J Periodontal Implant Sci.  2017 Oct;47(5):264-272. 10.5051/jpis.2017.47.5.264.

Trends in the incidence of tooth extraction due to periodontal disease: results of a 12-year longitudinal cohort study in South Korea

• Lee JH
• Oh JY
• Choi JK
• Kim YT
• Park YS
• Jeong SN
• Choi SH

• KMID: 2392715
• DOI: http://doi.org/10.5051/jpis.2017.47.5.264

Abstract

PURPOSE
This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002-2013.
METHODS
A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence).
RESULTS
The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance.
CONCLUSIONS
The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.

Keyword

Cohort studies; Periodontal diseases; Retrospective studies; Tooth extraction; Tooth loss

MeSH Terms

Cohort Studies*
Delivery of Health Care
Dental Clinics
Education
Family Characteristics
Follow-Up Studies
Humans
Incidence*
Insurance Coverage
Insurance, Health
Korea*
Logistic Models
National Health Programs
Periodontal Diseases*
Prescriptions
Public Health
Retrospective Studies
Tooth Extraction*
Tooth Loss
Tooth*

Figure

• 

  Figure 1 Incidence of tooth extraction according to the presence of acute PD in Koreans during 12 years of follow-up in the National Health Insurance Service-National Sample Cohort. PD: periodontal disease, TE: total extraction, EPD: extraction due to periodontal disease, IEPD: immediate extraction due to periodontal disease.

• 

  Figure 2 Incidence of tooth extraction according to the presence of chronic PD in Koreans during 12 years of follow-up. PD: periodontal disease, EPD: extraction due to periodontal disease, IEPD: immediate extraction due to periodontal disease.

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