RESUMEN
OBJECTIVES: The Universal Coverage Health Scheme (UCS) was implemented in Thailand in 2002 to increase access to health services among the Thai population. This study aimed to evaluate socioeconomic inequalities in dental service utilization (DU) before and after UCS implementation and to assess factors associated with DU among Thai adults. METHODS: This study is based on secondary data from four Thai national oral health surveys in 2000-2001, 2006-2007, 2012 and 2017. Whether an individual from a nationally representative sample of Thai adults aged 35-44 went to see the dentist during the past year was used to define DU. The slope index of inequality (SII) and relative index of inequality (RII) were used to assess and compare education and income-related inequalities in DU. Poisson regression was used to assess factors associated with DU. Income inequalities were not reported for the year 2001 (Income data not available). RESULTS: Although DU increased after UCS implementation, socioeconomic inequalities persisted. DU was concentrated among high-education and income groups. Absolute educational inequalities were 0.16 (95% CI: 0.09-0.22), 0.21 (95% CI: 0.10-0.32), 0.26 (95% CI: 0.14-0.38) and 0.25 (95% CI: 0.18-0.32) in 2001, 2007, 2012 and 2017, respectively. Absolute income inequalities were 0.15 (95% CI: 0.04-0.26), 0.07 (95% CI: -0.04-0.18) and 0.12 (95% CI: 0.05-0.19) in 2007, 2012 and 2017, respectively. Occupation, type of health insurance scheme, sex and oral health-related behaviour were associated with DU. CONCLUSION: UCS has improved accessibility to dental services, but UCS alone might not narrow the inequalities gap for Thai adults.
Asunto(s)
Renta , Pueblos del Sudeste Asiático , Humanos , Adulto , Factores Socioeconómicos , Tailandia/epidemiología , Atención Odontológica , Disparidades en el Estado de SaludRESUMEN
The purpose of this study was to describe the extent and distribution of gingival recession in Thai elderly. As part of a longitudinal geriatric oral health study, 453 community-dwelling dentate subjects, 51-92 years of age, were examined at baseline in 1999. All remaining teeth were measured on four periodontal sites to assess the amount of gingival recession. The percentage of sites with recession increased with age from 49.6% in 51-59 years of age to 72.0% in 70+ years of age (P < 0.001). Males exhibited greater levels of recession than females (P < 0.001). Regression analysis for the percentage of buccal sites with recession showed that recession was associated with age, gender, cervical abrasion, and amount of calculus (R2 = 0.15, P < 0.001). However, the regression model for the percentage of all sites with recession did not find an association between recession and cervical abrasion. Hence, it appears that gingival recession on different locations may involve different processes.