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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.
Subject(s)
Income , Southeast Asian People , Humans , Adult , Socioeconomic Factors , Thailand/epidemiology , Dental Care , Health Status DisparitiesABSTRACT
Background/purpose: The characteristic of soft tissue changes in buccal shelf area during function is unclear. This study aimed for evaluating the potential denture covering area in buccal shelf area in different ranges of mouth opening by a digital approach. Materials and methods: Nineteen qualified dentate participants were enrolled. An intraoral scanner was used to record soft tissue in buccal shelf area in different ranges of mandibular opening, which were maximum intercuspation, 10 mm, 20 mm, and 30 mm of interincisal distance. The experiment was performed by two examiners. The common area of each range was generated within the clinically acceptable denture adaptation range, which was represented as the potential denture covering area. Data were statistically analyzed using descriptive statistic, one-way repeated measure ANOVA, intraclass correlation coefficient (ICC), and the Pearson correlation test. Results: Trends of the mean distance of the potential denture covering area increased from the frenum area to the second premolar and the first molar area then decreased in the second molar area, along with the ranges of mouth opening increased. The distance in the second molar area had drastic percentage changes during the mouth opening. The mean distances changed significantly when the mouth opening increased (P < 0.001). All ICC values of intra-, inter-rater reliability indicated good to excellent reliability. The correlation between the results from two examiners was strong (P < 0.001). Conclusion: The characteristic of the denture covering area posteriorly to the first molar area is inversely proportional in length to ranges of mouth opening.
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Objectives: Plant-derived compounds are a major source of medicinal agents. Common oral diseases, including dental caries, periodontal disease, and candidiasis, are caused by biofilms. The nature of biofilm formations is complex, emphasizing the importance of finding novel products that possess bioactivity against microbes associated with those oral infections. The aims of this study were to determine the antimicrobial activity and antibiofilm formation of α-mangostin (α-MG) soluble film. Materials and Methods: Antimicrobial assays against Streptococcus mutans, Porphyromonas gingivalis, and Candida albicans were performed by identifying the minimal growth inhibition concentration and the minimal bactericidal concentration. Time-killing kinetic studies against the organisms and inhibition of biofilm formation were determined by the broth microdilution method. Human gingival fibroblast cell line and macrophage RAW267.4 cells were cultured, and the cell viability was assessed by the MTT assay. The anti-inflammatory effect of the α-MG film was investigated by measuring the inhibition of nitric oxide production. Results: The α-MG film demonstrated antimicrobial activity against the oral pathogens tested. The formulation reduced microbial growth about 1-3 Log CFU/mL at 2-4 h and complete killing at 24 h. No significant difference in inhibiting the biofilm formation of those three microorganisms was noted. In addition, the film containing α-MG demonstrated anti-inflammatory activity through the inhibition of nitric oxide production in a dose-dependent manner. The formulation was safe and showed no cytotoxicity at therapeutic dose. Conclusions: The α-MG film is effective against S. mutans, P. gingivalis, and C. albicans without significant cytotoxicity in vitro. Thus, this new product may have potential advantage in preventing those common oral infections.
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Silver diamine nitrate (SDN) is expected to help control caries similar to silver diamine fluoride (SDF). The aim of this study was to determine the mineral precipitation in demineralized dentin and the cytotoxicity of SDN and SDF to dental pulp cells. Demineralized dentin specimens were prepared, and SDF, SDN, or water (control) was applied. The specimens were then remineralized in simulated body fluid for 2 weeks. The mineral precipitation in the specimens was examined using FTIR-ATR, SEM-EDX, and synchrotron radiation X-ray tomographic microscopy (SRXTM). Additionally, the cytotoxicity of SDF and SDN to human dental pulp stem cells was analyzed using an MTT assay. The increase in FTIR spectra attributable to apatite formation in demineralized dentin in the SDF group was significantly higher compared to the SDN and control groups (p < 0.05). Dentinal tubule occlusion by the precipitation of silver salts was detected in both SDF and SDN groups. The mineral density as shown in SRXTM images and cytotoxicity of both SDN and SDF groups were comparable (p > 0.05). In conclusion, SDF demonstrated superior in vitro apatite formation compared to SDN. However, the degree of mineral precipitation and cytotoxic effects of both were similar.
ABSTRACT
Silver diamine fluoride (SDF) is a cost-effective method for arresting active dental caries. However, the limited cooperation of patients may lead to an SDF application time that is shorter than the recommended 1-3 min for carious lesions. Therefore, the aim of this study was to assess the effect of different application times of SDF on the degree of mineral precipitation in demineralized dentin. Demineralized dentin specimens from permanent maxillary molars were treated by applying 38% SDF for 30, 60, or 180 s. Water was applied in the control group. The specimens were immersed in simulated body fluid for 2 weeks, and the mineral precipitation in demineralized dentin was then analyzed using FTIR-ATR, SEM-EDX, and synchrotron radiation X-ray tomographic microscopy (SRXTM). The FTIR-ATR results showed a significant increase in mineral precipitation in the 180 s group after 1 week. However, after 2 weeks, the SRXTM images indicated comparable mineral density between the 30, 60, and 180 s groups. The precipitation of silver chloride and calcium phosphate crystals that occluded dentinal tubules was similar in all experimental groups. In conclusion, an application time of either 30, 60, or 180 s promoted a comparable degree of mineral precipitation in demineralized dentin.
