Relationships between Behavioral Risk Factors and Dental Care Costs in a Japanese Worksite

Abstract

Purpose. To identify the magnitude of dental care costs and examine the relationship between behavioral risk factors and dental care costs in a Japanese corporation. Design. A one-time cross-sectional design was used with each employee as a unit of analysis. Setting. The setting was a large Japanese corporation where Japan's standard health care insurance, including dental care coverage, was provided for all employees. Subjects. A full-time employee population of 6543 was included. Seventy-six percent were men, and the majority were white-collar workers. Measures. Data were available on dental care costs and self-reported behavioral dental care risk, including smoking and oral self-care, obtained from the company's annual physical checkups in the 2000 fiscal year. Dichotomous variables of expenditures for employees having no dental claims and those having high claims defined as 90th percentile or above were created. Results. The dental care costs made up approximately 24.3% of the health care costs. Thirty-five percent of the employees were smokers. Employees who were at least 40 years old and employees who were women were associated with the likelihood of using dental care services (odds ratio [OR] = 1.622 and 0.783, respectively), and no behavioral risk was associated. The likelihood of incurring high dental care costs was associated with smoking when including all employees in addition to those who used any dental care services (OR = 1.315 and 1.386, respectively). Conclusions. This study suggests the relationships of smoking as well as age and sex to dental care costs in an employer setting. To provide a strong case for health promotion in Japan, future research should address critical issues such as reliable and valid risk measurement and the use of longitudinal designs and intervention studies.