans. Lysozyme hydrochloride 0.01%, sodium fluoride 0.02%, and cetylpyridinium chloride 0.05% mouth fresheners showed 99.97% bactericidal activity against Lactobacillus acidophilus.Conclusions: Lysozyme hydrochloride 0.01%, sodium fluoride 0.02%, and cetylpyridinium chloride 0.05% mouth fresheners confirmed the sterilization and antibacterial effects on oral disease-causing bacteria.
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