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。     

低龄儿童龋与其相关致病菌的研究进展

低龄儿童龋(ECC)是一种早期累及幼儿上颌乳前牙的严重龋损,预防其发生发展是世界卫生组织在全球范围内进行龋病预防的重要工作。致龋菌在ECC发生中起主要作用,其中变异链球菌是ECC重要的致病菌,研究主要集中在该类微生物的定植、传播和基因型;放线菌和乳杆菌是ECC儿童口腔的优势菌群,白色假丝酵母菌和双歧杆菌在儿童口腔的定植...     

上海市浦东新区低龄儿童龋危险因素分析

目的：建立幼儿园儿童的前瞻性队列,纵向研究低龄儿童龋的发病原因。方法：采用整群随机抽样方法,在上海市浦东新区城郊各抽取1所幼儿园,共240名小班儿童加入本研究。采用SPSS 21.0软件包中的χ²检验、方差分析、二项logistic回归模型和一般线性回归模型,对该队列儿童基线及随访1年后的龋患情况进行分析。结果：该队列研究前2年随访率为88.3%,基线和随访第1年儿童患龋率分别为58.3%,69.8%,龋均分别为3.1±4.2、4.5±4.9,56.1%的儿童发生新龋。Logistic回归分析显示,居住在郊区（P=0.010）和吃糖果频率较高（P=0.036）的儿童,新发龋率较高。一般线性回归方程结果显示,郊区儿童（P<0.001）,未使用含氟牙膏（P=0.003）以及吃糖果频率较高（P=0.002）的儿童,新发龋均较高。结论：居住在郊区、未使用含氟牙膏以及进食糖果频率较高,是学龄前儿童新发龋的重要危险因素。     

一例低龄儿童龋的综合防治

低龄儿童龋（early childhood caries,ECC）包含两个主要因素,一个是年龄,即小于6岁的儿童,另外一个是任何一个乳牙的龋（无论是否成为龋洞）、失（因龋所致）、补牙数/牙面数≥1。做好ECC的早期预防,是儿童口腔保健的重要组成部分,对于ECC的综合治疗,结合儿童的生长发育特点,目的是使得患儿患龋高风险的口腔卫生状况得到有效的改善,从而恢复其口腔健康微生态,控制龋病进展和恢复牙齿的结构与功能。本文报道一例低龄儿童龋的综合防治。     

低龄儿童龋患儿中医体质分型初探

目的探索低龄儿童龋患儿的中医体质分型特点。方法依据儿童中医体质分类将232例低龄儿童龋患儿分为7种体质类型。结果心火偏旺质及热滞质患儿的患龋牙数明显多于其他体质患儿的患龋牙数,心火偏旺质患儿多易发生高龋,热滞质患儿多易发生低龋及中龋,并且心火偏旺质患儿龋坏牙数主要集中发生在上颌前段和下颌后段,而其他体质患儿的龋坏牙数则主要出现在上颌后段和下颌后段。结论低龄儿童龋患儿体质分型特点值得临床上关注,并采取相应的预防措施。     

低龄儿童龋微生物群落的研究进展

低龄儿童龋（ECC）的发生发展不仅仅是某几种特定致龋菌作用的结果,而是与整个口腔微生物群落的变化有关。在健康的生理状况下,口腔微生物群与宿主间保持着一种动态平衡,共同维系宿主的健康;若这种平衡若遭到破坏,口腔内某些健康的微生物将转变成致病微生物,导致龋病、牙周病和黏膜病等口腔感染性疾病。个体与个体之间,同一个体唾液和牙菌斑之间,微生物种群明显不同。无龋儿童的细菌多样性和复杂性高于重症低龄龋（SECC）儿童,而SECC儿童在龋发生前微生物多样性呈下降趋势,即龋病可能与微生物多样性降低相关。ECC儿童在治疗前后,其微生物群落构成会发生明显改变。益生菌可抑制致龋菌的活性,降低患龋率。了解口腔微生物菌群组的结构和组成,建立不同患龋风险儿童的微生物图谱,控制与管理儿童口腔微生态,ECC的防治将会呈现出一片曙光。     

母亲孕期及产后口腔行为干预对低龄儿童患龋影响的研究

目的 评价对母亲孕期及产后口腔行为干预控制低龄儿童龋发生的有效性.方法 选取110名妊娠期4~9月的孕妇及其所生孩子为干预对象,分别在孕期、儿童1岁时和2岁时3个阶段对其进行个性化口腔健康指导,每隔6个月定期回访,记录儿童牙齿萌出情况、患龋情况和早期龋的发生,并对儿童饮食喂养习惯进行问卷调查.对照组是选择月龄为11 ~14月的母子为研究对象,每隔6个月定期回访,进行口腔检查和问卷调查.结果 经过2年纵向观察,干预组儿童1岁时和2岁时失访率分别为2.7%和12.7%,而对照组儿童2岁时失访率为10.0%.干预组儿童1岁时龋齿发病率为0.9%,龋均为0.02,其中早期龋发病率为1.9%,均显著低于对照组儿童;2岁时儿童龋齿发病率为3.1%,龋均为0.07,其中早期龋发病率为6.3%,均显著低于对照组儿童.2岁时儿童问卷调查结果显示,6个月开始刷牙、1岁前断奶、吃甜食频率、饮水频率以及是否含奶瓶入睡习惯与龋齿发生有重要关系,其中吃甜食频率影响最强.经卡方检验,干预组与对照组之间均有显著差异(P<0.05).结论 通过对母亲孕期及产后进行长期的口腔健康行为干预,降低了低龄儿童龋的发生率,改善了母亲对婴幼儿的饮食喂养习惯和口腔护理行为,同时高频摄取甜食是儿童患龋的重要易感因素.     

农村儿童乳牙龋与部分危险因素的相关分析

目的作为农村社区项目开展前的部分基线资料，分析安徽和陕西农村1～6岁儿童乳牙患龋状况．龋病与儿童年龄、家庭环境、口腔卫生习惯等因素间的关系。方法随机抽取两地1～6岁儿童1129名进行患龋状况调查，对其中二分之一的儿童家长进行问卷调查，有效问卷399份，统计分析110名患龋儿童和238名无龋儿童间部分患龋危险因素的差异。结果儿童乳牙患龋率45．4％，龋均2．01，其中5岁年龄组患龋率66％，龋均3.28。除年龄因素外，影响儿童患龋的主要因素还有家长的受教育程度，一年内是否就医，及是否能在当地商店买到牙膏牙刷等。结论安徽和陕西农村儿童患龋状况低于全国平均水平。年龄越大，家长受教育程度越低，一年内曾经就医和不能在当地商店买到牙膏牙刷的儿童龋易感性较高。     

母亲患龋风险对儿童龋易感性的影响

目的: 评价母亲孕期患龋风险对婴幼儿龋易感性的影响,为有效控制和预防低龄儿童龋的发生和发展提供依据。方法: 从北京市西城和密云区妇幼保健院选择140名妊娠4~9个月的孕妇及婴幼儿作为研究对象,采用WHO 2013年龋病诊断标准,进行口腔检查、问卷调查并收集母亲刺激性唾液样本,应用Dentocult SM、Dentocule LB和Dentobuff Strip标准试剂盒进行龋活性检测。在婴儿出生后6个月、1岁和2岁时,采用ICDAS II龋齿诊断为标准记录儿童患龋情况。收集婴幼儿静息唾液样本,应用巢式PCR检查6个月、1岁和2岁婴儿变异链球菌（S.mutans）的定植情况。采用SPSS 21.0软件包对数据进行统计学分析。结果: 经过2年观察,失访率 11.43% ,共有124对母子（女）完成随访观察。根据母亲开放龋洞（即未经治疗龋洞）数、Dentocult SM法检测变异链球菌、Dentocule LB法检测乳酸杆菌、Dentbuff Strip法检测唾液缓冲能力及问卷调查结果,将母亲分为中、低龋风险（LCR）组和高龋风险（HCR）组。HCR组1岁儿童非洞龋患龋率（18.33%）和龋均（0.3±0.087）显著高于LCR组患龋率（3.13%）和龋均（0.06±0.044）（P<0.05）,HCR组2岁儿童成非洞龋患龋率（21.67%）和龋均（0.33±0.088）显著高于LCR组患龋率（6.25%）和龋均（0.09±0.048）（P<0.05）,HCR组2岁儿童成洞龋患龋率（20.00%）和龋均（0.33±0.10）显著高于LCR组患龋率（6.25%）和龋均（0.11±0.055）（P<0.05）。HCR组儿童6个月、1岁、2岁时S.mutans检出率显著高于LCR组（P<0.05）。6个月检出S.mutans的儿童,2岁时患龋率（29.62%）和龋均（0.67±0.22）显著高于未检出儿童的患龋率（13.40%）和龋均（0.30±0.082）（P<0.05）。结论: 经2年观察,高龋风险的母亲,其儿童龋易感性相应升高。母亲高龋风险在一定程度上影响儿童口腔内S.mutans定植;S.mutans定植时间越早的婴幼儿,2岁时患龋风险相应增加。建议通过对高龋风险母亲进行孕期早期口腔健康行为干预,阻断或延缓S.mutans垂直传播,有效预防和减少ECC发生、发展。     

北京市1～4岁儿童龋流行情况调查及其危险因素的初步研究

目的 调查婴幼儿龋流行情况及其相关因素的分析以利于早期防治。方法 对北京市海淀、丰台8所幼儿园408名1～4岁儿童，女195名，男213名，通过口腔检查龋齿及详细问卷调查，最后分别作统计分析及Logistic回归分析。结果 本研究婴幼儿龋患病率为40．19％，男性45．07％，女性34．87％，两性间有显著差异。各年龄组间患病率也有显著性差异。婴幼儿龋和乳磨牙龋的发生密切相关，Logistic回归分析结果显示，婴幼儿龋发生的危险因素依次为睡前哺乳，年龄，母亲受教育的程度，每天吃甜食及含糖饮料的次数，哺乳持续时间，刷牙的频率，均有相关性。针对婴幼儿龋的危险因素予以早期防治。结论 强调对双亲早期教育，尽早地去看口腔医生及局部用氟极为重要。     

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.     

婴幼儿龋病相关因素的初步研究

目的 :了解我国婴幼儿龋病发病的相关因素。方法 :对沈阳市 1860名 8～ 3 6个月的儿童进行患龋情况检查。随机抽取婴幼儿龋组和无龋组各 12 0对母子进行问卷调查及口腔卫生检查。结果 :母亲的文化水平、DMFT及菌斑产酸能力对婴幼儿龋病有影响 (P <0 .0 1) ;婴幼儿期喂养方式与婴幼儿龋病无明显关系 (P >0 .0 5 ) ;断奶时间、含奶瓶或乳头睡觉习惯、甜食习惯与婴幼儿龋病的发生有关系 (P <0 .0 5 ) ;婴幼儿口腔卫生与婴幼儿龋病的发生有关系 (P <0 .0 0 1)。结论 :为了预防婴幼儿龋病应提高母亲素质、宣传正确的饮食方式及注意婴幼儿口腔卫生。     

婴幼儿龋危险因素的研究近况

婴幼儿龋发病年龄低，可以波及多个乳牙引起广泛龋损，不仅严重的影响了患儿的健康，并且给治疗带来很大难度。本文就国内外近期对婴幼儿龋发病危险因素的研究进行了综述：①喂养方式；②环境因素；③细菌因素。     

Early childhood caries: prevalence and risk factors in Seoul,Korea

OBJECTIVE: The purpose of this study was to determine the prevalence of early childhood caries (ECC), including noncavitated lesions (d1), in children 6-59 months of age in relation to socioeconomic factors, feeding practices, and oral health behaviors in Seoul, Korea. METHODS: The children attended child care facilities and were selected from 32 primary sampling units. Two dentists examined 470 children. Parents of 383 of the subjects were interviewed by phone regarding caries risk factors. RESULTS: For children 6-59 months of age, the prevalence of ECC and severe ECC were 56.5 percent and 47.0 percent respectively. In bivariate analysis, the children whose nursing bottle contained sweetened solution had higher severe ECC prevalence (P=.035), and children whose parents reported a lower frequency of between-meal snacks showed lower ECC prevalence (P=.046). By logistic regression analysis, age and frequency of between-meal snacks were associated with the prevalence of ECC (P<.05). CONCLUSION: This study demonstrates that the prevalence of ECC was high among children in Seoul. Early educational intervention programs for pregnant women and mothers of young children should be developed based on the risk factors identified in this study.     

Validity of caries risk assessment programmes in preschool children

Objectives

Various programmes have been developed for caries risk assessment (CRA). Nevertheless, scientific evidence on their validity is lacking. This study aimed to compare the validity of 4 CRA programmes (CAT, CAMBRA, Cariogram, and NUS-CRA) in predicting early childhood caries.

Methods

A total of 544 children aged 3 years underwent oral examination and biological tests (saliva flow rate, salivary buffering capacity and abundance of cariogenic bacteria mutans Streptococci and Lactobacilli). Their parents completed a questionnaire. Children's caries risk was predicted using the 4 study programmes without biological tests (screening mode) and with biological tests (comprehensive mode). After 12 months, caries increment in 485 (89%) children was recorded and compared with the baseline risk predictions.

Results

Reasoning-based programmes (CAT and CAMBRA screening) had high sensitivity (≥93.8%) but low specificity (≤43.6%) in predicting caries in children. CAMBRA comprehensive assessment reached a better balance (sensitivity/specificity of 83.7%/62.9%). Algorithm-based programmes (Cariogram and NUS-CRA) generated better predictions. The sensitivity/specificity of NUS-CRA screening and comprehensive models were 73.6%/84.7% and 78.1%/85.3%, respectively, higher than those of the Cariogram screening (62.9%/77.9%) and comprehensive assessment (64.6%/78.5%). NUS-CRA comprehensive model met the criteria for a useful CRA tool (sensitivity + specificity ≥ 160%), while its screening model approached that target.

Conclusions

Our results supported algorithm-based approach of caries risk modelling and the usefulness of NUS-CRA in identifying children susceptible to caries.

Clinical significance

This prospective study provided evidence for practitioners to select tools for assessing children's caries risk, so that prevention measures can be tailored and treatment plan can be optimised.     

上海市2岁幼儿龋病现状和危险因素的初步分析

目的调查分析上海市2岁幼儿龋病患病现状及其危险因素,为上海市幼儿龋病的早期防治提供依据。方法采用多阶段随机抽样方法抽取上海市576名2岁幼儿进行龋病检查和相关饮食喂养习惯的问卷调查,并对结果进行统计学分析。结果上海市576名2岁幼儿乳牙患龋率为18.40%,龋均为0.61,龋面均为0.84。高频率摄取甜食和非定时喂养是幼儿龋病发生的重要危险因素。结论对家长进行早期口腔健康教育,养成合理的饮食喂养习惯是预防幼儿龋病的重要措施。     

Caries-risk assessment in early childhood using a caries activity test

BackgroundCaries-risk assessment based on the individual caries-risk is very important in the public health setting. The objective was to longitudinally assess the caries-risk of each group using cutoff points. Each groups were low, moderate, progressive border, improved border, moderately high, and high caries-risk groups which were determined based on the 18-month and 2-year-old current and 3.5-year-old predicted cutoff points.MethodsThis study was a two-year longitudinal study of 1,206 children born in 2000. The children were divided into six caries-risk groups using the current and 3.5-year-old predicted cutoff points at 18 months and 2 years of age. It was investigated as to which caries-risk assessment was better.ResultsThe 3.5-year-old predicted cutoff points calculated based on the 18-month and 2-year-old caries activities were more suitable for caries-risk assessment through analysis of significant differences of the mean numbers of dft in each groups.ConclusionIt was suggested that researchers and practitioners should try to keep caries-risk of children in the low or moderate caries-risk groups for caries prevention.