Exploring dental care improvement needs and semantic networks among North Korean defectors by length of settlement in South Korea

Purpose: This study aimed to explore the problems and needs of North Korean defectors in accessing dental care in South Korea by analyzing open-ended survey responses with Word2Vec, and to derive implications for oral health support strategies.Materials and Methods: A cross-sectional survey was conducted among 200 North Korean defectors in South Korea. Of these, 133 respondents who answered an open-ended question on improving dental care utilization were included in the text analysis. Data were analyzed using frequency analysis and Word2Vec in a Python-based Google Colab environment. To improve stability, the model was trained 10 times with random seeds, and only neighboring words reproduced in at least 70% of runs were interpreted. Subgroup analyses were performed according to settlement period in South Korea (≤10 vs. ≥11 years).Results: Although overall satisfaction with dental care in South Korea was high, “cost” emerged as the most frequent and central keyword, linked with “burden,” “high cost,” and “dental implants.” “Consultation/Education” was associated with “understanding,” “be unable to,” and “lack,” indicating gaps in comprehensible communication. Respondents with ≤10 years of settlement showed greater needs related to insurance, language, and service adaptation, whereas those with ≥11 years of settlement showed more concentrated concerns about financial burden, policy support, and persistent communication gaps.Conclusion: Despite high reported satisfaction, North Korean defectors’ dental care experiences in South Korea were shaped by persistent economic and communicative barriers. These findings suggest the need for financial support for high-cost treatments, health literacy-sensitive and culturally tailored explanations, and settlement-stage- specific support strategies.