Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.
Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
JDR Clin Trans Res. 2022 Jul;7(3):307-314. doi: 10.1177/23800844221094479. Epub 2022 May 9.
In April 2020, the Japanese government declared a state of emergency owing to the outbreak of the novel coronavirus disease (COVID-19) pandemic, which resulted in reduced workforce and job losses. Furthermore, income is one of the most consistent predictors of dental visits. Therefore, this study examined the association between income changes and dental clinic visits during the COVID-19 state of emergency in Japan.
An online, self-reported cross-sectional survey about health activities including dental visits during the first COVID-19 state of emergency was conducted in Osaka, Japan (June 23 to July 12, 2020). Among participants with toothaches, the assessment for the association between "refrained from visiting a dentist despite wanting treatment for toothache during the state of emergency (refrained treatment)" and income changes before and after the state of emergency using a multivariate Poisson regression model adjusted for sex, age, self-rated health, frequency of regular dental visits, and employment status.
Among 27,575 participants, 3,895 (14.1%) had toothaches, and 1,906 (6.9%) reported refrained treatment. Among people with decreased income ( = 8,152, 29.6% of overall participants), the proportions of the refrained treatment group were 8.0% (income decreased by 1%-49%), 9.9% (50%-99% decreased), and 9.1% (100% decreased). Among participants with toothache, after adjusting for all variables, compared with participants with no income change, we observed significantly higher prevalence ratios (PRs) for refrained treatment in those who experienced a decreased income owing to COVID-19 (1%-49% decrease: PR = 1.08; 95% confidence interval [CI], 1.005-1.17; 50%-99% decrease: PR = 1.18; 95% CI, 1.06-1.32; 100% decrease: PR = 1.18; 95% CI, 1.04-1.33).
Decreased income was associated with refrained dental treatment during the COVID-19 state of emergency in Osaka, Japan. The economic damage related to the COVID-19 pandemic could lead to oral health inequalities.
Our study found that individuals with decreased income owing to COVID-19 before and after the state of emergency showed significantly higher prevalence ratios for refraining from visiting a dentist despite wanting treatment for toothache. We believe that our study makes a significant contribution because it provides novel, basic data that economic damages related to the COVID-19 pandemic might expand to oral health inequalities.
2020 年 4 月，由于新型冠状病毒病（COVID-19）大流行，日本政府宣布进入紧急状态，导致劳动力减少和失业。此外，收入是预测看牙频率最一致的因素之一。因此，本研究旨在探讨 COVID-19 紧急状态期间日本收入变化与牙科诊所就诊之间的关系。
在日本大阪（2020 年 6 月 23 日至 7 月 12 日）进行了一项关于健康活动的在线、自我报告的横断面调查，包括 COVID-19 紧急状态期间的牙科就诊情况。在有牙痛的参与者中，使用多变量泊松回归模型调整性别、年龄、自我评估健康状况、定期看牙频率和就业状况，评估“在紧急状态期间尽管有治疗牙痛的意愿但仍未去看牙医（避免治疗）”与紧急状态前后收入变化之间的关联。
在 27575 名参与者中，有 3895 名（14.1%）有牙痛，有 1906 名（6.9%）报告避免了治疗。在收入下降的人群中（n=8152，占总参与者的 29.6%），避免治疗组的比例分别为 8.0%（收入下降 1%-49%）、9.9%（下降 50%-99%）和 9.1%（下降 100%）。在有牙痛的参与者中，调整所有变量后，与收入无变化的参与者相比，我们观察到 COVID-19 导致收入下降的参与者中避免治疗的患病率比值（PR）显著更高（收入下降 1%-49%：PR=1.08；95%置信区间[CI]，1.005-1.17；下降 50%-99%：PR=1.18；95%CI，1.06-1.32；下降 100%：PR=1.18；95%CI，1.04-1.33）。
在日本大阪 COVID-19 紧急状态期间，收入下降与避免牙科治疗有关。与 COVID-19 相关的经济损失可能导致口腔健康不平等。
我们的研究发现，紧急状态前后因 COVID-19 而收入下降的个体尽管有治疗牙痛的意愿但仍未去看牙医的患病率比值显著更高。我们相信我们的研究做出了重要贡献，因为它提供了与 COVID-19 大流行相关的经济损害可能扩大到口腔健康不平等的新的、基础数据。
