Abstract
Introduction
In 2018, disease of developmental insufficiency of oral function (DIOF) was added to the Japanese national dental health insurance for typically developing children. We aimed to confirm the actual number of typically developing children with DIOF using the national database (NDB) and estimate the incidence rate of DIOF among such children.
Methods
The number of children with DIOF was calculated using the NDB in 2020, 2021, and 2022 and activities in the June 2023 of Public Health Insurance. We based the population data on the annual report of single year current population estimates in 2022.
Results
Using the 2022 population data of children aged 0–17 y (17,738,000 children) and the 2022 DIOF patient data, we calculated that the incidence rate was 2431.3/100,000 children (2.4%) in 2022. The number of these children increased each year between June 2020, June 2021, and June 2022; in June 2022, there were almost 1.3 times the number of visits as that in June 2021. There were 130,259 visits based on the estimated DIOF outpatient data in June 2023, 1.1 times that of June 2022.
Conclusion
This study is the first to report the incidence rate of DIOF in typically developing children in Japan. However, we only assessed outpatients; there may be more affected children in Japan. Therefor DIOF examination is a necessary public health approach to support oral function development and to reduce the incidence of DIOF.
1
Introduction
The Japanese National Insurance System provides dysphagia rehabilitation for children, involving doctors, nurses, physical therapists, occupational therapists, speech pathologists, dentists, and dental hygienists. However, the purpose of this system does not include rehabilitation for typically developing children. In 2018, the Japanese Association for Dental Science declared that delayed oral function in such children is a concern and emphasized the importance of early intervention with dental support when there are delays in oral function development [ ]. In the same year, developmental insufficiency of oral function (DIOF) was added to the list of conditions covered by the National Dental Health Insurance [ ]. The clinical diagnostic criteria for DIOF are determined using an original assessment check sheet [ , ] ( Table 1 ). In its first year, only one assessment check sheet was employed; in 2020, it was divided into two assessment sheets, including the DIOF criteria as comprehensive care until after the weaning period.
| A (Function) | B (Classification) | C (Item) | Lactation and weaning period assessment items | Postweaning completion period assessment items |
|---|---|---|---|---|
| Eating | Lactation period | Presence of congenital teeth anomalies | C-1 | |
| Abnormal lip or alveolar morphology (e.g., cleft malformations) | C-2 | |||
| Abnormal lingual frenulum | C-3 | |||
| Does not adhere to the nipple | C-4 | |||
| Too long and/or short breastfeeding time | C-5 | |||
| Amount or/and frequency of feeding milk is too high and/or low at the time. | C-6 | |||
| Weaning period | Cannot hold head up in the weaning period | C-7 | ||
| Pushes out the spoon with tongue | C-8 | |||
| Does not progress | C-9 | |||
| Mastication | Delayed teeth eruption | C-1 | ||
| Abnormal dental arch and/or malocclusion | C-2 | |||
| Dental caries are the reason for mastication problems | C-3 | |||
| Does not have a strong bite force | C-4 | |||
| Too long and/or short mastication time | C-5 | |||
| Mastication only on one side | C-6 | |||
| Swallowing function | Infantile swallowing and/or lingual habit | C-7 | ||
| Eating behavior | Amount or/and frequency of eating food is too high and/or low at the time. | C-8 | ||
| Speech | Articulation | Abnormal articulation | C-9 | |
| Lip does not close at rest | C-10 | C-10 | ||
| Oral habits | C-11 | |||
| Abnormal lingual frenum | C-12 | |||
| Others | Nutrition | Thin or overweight | C-11 | C-13 |
| Other | Hypersensitive in the orofacial area | C-12 | ||
| Mouth respiration | C-14 | |||
| Tonsillar hypertrophy | C-15 | |||
| Snoring | C-16 | |||
| Low tongue pressure | C-17 | |||
| Another problem | C-13 | C-18 |
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