Adult Oral Health Programs in Japanese Municipalities: Factors Associated with Self-Rated Effectiveness.

Health Japan 21 plan establishes specific targets for aspects of health including oral health for 2010, in an effort to increase health expectancy. Despite this, there has been insufficient improvement in oral health status in adults. The objective of this cross-sectional study was to determine the factors associated with effective oral health programs for adults in Japanese municipalities. Questionnaires were mailed to all 1,472 municipalities in Japan and responses were obtained from 862 municipalities (response rate: 58.6%). After excluding 71 municipalities with "unknown" answer, no answer, or lack of relevant information, we analyzed the data from the remaining 791 municipalities with or without oral health programs for adults self-reported as effective within three years. Multilevel Poisson regression models were used to examine the associations of effective programs with oral health personnel, contact with related agencies, the establishment of Health Japan 21 goals, financial status, the density of dentists and population density at the municipality level, and having oral health personnel at the prefecture level. Three hundred and fifty-four municipalities reported having effective programs. In the fully adjusted model, having dental hygienists in the municipal office (P < 0.05) and a high number of contacts with related agencies (P < 0.05) were significantly associated with having effective programs. These results suggest that having dental hygienists and contact with related agencies such as residents, local dental associations, companies, community general support centers, or medical, nursing or welfare facilities are promoting factors for effective adult oral health programs in Japanese municipalities.