Practical lessons from a general dentist of more than 50 years private practice plus 2 years of United States Air Force practice

Having practiced over 54 years the art and science of general dentistry, many changes in philosophy and performance have occurred. Some are minor while others very major. This series of observations will treat some in detail while others very briefly. The physical locations have been in the Dallas, Texas area of the USA. Definitions of terms set the stage for discussion of the basis of dentistry. Support for the scientific as well as evidence-based approaches is laid forth. Filling materials have transitioned from amalgam to composite being most prevalent. Fluoride added to local water supplies has decreased the number of decayed/sensitive teeth, the timing of initial decay, and the prognosis for remediation. pH is a major player in the deterioration of tooth structure. New understandings of tooth brushing and oral hygiene have significantly improved the future for continuing dental health. Absence of fluoride in bottled water has taken a front-center stage for helping/hurting chances of keeping teeth free of decay. Fluoride varnishes have widespread acceptance in America. Failure to seek routine dental care has influenced the outcomes for many younger patients, especially those who have graduated high school, gone off to college or into the workforce. Such lack of routine preventive influence raises the costs of care when it is received, often leading to complaints from patients about the high costs of repair. The alternative is prevention with ongoing consistent 6-month recalls/repairs when problems initiate, rather than allowing problems of long duration. The USA dental insurance industry adverse impact on practicing dentists is a vital monologue. Revealing the dental insurance industry as a number one concern of many surveys of practicing dentists is a way of preparing international countries for learning from the flawed USA models. Recent Congressional law, HR 1418, the Competitive Health Insurance Reform Act, will address some of the most critical wrongs by placing the dental insurance industry into antitrust restraints. Current concerns about digital X-ray’s diagnostic potential are revealed. Conservative dentistry is promoted. Results of conservative practice from nearly 50 years are documented with photos and X-rays. Bonded bridge technology is highlighted for its valued impact.

The Relationship between Oral Health Knowledge and Understanding of Oral Health Information according to Whether Some Adults have a Private Dental Health Insurance

Objectives: More and more private dental insurance products are becoming available in Korea, but little is known about how well purchasers of these products understand them. Methods: Some adults conducted a survey to check their oral health knowledge according to whether they joined for private dental health insurance. Results: Adults enrolled in private dental insurance have high levels of knowledge and understanding about oral health. Participants’ knowledge of oral health positively correlated with their understanding of oral health information (r=.408, p<0.01). Conclusions: Education targeted at improving individuals’ understanding of oral health should be strengthened in the future, as patients’ general knowledge of oral health supports the prevention and treatment of oral disease.

Access to root canal treatment in a Nigerian sub-population: assessment of the effect of dental health insurance

Background: The final pathway of tooth mortality lies between tooth extraction, and the more expensive and less accessible root canal treatment (RCT). Aim: To determine the extent to which individuals’ financial resources as measured by socioeconomic status and dental insurance coverage affects their access to RCT. Methods: A hospital-based study that used a 15-item questionnaire to collect data among patients scheduled for RCT. All scheduled subjects (N = 291) over a one-year period constituted the sample for the study. Using the SPSS software, associa- tions between the subjects’ variables, and the dental insurance status were carried out with Chi square and independent t test respectively at 95% confidence interval. Results: Two hundred and ninety-one subjects were to have 353 RCTs within the study period. A high proportion (79.7%, p < 0.001) of the subjects had dental health insurance, majority (95.3%) of which was government funded. 20.9% of those with previous tooth loss was due to inability to afford cost of RCT. The lowest socioeconomic group had the highest pro- portion (90%, p = 0.421) of insured that visited for RCT. Conclusion: Dental insurance increased access to RCT. Socioeconomic status did not affect dental insurance status and dental visit for RCT. Keywords: Dental insurance; health insurance; root canal treatment.

Did Expanded Dental Insurance Reduce Out-of-Pocket Expenditures on Dental Care among Older Adults in Korea? Interrupted Time-Series Analysis

The Korean National Health Insurance extended its coverage to reduce the economic burden of receiving dentures and implants for older adults in 2012 and 2014, respectively. We examined whether the new policy resulted in reduced out-of-pocket dental care expenditure in the eligible population, specifically focusing on low-income adults. We used interrupted time-series analysis (ITSA), a quasi-experimental design, to identify the effects of the policy among persons aged 65 or older. Data were extracted from the Korea Health Panel Survey (KHP; 2008–2017). The main outcome was out-of-pocket expenditures on dental care. The ITSA showed that expenditures decreased annually by 4.5% (RR: 0.96, 95% CI: 0.95–0.96) between 2012 and 2014. However, expenditure increased by 7.8% (RR: 1.08, 95% CI: 1.07–1.08) after 2014. Dental insurance coverage did not contribute to reducing the out-of-pocket expenses for dentures among low-income adults, while coverage of dental implants led to an increase in dental expenditure.

Correction to: Providing dental insurance can positively impact oral health outcomes in Ontario

An amendment to this paper has been published and can be accessed via the original article.