Children's dental health: British expatriate residents in Tokyo, Japan

AIM: To identify in expatriate British parents resident in Tokyo, Japan, their levels of dental health knowledge, patterns of dental health behaviour, and caries status of their children compared to Japanese children. METHODS: 223 parents with children at one school were asked to complete a structured questionnaire. Data were collected on: parental knowledge and behaviours with respect to caries prevention, and sweet consumption of the children. The caries status of the children was established by a clinical examination, using standard criteria. RESULTS: The questionnaire response rate was 66.8%. The mean age of the children was 7.6 years (range 3-11 years). The responses related to 51 British, 21 Japanese, and 20 children who had British and Japanese mixed parents. 33% of British and none of Japanese children had sweet foods frequently. Fluoridated toothpaste was used by 67% of British and 10% of Japanese children. British parents knew about dental caries more than Japanese. 13% of British and 38% of Japanese children were found in the higher caries experience group. CONCLUSION: Parental access to information in the UK and to fluoridated toothpaste in Japan could have helped to prevent dental caries in these expatriate British children.     

Oral health status of homeless people in Hong Kong

The authors report on an oral health survey among Hong Kong Chinese homeless people. A total of 140 homeless men underwent clinical examination and were interviewed with a structured questionnaire. More than 90% had evidence of caries experience; most (75%) were related to untreated caries. The mean DMFT score was 9.0 (DT=3.2, MT=5.2. FT=0.6). Periodontal disease was highly prevalent, with 96% having periodontal pockets. The dental problems most frequently reported by the homeless were: bleeding gums or drifting teeth (62%), dental pain (52%) and tooth trauma (38%). More than 70% of the study's participants perceived a need for dental care. The population surveyed had poorer oral health compared to the general population. High levels of dental needs, both normative and perceived, were found. There is a need to provide more accessible and affordable oral health services to this group of people.     

Pre-school child oral health in rural Western Australia

BACKGROUND: In light of the various challenges faced by public dental health services, especially when large geographical areas and isolated communities are concerned, targeting of high risk groups within these populations needs to be investigated. This study aimed to assess caries experience, dental health behaviour and dental service utilization among a sample of pre-school children in a rural community in Western Australia. METHODS: The study was a cross-sectional oral health survey of pre-school children between the ages of 2 and 5 in Carnarvon, Western Australia. RESULTS: In total, 70 pre-school children (representing approximately 15 per cent of the total 2-5 year old population of Carnarvon) were examined. Less than half of the children were caries free. Both caries prevalence and severity (mean dmft) were significantly higher among Aboriginal children than non-Aboriginal children. Caries prevalence and severity were also significantly higher among children who often consumed carbonated drinks. CONCLUSIONS: This survey indicates that some pre-school children in rural areas, and especially Aboriginal pre-school children, are at high risk of developing dental caries. Effective oral health programmes commencing well before the usual first contact with dental services at age 5 are needed for young children at high risk of dental caries.     

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目的了解辽宁省沈阳市铁西区3岁儿童口腔健康行为和口腔健康状况,从而为制定相应的龋齿预防措施提供参考。方法通过临床检查与问卷调查相结合的方式,于2011年11月至2012年2月对随机抽取的沈阳市铁西区10所幼儿园共计473名3岁儿童进行龋病流行病学调查,并对结果进行分析。临床检查参照世界卫生组织口腔健康调查标准。结果本次共抽样调查3岁儿童473人,其中患龋者236人,占调查总人数49.9%。被调查儿童龋面均(DMFS)为3.53。最易患龋的牙面为上颌中切牙近中面。Logistic回归分析显示:儿童缩短使用奶瓶时间和家长协助儿童刷牙可有效降低牙齿患龋率。结论沈阳市铁西区3岁儿童患龋率较高,充填率低。建议加大该区口腔教育宣传,推广牙病防治适宜技术,减少儿童口腔疾病的发生。     

上海市5岁本地和外来儿童患龋状况和口腔健康行为的调查

目的分析上海市5岁本地和外来儿童患龋状况和口腔健康行为的差异,为设计口腔卫生服务项目和相关政策制订提供信息支持。方法采用分层等容量随机抽样方法,调查上海市共575名5岁儿童口腔健康状况,并对家长进行相关问卷调查。结果 5岁乳牙患龋率为65.74%,龋均为3.35,本地儿童明显低于外来儿童(P<0.05)。5岁儿童龋失补充填构成比为12.57%,本地和外来儿童有显著差异(P<0.01)。外来儿童睡前进食甜食的比例高于本地儿童(P<0.05)。外来儿童每天刷牙2次及以上的仅占19.44%,明显低于本地儿童(P<0.01)。从没看过牙的外来儿童比例比本地儿童更高(P<0.01)。结论上海外来儿童患龋状况和口腔健康行为均比本地儿童差,未来需加强对外来儿童的口腔保健力度,有针对性地采取防治措施及健康教育,提高儿童口腔健康整体水平。     

北京永定路社区居民口腔卫生服务需要和利用调查

目的了解北京社区居民口腔医疗需要和口腔卫生服务资源利用现况,为推动社区居民口腔医疗保健服务提供参考。方法以世界卫生组织口腔健康调查基本方法为标准,采用随机等比抽样调查方法,对北京永定路社区2 000名居民进行口腔健康检查和问卷调查,了解其口腔医疗需要情况及口腔卫生服务资源利用情况。结果共计1 845人的口腔健康调查表符合要求。其中254人(13.77%)不需要口腔医疗,864人(46.83%)需要择期口腔医疗,715人(38.75%)需要及早口腔医疗,12人(0.65%)需要紧急口腔医疗。社区居民1年内就诊率为39.73%。就诊选择国营口腔专科医院的占37.02%,选择私营口腔诊所的占35.88%。结论社区居民的口腔医疗需求普遍,口腔医疗保健任务艰巨,应加强社区口腔疾病预防控制工作。     

Dental caries status and treatment needs of the permanent dentition of 6–12-year-olds in Hong Kong

An oral health survey was conducted in 1986 on a representative sample of primary school children in Hong Kong. 1483 Chinese children of both sexes, aged 6-12 yr, attending 56 primary schools were surveyed. The DMFT index for the 6-yr-olds was 0.1, and for the 12-yr-olds it was 1.5. Forty percent of the 12-yr-olds were clinically caries-free. The permanent molars constituted 90% of the total caries experience of the 12-yr-olds. Over 90% of the caries lesions were found in pits and fissures. The dental caries treatment need in the permanent dentition was low and of the simple type. A great reduction in the dental caries experience of the permanent dentition of children has occurred since the introduction of water fluoridation 25 yr ago. In addition to treatment care, preventive measures should be provided by the School Dental Care Service for children with a high caries risk.     

儿童乳牙患龋状况及其家庭口腔健康行为的差异

目的研究家庭口腔健康行为对辽宁省城乡儿童乳牙患龋状况的影响。方法采用多阶段、分层、等容量、随机抽样的方法,运用世界卫生组织《口腔健康调查基本方法》诊断标准对辽宁省城乡792名5岁儿童进行乳牙龋病检查,并随机抽取50%受检者的家长进行问卷调查。结果1）辽宁省5岁儿童乳牙患龋率为73.86%,龋均（dmft）为4.38;其中城市儿童乳牙患龋率为64.14%,农村儿童乳牙患龋率为83.59%,城乡之间儿童乳牙患龋率具有统计学差异（P<0.01）。2）口腔健康行为分析表明,农村儿童进食糖果、巧克力、糖水、碳酸饮料、果汁等的频率高于城市。城市儿童开始刷牙时间、频率、用含氟牙膏的比例均高于农村。城市家长普遍学历高,收入多,儿童定期检查和采取预防措施的人数高于农村。结论辽宁省,尤其是农村地区应加强对家庭口腔健康行为的教育。     

Oral health of young children in Mississippi Delta child care centers: a second look at early childhood caries risk assessment

Objectives: To identify the predictors of early childhood caries and urgent dental treatment need among primarily African‐American children in child care centers in the Delta region of Mississippi. The purpose of this study was to replicate predictors of caries and urgent dental treatment needs that were identified in an earlier study conducted in Delta child care centers and to assess additional caries risk factors not collected in the original study. Methods: Children in 19 child care centers were examined by the dentists, and the parents provided data on oral health practices, oral health history, and on children's oral health‐related quality of life (QOL). The dentists also assessed visible plaque and tested levels of mutans streptococci. Predictors of caries and treatment need among children 24 to 71 months of age were examined using logistic regression. Results: Two parent predictors of caries identified in the earlier study (parent flossing and soft/sugary drink consumption) were not predictive in the current study. Parent history of abscess continued to predict their child's urgent need for treatment. Young children's level of salivary mutans streptococci, maxillary incisor visible plaque, and parents' reports of child oral health‐related QOL measures predicted the presence of both caries and urgent treatment need. Some expected predictors, such as frequency of child's toothbrushing, were not predictive of caries. Conclusions: Parental abscess and parent's report of the child's oral health‐related QOL are risk indicators for poor oral health outcomes that could be used by nondental personnel to identify young children in need of early preventive intervention and dental referral.     

Guttman scale analysis of dental health attitudes and knowledge

Indexes on attitudes and knowledge are very often used in community dentistry research. However, such indexes are seldom evaluated with respect to validity. In the social sciences, complicated and advanced scaling methods are widely used. One of the methods, The Guttman scaling, is a means of analyzing the underlying characteristics of several items in order to determine whether the scale is unidimensional and cumulative. The purpose of the present study was to develop and evaluate two Guttman scales: 1) attitudes to prevention of dental diseases and 2) knowledge about sugar and caries. The scales were evaluated on the basis of survey data on health behavior, dental attitudes and knowledge among parents of Danish children 6 years of age. A total of 193 parents (71% of original sample) responded to a postal questionnaire including questions on attitudes to prevention of dental diseases and knowledge about sugar and caries. In the analyses, the scales were evaluated according to standard criteria of scalability: Coefficient of Reproducibility, Minimal Marginal Reproducibility, and Coefficient of Scalability. The analyses showed that unidimensional and cumulative scale was indicated for attitudes to prevention while the scale on knowledge about sugar and caries failed on the criteria of validity. In community dentistry, future studies ought to be more concerned with the construction and testing of scaling models in order to provide valid analyses of dental health attitudes and knowledge.     

重庆市主城区学龄前儿童患龋情况及口腔卫生服务需要、利用情况和影响因素的研究

目的 对重庆市主城区学龄前儿童口腔健康状况及其口腔卫生服务的需要和口腔卫生服务实际利用情况进行调查,分析其可能的影响因素,为重庆地区有针对性开展学龄前儿童口腔预防保健工作提供参考。方法 参考第四次全国口腔健康流行病学调查实施方案,采用整群随机抽样的方法抽取主城9区中的3区12个街道24所幼儿园共1 300名3~4岁儿童进行口腔检查,并根据安德森卫生服务利用行为模型设计调查问卷并发放给家长填写。对口腔卫生服务利用情况采用卡方检验和logistic逐步回归分析。结果 重庆市主城区学龄前儿童患龋率为55.4%,龋失补牙面数为6 696,龋面均为5.2,龋齿充填构成比为2.3%。有效问卷共1 173份,结果显示过去1年治疗性口腔就诊率为6.31%（74/1 173）,预防性口腔就诊率为22.93%（269/1 173）。照顾者的受教育程度、受口腔问题困扰、每天何时刷牙和过去1年牙疼史为口腔就诊率的影响因素。结论 重庆市学龄前儿童的口腔卫生服务需要仍普遍,口腔卫生服务利用不足,口腔医疗保健任务仍然十分艰巨,应进一步制定有针对性的口腔预防政策。     

城乡3～5岁儿童家庭口腔健康行为与乳牙患龋状况对比观察

目的：探讨城乡3～5岁儿童家庭口腔健康行为与乳牙患龋状况的相关性。方法：采用多阶段、分层、随机抽样的方法,在北京、吉林4个地区幼儿园（城乡各2个）抽取3～5岁儿童共512例,城市儿童268人,农村儿童244人进行乳牙龋病检查,并对受检者的家长进行家庭口腔健康行为问卷。结果：①3～5岁儿童乳牙患龋率为71.23%,龋均4.16;城市儿童乳牙患龋率62.26%,农村81.41%,城乡儿童之间乳牙患龋率具有统计学差异（P〈0.01）。②农村儿童进食甜点心、碳酸饮料、果汁、糖果/巧克力等的频率高于城市。城市儿童开始刷牙时间、频率、用含氟牙膏的比例高于农村。城市家长对儿童定期检查和采取预防措施的人数高于农村。结论：加强对农村儿童家庭口腔健康行为的教育至关重要。     

Caries experience in the primary dentition among French 6-year-olds between 1991 and 2000

BACKGROUND: There are few national caries preventive policies for children in France. Various surveys suggest that in the late 1980s, oral health of the 6-year olds in France was poorer than in those of other European countries. In Val de Marne (a Department just east of Paris) a public dental service was established in 1991. A programme to inform preschool staff about dental diseases was commenced and volunteers brought oral health information to parents and health professionals. Periodical monitoring of primary tooth caries of 6-year olds was planned. AIM: The aim of the study was to evaluate changes in primary tooth caries in 6-year olds over the 10 years of the programme. METHODS: Participating 6-year olds, randomly selected, were examined in schools by dentists. Clinical data were collected (WHO criteria). Sociodemographic data were collected through questionnaire. Statistical analysis involved comparison of mean values, variance analysis and chi-square test for categorical variables. RESULTS: The proportions of children with caries experience were, 38.9%, 30.6% and 22.2% in 1991, 1995 and 2000 respectively (P < 0.01). The dft index decreased from 1.74 to 1.39 and 1.05 respectively. About 75% of children with dental caries remained untreated. Children of non-European native parents or belonging to low socioeconomic families remained those most affected by dental caries in 2000. CONCLUSION: Dental caries in 6-year olds improved between 1991 and 2000 in Val de Marne but caries remained a socially inequitable disease. Most children did not have access to dental care. The situation requires changes to the dental care provision system.     

东莞市12岁儿童龋病现状及其行为影响因素分析

目的:研究东莞市城乡12岁儿童恒牙龋病现状及其行为影响因素,分析两者之间的关系,为东莞市儿童口腔卫生保健工作提供科学依据。方法:采用多阶段、分层、整群、随机抽样的方法,抽取东莞市12岁城乡常住人口604人,检查全口恒牙龋病的患病状况并用问卷调查的方式收集全部受检儿童口腔健康行为等相关因素。结果:东莞市12岁儿童患龋率和龋均分别是40.89%和1.47。Logistic回归分析显示:口腔保健知识掌握越多的儿童其患龋率越低,食用水果的频率越高,儿童患龋率也相应增加。结论:东莞市12岁儿童患龋水平较高,口腔卫生行为较差,口腔保健知识掌握情况是致龋最为重要的影响因素,食用水果的频率是危险因素。     

Oral health status of mississippi delta 3- to 5-year-olds in child care: an exploratory study of dental health status and risk factors for dental disease and treatment needs

OBJECTIVES: For poor and minority young children, disparities exist in dental health and treatment. In rural impoverished areas, institutions that reach young children and potentially offer access to care are limited. In the current Mississippi Delta study, child care centers were examined as potential venues for oral health intervention and research, and potential risk factors for dental caries and treatment urgency in high-risk preschool children were explored. METHODS: Child care centers were selected and attending children recruited. Data on oral health practices were collected from surveys of center directors and parents/caregivers. Children were examined for caries and treatment urgency at centers by dentists. Bivariate and multivariate analyses with a 0. 05 alpha were used to examine data. RESULTS: A total of 346 preschool children at 15 participating centers were examined: 46% were female, 68% minority. Minority children and those with public insurance were more than twice as likely to have caries and urgent treatment needs as non-minorities or those with private insurance. The odds of children having caries were half as great if parents reported using floss and nearly twice as great if the parent had experienced a dental abscess. For every soft drink the parent consumed daily, the odds of dental caries for children increased by 44%. CONCLUSIONS: Conducting oral health exams and research in child care venues was possible, yet presented challenges. The combined use of two parental variables, reported soft drink consumption and abscess history, appears promising for caries prediction. Implementation of oral health programs and research in child care venues merits further exploration.     

Characteristics of publicly insured children with high dental expenses

BACKGROUND: Dental coverage is provided for all children with Medicaid in Washington State. The goal of this study was to illuminate the characteristics of a sample of Medicaid-enrolled children with high dental expenses. METHODS: Dental care utilization data for a 33-month period were obtained from Washington State's Medicaid database. For children, 0 to 6 years, these data were linked with a parent survey addressing oral health behaviors, knowledge, family history of caries, snacking patterns, and access to dental care. Children with dental expenses of $1,000 or more were classified as the "high-expense" group. Risk factors for the high-expense group were evaluated using multiple logistic regression. RESULTS: 345 children had at least one dental procedure including preventive and diagnostic care. Among these, 30 children (9 percent) incurred 64 percent of total dental expenses for the entire group. Parent perception of lack of dental coverage was associated with incurring high dental expenses. Children of Asian or Pacific Islander heritage were at disproportionately high risk compared to White children. Age of child and family history of caries were also associated with increased risk for high expenses. CONCLUSIONS: Not all low-income children on Medicaid are at high risk for caries. A combination of factors, including family history of caries and parent's perception of lack of dental insurance coverage, can potentially increase a child's likelihood for high-expense dental treatment. This study highlighted a small group of children with disproportionately high dental expenses. For some, earlier knowledge of coverage may have resulted in more timely access to preventive and diagnostic care, reducing the subsequent need for expensive restorative treatment.