北京市海淀区3岁儿童龋病患病状况及龋病活跃性检测的研究

目的 通过了解北京市2所大学附属幼教机构学龄前儿童的口腔健康状况、龋病活跃性,了解儿童患龋情况与龋病活跃性之间的关系,探讨龋病活跃性检测筛查龋易感儿童及反映龋活跃性检测试剂的灵敏性和特异性,评价其对患龋预测的有效性和可行性.方法 对3岁年龄组儿童进行连续1年的口腔检查和龋活跃性检测,分析儿童患龋情况的变化与龋病活跃性之间的关系.结果 3岁儿童的患龋率为44.80%,龋均dft为2.04,龋面均dfs为2.79,儿童龋活跃性检测结果的各个分值与儿童患龋程度呈高度正相关关系(P<0.001).1年后随访,龋高危组儿童的新龋发生率显著高于龋低危组,经统计学检验其差异具有显著性意义(P<0.001).Cariostat法进行龋活跃性检测的敏感度可达95.1%,特异度达50.2%.结论 龋活跃性检测能够准确的反映儿童龋患现状,预测儿童患龋的趋势,为儿童制定个性化的预防保健计划.     

北京市幼儿园3～4岁儿童龋齿活动性研究

目的调查北京市幼儿园3~4岁幼儿龋的患病情况,了解该年龄组儿童患龋的特点;并通过龋齿活动性实验研究,揭示这部分儿童口腔中细菌的产酸能力与龋齿严重程度的关系。方法以北京市5所幼儿园3~4岁的207名儿童为研究对象,行龋齿检查并采集菌斑和软垢混合样本进行龋活动性(Cariostat,SankinCo,Tokyo)检查。结果该年龄组儿童患龋率为47.34%;龋均dmft(s)=1.96±2.92(2.96±5.10),dt(s)=1.84±2.77(2.82±4.92);患龋儿童的龋均为dmft(s)=4.14±3.00(6.24±5.88),dt(s)=3.90±2.86(5.94±5.70);其中重度低龄儿童龋(SECC)患儿53名,SECC发病率为25.60%;龋齿活动性比较,发现患龋组与无龋组在Cariostat值分布上有显著差异(P<0.01)。结论本年龄组儿童一旦患龋累及牙齿和牙面多,但是治疗率很低;患龋组比无龋组龋齿活动性高。使用Cariostat龋齿活动检测有助于筛选龋齿易感者。     

口腔乳杆菌菌落密集度与乳牙龋患状况及进展的相关性分析

目的:观察口腔唾液中乳杆菌菌落密集度与乳牙龋患状况及进展的相关性,评价Dentocult LB龋活跃性检测方法的有效性。方法:以223名2~4岁深圳市属幼儿园小班儿童为研究对象,进行口腔检查并采用Dentocult LB法检测口腔唾液中乳杆菌菌落密集度,2年后复查,分别计算2年前后患龋率、龋失补牙数(dmft)、龋失补牙面(dmfs)、龋蚀指数(CSI),统计学分析相关指标。结果:两年前后的患龋率、dmft、dmfs和CSI均随Dentocult LB分度的增加而增加,dmft、dmfs和CSI的增加值也随Dentocult LB分度的增加而有增加趋势,差异均有统计学意义(P<0.001);患龋率的增加值在Dentocult LB各分度之间无统计学差异(P>0.05);Dentocult LB分度与2年前后的dmft、dmfs和CSI以及其增加值之间均呈正相关。结论:口腔乳杆菌菌落密集度与儿童乳牙龋患状况和龋病发展趋势之间呈正相关,Dentocult LB是一种可靠有效的龋活跃性检测方法。     

南京市低龄儿童龋风险的影响因素研究

目的 分析低龄儿童龋风险的影响因素,完善低龄儿童龋风险评估模型,以便辅助诊断低龄儿童龋,提供有效的预防及治疗建议。方法 收集来自南京医科大学附属口腔医院儿童牙病预防科临床就诊患者的基线资料,使用CPI探针检查全口牙齿状况,对儿童家长进行问卷调查。所有儿童采集静脉血5 mL。采用单因素及多因素Logistic回归进行相关因素分析。结果 本研究纳入199例龋高风险儿童,多因素logistic回归分析结果显示,血液中总蛋白比值比（Odds ratio,OR）=1.092,95%可信区间（Confidence interval,CI)：1.034~1.155、血清钾（OR=2.175,95%CI：1.056~4.48）、二氧化碳（OR=1.32,95%CI：1.194~1.459）及磷酸肌酸激酶水平（OR=1.007,95%CI：1.001~1.014）与低龄儿童龋风险相关。结论 龋高风险儿童血检生化指标中总蛋白、血清钾、二氧化碳及磷酸肌酸激酶水平均高于无龋儿童,提示这些指标均可能是低龄儿童龋风险的影响因素。     

快速龋病活跃性检测-刃天青药片的研究

目的 研制一种能快速检测龋活性的刃天青成品药片,预测龋活跃性与幼儿乳牙龋蚀状况的相关性,为幼儿龋病预防工作提供一种成品化的预测方法.方法 用研制的检测龋病活跃性的刃天青药片,和日本R.D test成品药片对照,分别检测大连市1019名4-6岁幼儿口腔情况并观察其纸片变色程度与龋失补牙数(dmft)的关系,评价与龋失补牙数(dmft)的相关性.结果 本试验研制的刃天青药片变色程度与龋失补牙数(dmft)呈正相关关系(r=0.441,P＜0.01),与对照组(r=0.364,P＜0.05)无显著性差异(P＞0.5);灵敏度为91.39%,特异性为20.65%,阳性预测值70.84%.结论 本试验所研制的刃天青药片,灵敏度,准确率高,与日本R.D test成品药片相一致,可反映受试者的患龋现状.     

深圳地区学龄前儿童龋活跃性的研究分析

目的:通过对深圳地区学龄前儿童患龋状况的调查,采用龋病活跃性试验(CAT)检测幼儿龋病活跃性,了解学龄前儿童龋发病情况及龋活跃性与患儿性别、年龄之间的关系。方法:选择深圳地区某幼儿园3~5岁189名幼儿,进行口腔龋齿检查并记录患龋状况,同时采用CAT试剂检测其龋活跃性,分析幼儿患龋状况、CAT、性别及年龄之间的关系。结果:①患龋状况:总患龋率73.02%;总龋失补牙数(dft)3.96±4.06;总龋蚀指数(CSI):11.80±15.53;②性别及各年龄组间dft、CSI无显著性差异(P>0.05);③CAT 3度与其他度之dft、CSI差异有统计学意义(P<0.05)。CAT度数越高,患龋状况越严重;④CAT分度与dft、CSI高度相关(r=0.378,r=0.360,P<0.05)。结论:CAT各度间患龋状况有显著性差异,与患龋状况有高度相关性,提示CAT能反映机体之患龋状况。     

大连市某幼儿园儿童的龋齿活跃性与患龋状态的关系

目的研究大连市某幼儿园儿童龋齿活跃性与患龋状态之间的关系。方法选择3～6岁大连市某幼儿园儿童151名,进行口腔检查及龋齿活跃性试验(cariosat test,CAT),根据口腔检查及CAT值,分析调查对象的患龋状态。结果该幼儿园儿童患龋率为64.9%,龋均为2.77。CAT值低度组的患龋率是32.5%(49/151),中度组是54.3%(82/151),高度组是13.2%(20/151)。CAT值低度组与中度组的患龋率差异有统计学意义(χ2=2.539,P=0.025),CAT值低度组与高度组的患龋率差异有统计学意义(χ2=13.452,P<0.001),CAT值中度组与高度组的患龋率差异有统计学意义(χ2=9.910,P=0.016)。比较龋均在不同CAT值分度组的差异,CAT值高度组与中度组(t=2.264,P=0.037)、低度组(t=12.476,P<0.001)比较,差异均有统计学意义。结论大连某幼儿园儿童患龋率较高,龋齿活跃性高的儿童占大多数。     

五种龋病风险评估方法对口腔门诊患者患龋风险水平区分能力的研究

目的本研究旨在建立一种适合我国门诊病人龋风险评估体系-龋风险窗口(caries risk window,CRW)预测法,并与现有国外龋风险评估系统进行比较,评价其对门诊患者患龋风险等级区分能力和检测结果的一致性。方法选取111名门诊患者,进行临床检查和问卷调查。口腔检查包括患龋状况、口腔卫生状况、牙齿发育缺陷等;问卷调查包括饮食习惯、口腔卫生行为和就医行为。分别用五种龋风险评估方法确定个体的患龋风险等级:CRW预测法、Cariostat法、ADA龋风险评估、CAMBRA(Caries Management by Risk Assessment)、Cariogram系统。采用卡方检验比较五种方法对患者患龋风险水平的区分度;采用加权kappa比较五种方法检测结果的一致性。结果五种方法判断出龋高风险个体的比例从高到低分别是:CAMBRA(93%)、ADA(86%)、Cariogram(77%)、CRW(65%)和Cariostat(56%)。ADA和CAMBRA的一致性最高(加权kappa:0.593,P<0.05),属于中等水平。Cariogram与CAMBRA和ADA,CRW与ADA和Cariogram的一致性属于一般水平(加权kappa:0.221~0.358,P<0.05)。CRW与CAMBRA和Cariostat的一致性属于较差水平(加权kappa:0.150~0.161,P<0.05)。其它方法之间的一致性没有统计学意义。结论CRW和Cariogram对门诊患者患龋风险等级的区分能力优于CAMBRA和ADA龋风险评估方法,Cariostat居中,不同龋风险评估体系结果的一致性不高。需通过纵向研究进一步评价龋风险评估体系的准确性。     

海淀区0～3岁婴幼儿龋危险因素的分析研究

目的 探讨低龄儿童龋(early childhood caries,ECC)与口腔健康行为的相关关系,为0～3岁婴幼儿龋病的综合防治提供科学依据.方法 纳入395名1岁以下无龋儿童进行2年的纵向观察,每半年定期口腔检查和问卷调查,对家长进行口腔健康指导.统计分析喂养、口腔卫生状况、定期口腔检查等因素与ECC的相关性.结果 进入课题观察终点253人,平均月龄(27.67±5.98)个月,患龋率36.76％,龋均1.04±1.68.口腔卫生状况、检查次数、奶瓶喂养、夜间喂养、睡前进食后清洁和刷牙频率是ECC的影响因素(P<0.05).口腔检查次数是婴幼儿龋的重要负相关影响因素(P<0.05),每增加1次口腔检查,患龋风险降低61.6％.结论 定期口腔检查和菌斑控制是预防婴幼儿龋的关键因素.     

亲代教育程度对太原市3岁及以下儿童患龋影响的调查研究

目的    调查分析亲代教育程度对太原市3岁及以下儿童患龋状况的影响,为社区根据亲代教育程度的差异高效预防低龄儿童患龋提供相关依据。方法    随机抽取太原市高校职工社区与非高校职工社区各1所,选取这两所社区中于2019年10月至2020年10月行预防接种的3岁及以下儿童739名（高校职工社区儿童350名、非高校职工社区儿童389名）进行口腔检查及问卷调查。结果    350名高校职工社区儿童的患龋率为28.57%,龋均为1.42,治疗率为4.11%。389名非高校职工社区儿童患龋率为49.61%,龋均为2.34,治疗率为2.29%。高校职工社区儿童的患龋率明显低于非高校职工社区儿童,差异有统计学意义（P < 0.05）。影响高校职工社区儿童患龋的独立危险因素有：不定期口腔检查（OR = 1.721,95%CI：1.618 ~ 4.840,P < 0.05）、饮用含糖饮料（OR = 5.429,95%CI：2.482 ~ 11.874,P < 0.05）、刷牙时间少（OR = 1.732,95%CI：1.065 ~ 2.816,P < 0.05）、不定期涂氟（OR = 1.426,95%CI：1.195 ~ 3.933,P < 0.05）。影响非高校职工社区儿童患龋的独立危险因素有：与父母共用餐具（OR = 1.440,95%CI：1.241 ~ 3.804,P < 0.05）、甜食进食频率高（OR = 2.199,95%CI：1.497 ~ 3.229,P < 0.05）、刷牙时间少（OR = 1.592,95%CI：1.117 ~ 2.270,P < 0.05）、不使用含氟牙膏（OR = 2.084,95%CI：1.333 ~ 3.257,P < 0.05）。结论    亲代教育程度对太原市3岁及以下儿童患龋率具有一定影响,社区应根据亲代教育程度进行个性化的低龄儿童口腔健康宣教。     

Pattern and severity of early childhood caries

OBJECTIVES: The aim of this study was to investigate the association between selected social and behavioural variables and the pattern and severity of early childhood caries (ECC) within a community child population. METHODS: A cross-sectional sample of 2515 children aged 4-5 years were examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) indices and a self-administered questionnaire was used to obtain information regarding social, demographic, birth, infant feeding, oral and general health attitudes. Children with caries (847) were divided into anterior or posterior caries pattern groups and severe (dmfs score > or =6) or non-severe (dmfs score <6) caries groups. The data were analysed using a chi-square test and modelled using a logistic regression procedure. RESULTS: Significant variables associated with anterior ECC pattern were ethnicity other than Caucasian (OR = 2.1, 95% CI = 1.4-3.1), sipping from the bottle during the day (OR = 1.9, 95% CI = 1.3-2.7), male gender (OR = 1.6, 95% CI = 1.2-2.2) and sleeping with a bottle at night (OR = 1.5, 95% CI = 1.1-2.2). Significant variables associated with severe ECC form were sipping from the bottle during the day (OR = 2, 95% CI = 1.4-2.8), maternal age at birth < or =24 years (OR = 1.8, 95% CI = 1.3-2.7), ethnicity other than Caucasian (OR = 1.6, 95% CI = 1.1-2.5) and sleeping with a bottle at night (OR = 1.5, 95% CI = 1.1-2.2). CONCLUSIONS: Infant bottle-feeding habits (either allowing a child to sip from a bottle during the day or put to sleep at night) and ethnicity other than Caucasian were significant determinants for both anterior caries pattern and severity of ECC in 4-5-year-old Australian children.     

A randomized trial of the effectiveness of home visits in preventing early childhood caries

OBJECTIVES: Assess the effectiveness of home visits for advising mothers about breast feeding and weaning on early childhood caries (ECC) at the age of 12 months. METHODS: A randomized field trial was conducted in mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo (intervention group = 200; controls = 300). The intervention group received the advice 10 days after the child's birth, monthly up to 6 months, at 8, 10 and 12 months, based on the 'Ten Steps for Healthy Feeding', a Brazilian national health policy for primary care, based on WHO guidelines. Both groups had research assessment at 6 and 12 months, with dental caries investigated in this last assessment; 122 children were lost in the 1-year follow-up; 378 were assessed for caries: two predentulous children were excluded from the analysis. Mann-Whitney U was used to test if the average number of decayed surfaces (DS; white spots and cavities) differed between the intervention and control groups, and logistic regression to estimate the effects of the intervention on the odds of ECC. Chi-square test was used to test for differences between the intervention and control groups in the distribution of feeding behaviours tackled by the dietary intervention. RESULTS: 10.2% of the children in the intervention group and 18.3% of the controls had caries. The odds of caries was 48% lower for the intervention group, adjusted for number of teeth (OR = 0.52, 95% CI = 0.27-0.97). Mean DS were lower for the intervention group (0.37) when compared with the control group (0.63), (Mann-Whitney U, P = 0.03). The intervention group had significantly longer duration of exclusive breast feeding (P = 0.000), later introduction of sugar (P = 0.005), and smaller probability of ever having eaten biscuits (P = 0.000), honey (P = 0.003), soft drinks (P = 0.02), fromage-frais (P = 0.001), chocolate and sweets (P = 0.001). CONCLUSIONS: ECC is a public health problem in that population. The home visits for dietary advice appear to help reducing dental caries in infants. Greater efforts are needed to tackle cariogenic dietary behaviours even further, as a relevant proportion of children of the intervention group were shown to present with dental caries. Further studies should examine the effect of the intervention in the longer term.     

The geodemographic distribution of caries experience in neighboring fluoridated and nonfluoridated populations

OBJECTIVE: This study compares the geodemographic distribution of caries experience in neighboring fluoridated and nonfluoridated populations. METHODS: All 5-year-old children living in fluoridated (N=1,422) and nonfluoridated (N=4,779) areas of Cheshire, UK, were examined by trained and calibrated examiners. The Target Market level of the Super Profiles geodemographic classification was used to produce market penetration ranking reports for caries experience. The same area types were compared in fluoridated and nonfluoridated populations. Lorenz curves and Gini coefficients were generated from the outputs of the penetration rankings. RESULTS: There was a 12.4 percent difference in prevalence and a 29.4 percent difference in dmft between fluoridated (dmft>0=32.4%, dmft=1.01) and nonfluoridated (dmft>0=37.0%, dmft=1.43) areas. The area types at the top of both penetration rankings were deprived in nature and those at the bottom were affluent. The Gini coefficients in each area were 22.7 and 23.7 percent. CONCLUSIONS: The results demonstrate that water fluoridation is effective at preventing dental disease after controlling for confounding factors. In both populations the majority of disease was not confined to a small number of deprived area types. This undermines the contention that a targeted approach to caries prevention is a practical option.     

Early childhood caries prevalence and associated risk factors among Saudi preschool children in Riyadh

AimTo determine the prevalence of early childhood caries (ECC) and investigate the effect of associated risk factors on ECC prevalence in preschool children in Riyadh, Saudi Arabia.MethodsThis cross-sectional study included Saudi preschoolers aged 36–71 months. Parents/guardians completed a structured, self-administered questionnaire assessing sociodemographics; medical, dental, and dietary history; and oral hygiene practices. Children were orally examined for dental caries, oral hygiene, and plaque deposition.ResultsA total of 383 children were examined. ECC prevalence was 72.6%, with a mean decayed, missing, and filled teeth (dmft) score of 4.13 (±3.99) and a mean decayed, missing, and filled surfaces (dmfs) score of 7.0 (±9.1). Children from schools in northern Riyadh and those of fathers in professional jobs were less likely to have ECC [(OR: 0.203; 95% CI: 0.082–0.503)] and [(OR: 0.472; 95% CI: 0.256–0.871)], respectively. Children with a nocturnal feeding history and poor oral hygiene were more likely to have ECC [(OR: 2.281; 95% CI: 1.143–4.553)] and [(OR: 5.523; 95% CI: 2.269–13.441)], respectively.ConclusionsThe prevalence of ECC in preschool children in Riyadh is high and affected by parental socioeconomic factors, infant feeding practices, and children’s oral hygiene status.     

Evaluation of the relationship between severe early childhood caries and vitamin D

ObjectiveTo evaluate the relationship between the factors affecting the formation of severe early childhood caries (S-ECC) in preschool children, dental caries and serum 25-hydroxyvitamin D (25(OH)D) and to contribute to the literature on this subject.MethodsASA I-II children aged <72 months and their volunteer parents who had no apparent learning disability were included in the study. 25(OH)D, calcium and albumin levels were measured from the serum samples taken from the children. Dft, dfs and plaque scores were calculated after the oral examination of the children. Parents were asked to fill out a questionnaire assessing the child's dietary habits and family demographics.ResultsTotal of 175 children (56% male) participating in the study (n = 98; ECC, n = 77; caries-free). S-ECC was present in 42.8% of children with adequate 25(OH)D levels and 63.4% of children with deficient or insufficient levels. Children with S-ECC had significantly lower mean 25(OH)D levels than those caries-free. A very weak negative correlation was detected between 25(OH)D level and dft score.ConclusionsIt was difficult to confirm the relationship between 25(OH)D levels and S-ECC. Again, there was a weak correlation between the dft score and 25(OH)D levels.     

Surveillance of primary dentition caries in Germiston, South Africa, 1981-97

OBJECTIVE: This 17-year-long study examined trends of dental caries rates in the primary dentition of 6843 preschool children in a South African city. METHODS: Calibrated dentists did repeated cross-sectional epidemiological surveys of dental caries in 2- to 5-year-old nursery school children using WHO diagnostic criteria between 1981 and 1997. RESULTS: Both the percentage of children with dmft>0 and mean dmft increased between 1981 and 1989 and have slowly declined ever since in the absence of organised prevention to produce a secular trend of decreasing caries rates. The dt/dmft percentage ranged between 60% and 100% except in 1991 when it dropped to 40% and the ft/dmft percentage component rose proportionally, probably due to an economic effect. CONCLUSIONS: The percentage of children with dmft>0 and mean dmft decreased over the study period at all ages, the reason for which is unknown but is speculated to be due to a change in mutans streptococci strains.     

四川省6岁儿童乳恒牙患龋状况及相关性研究

目的了解四川省6岁儿童患龋情况,探讨乳磨牙患龋与第一恒磨牙患龋之间的相关性。方法参照第三次全国口腔健康流行病学抽样调查方案,在四川省3个城市、3个农村随机抽样选取调查点,共调查714名6岁儿童的患龋情况,并分析乳磨牙患龋情况与第一恒磨牙患龋情况之间的相关性。结果四川省6岁儿童乳牙患龋率为74.37%,龋均为3.94±3.93,龋齿充填率为4.96%。乳牙患龋率和龋均在男性和女性、城市和农村儿童间无统计学差异（P>0.05）,城市乳牙龋齿充填率高于农村（P<0.05）。已萌的第一恒磨牙中有2.98%患龋,充填率为7.69%。乳磨牙患龋是第一恒磨牙患龋的危险因素[P=0.001,r=0.175,OR=5.756,95%CI（1.733,19.121）],乳磨牙与第一恒磨牙的龋均呈弱相关（P<0.001,r=0.194）。结论四川省6岁儿童乳牙患龋情况较重,乳磨牙龋坏可作为临床及预防工作中预测第一恒磨牙龋坏的因素之一。     

先天性心脏病儿童龋齿患病情况及相关因素研究

目的研究先心病儿童龋病患病情况并分析其影响因素。方法选取北京安贞医院小儿心脏病房100例2~15岁先心病儿童进行患龋状况调查并对其进行问卷调查,收回有效问卷100份,统计分析龋齿与其影响因素间的关系。结果先心病儿童乳牙列及混合牙列期龋患率为57.6%和54.2%,5岁组龋均为3.94,非青紫型儿童龋失补牙数大于青紫型儿童（P=0.014）。结论与第三次全国口腔健康流行病学调查结果相比,先心病儿童乳牙列及混合牙列期龋患率高,龋齿充填率低。进食含糖类食品频率低的儿童龋齿发病率低,受教育水平高的父母孩子口内的龋齿少。     

Dental caries and dental registration status in nursery school children in Newry, Northern Ireland

Abstract 294 children aged 2–4 yr attending nursery schools in Northern Ireland were examined for dental caries and dental registration status under the capitation system in general dental practice. Their mean age was 3 yr 10 months. Sixty eight per cent were caries free, mean dmft was 1.10 and dt, mt and ft scores were 0.74, 0.28 and 0.09, respectively. With increasing age the prevalence of caries increased, though the very low care index (d/dmft) did improve in the older children. Seventy per cent reported being registered for dental care and their levels of dental caries were significantly higher than those who were not yet enrolled (P < 0.001). For those not enrolled for dental care the main perceived barriers to seeking care related to lack of symptoms (33.6%) and apathy (31.6%) while few reported fear as a barrier (4.5%).