Lee Jae-Hong, Oh Jin-Young, Choi Jung-Kyu, Kim Yeon-Tae, Park Ye-Sol, Jeong Seong-Nyum, Choi Seong-Ho
Department of Periodontology, Wonkwang University Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea.
Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
J Periodontal Implant Sci. 2017 Oct;47(5):264-272. doi: 10.5051/jpis.2017.47.5.264. Epub 2017 Oct 30.
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.
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).
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.
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.
本研究利用2002 - 2013年国民健康保险服务全国样本队列的数据，评估因急慢性牙周病（PD）导致的拔牙趋势。
随机抽取1,025,340名个体作为总体的代表性样本，并对诊断和处方代码数据库进行了12年的随访。我们使用多因素逻辑回归分析，根据社会人口学因素（性别、年龄、家庭收入、健康状况和居住地区）评估总拔牙（TE）、因牙周病拔牙（EPD）以及因牙周病即刻拔牙（IEPD）的发生率。
发现拔牙发生率呈上升趋势，且PD患者中TE的上升速度更快。2002年，50.6%的TE病例由PD引起，到2013年这一比例增至70.8%，而同期IEPD病例数从42.8%增至54.9%。急慢性PD导致的拔牙发生率呈单调上升。我们发现，高收入水平患者和非医疗保险受益人的TE、EPD和IEPD发生率均高出2倍。
尽管有扩大公共医疗保险覆盖范围、增加牙科诊所可及性的牙科保健政策，但TE、EPD和IEPD的发生率仍在稳步上升。此外，这些政策的效果因收入和教育水平而异。需要持续对患者进行随访，以观察根据牙科保健政策变化而出现的拔牙趋势变化，对此类变化进行细致研究将确保进行最佳的政策评估和修订。
