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。     

维生素D水平与低龄儿童龋风险的相关性分析

目的探讨维生素D水平与低龄儿童龋(early childhood caries,ECC)发生风险的相关性分析,为ECC儿童的一级预防提供依据。方法收集389名6~48月龄儿童的月龄、喂养方式、口腔健康行为等资料,记录龋、失、补指数(decayed?missing?filled teeth,dmft),分为ECC组(n=146)和无龋组(n=243),采集指尖末梢血检测维生素D体内活性形式--25?羟维生素D[25(OH)D],采集牙菌斑行龋活跃性检验检测龋态(Cariostat)值,Logistic回归分析25(OH)D等龋相关因素与ECC发生风险的相关性。结果25(OH)D缺乏、不足、正常的儿童的患龋率差异无统计学意义(c2=2.320,P=0.313)。dmft与25(OH)D水平之间无相关(dmft=1~3,r<0.001,P>0.05;dmft>3,r=0.009,P>0.05)。而月龄(OR=1.082,95%CI:1.045~1.121,P<0.001)、出生后6个月内母乳喂养(OR=2.789,95%CI:1.581~4.921,P<0.001)、吃夜奶或含乳头睡(OR=4.187,95%CI:1.938~9.048,P<0.001)、1.5~3.0的高Cariostat值(OR=4.173,95%CI:2.014~8.646,P<0.001)是ECC的风险因素。结论25(OH)D水平与6~48月龄儿童龋无相关性,而月龄、出生后6个月内母乳喂养、吃夜奶或含乳头睡、高龋活跃性(Cariostat值1.5~3.0)是ECC的风险因素,提倡母乳喂养的同时,应为幼儿树立良好的喂养习惯及口腔卫生习惯。     

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。     

辽宁省老年龋病高危人群Logistic回归模型研究

目的　了解辽宁省老年人群患龋状况,分析影响龋病发生的危险因素,为建立老年龋病高危人群Logistic模型提供基线研究资料。方法　2015年5—12月,采用随机抽样方法对辽宁省65 ~ 74岁年龄组的城乡居民1144名进行龋病临床调查,并进行问卷调查。采用SPSS13.0统计软件对患病情况和相关因素进行χ2检验及多因素Logistic回归分析。结果　辽宁省老年人群患龋率为68.53%,城市患龋率为73.12%,农村患龋率为63.92%,城乡间差异无统计学意义（P＞0.05）;男性患龋率为67.78%,女性患龋率为69.27%,性别间差异无统计学意义（P＞0.05）。Logistic回归分析显示：过去1年有牙痛史（OR = 1.550,95%CI：1.164-2.063）是老年人易患龋的危险因素;农村户口（OR = 0.676,95%CI：0.503-0.908）、不吸烟（OR = 0.681,95%CI：0.502-0.923）、不饮酒（OR = 0.628,95%CI：0.446-0.885）是老年人患龋的保护因素。结论    辽宁省老年人患龋率较高,口腔保健意识不强;过去一年有牙痛史、城市居民、有饮酒和吸烟习惯者更易患龋。     

南宁市江南区多元普惠幼儿园5岁儿童龋病及其影响因素调查分析

目的 了解南宁市江南区多元普惠幼儿园5岁儿童的龋病及其影响因素,为多元普惠幼儿园儿童龋病防治提供依据。方法 随机抽取南宁市江南区10所多元普惠幼儿园共470名5岁儿童,进行口腔检查,并对其家长进行问卷调查。采用单因素和多因素Logistic回归进行龋病相关影响因素分析。结果 南宁市江南区多元普惠幼儿园5岁儿童患龋率为78.3%,龋均为5.73±5.00。多因素Logistic回归分析显示,母亲受教育程度低的孩子患龋风险是受教育程度高的2.260倍（95%CI=1.429～3.574）;有睡前吃甜食或甜饮料行为（包含经常和偶尔）的孩子患龋风险是无该行为的1.956倍（95%CI=1.140～3.357）;有含糖类液体奶瓶入睡行为（包含经常和偶尔）的孩子患龋风险是无该行为的4.526倍（95%CI=1.898～10.793）。结论 母亲受教育程度低、睡前吃甜食或甜饮料、含糖类液体奶瓶入睡是南宁市江南区多元普惠幼儿园5岁儿童患龋的危险因素。     

成都地区混合牙列期及恒牙列初期儿童错牙合畸形患病率的调查研究

目的    调查研究成都地区混合牙列期及恒牙列初期儿童错牙合畸形的患病率,分析影响错牙合畸形发生的相关危险因素。方法    通过问卷调查及临床检查的方法,抽样调查5 ~ 13岁处于混合牙列期及恒牙列初期成都地区2056名儿童的错牙合畸形患病情况,统计错牙合畸形患病率并分析其可能的危险因素。结果    调查儿童患龋率为59.78%,龋均为2.33。混合牙列期儿童错牙合畸形患病率为64.64%,恒牙列初期错牙合畸形患病率为71.01%。错牙合畸形发生的危险因素包括龋病（OR = 3.805,95%CI：3.029 ~ 4.778,P < 0.001）、错牙合畸形遗传史（OR = 2.251,95%CI：1.219 ~ 4.156,P = 0.010）、口腔不良习惯（OR = 18.794,95%CI：9.643 ~ 36.629,P < 0.001）及食物精细（过于精细食物OR = 7.016,95%CI：4.557 ~ 10.802,P < 0.001;一般精细食物OR = 3.714,95%CI：2.587 ~ 5.333,P < 0.001）。结论    成都地区混合牙列期及恒牙列初期儿童患龋率及错牙合畸形患病率均处于较高水平;错牙合畸形发生的危险因素包括龋病、错牙合畸形遗传史、口腔不良习惯及食物过于精细。     

不同龋敏感儿童牙菌斑中4种致龋菌的动态监测分析

目的:监测无龋儿童组（caries free,CF）、低龄儿童龋组（early childhood caries,ECC）和重度低龄儿童龋组 (severe early childhood caries,S-ECC)牙菌斑中4种致龋菌的动态变化。方法:选取60名3~5岁儿童,对其进行龋病检查和牙菌斑样本收集,追踪观察1 a。采用实时荧光定量PCR技术对2次取样的4种致龋菌（变形链球菌、远缘链球菌、嗜酸乳杆菌和内氏放线菌）进行定量检测,计算各致龋菌所占总菌的比例。采用SPSS17.0软件包对实验数据进行χ²检验和配对t检验。结果:在基线及1 a后患龋率分别为66.7%和81.7%,差异无显著性（χ²=1.76,P>0.01）;龋失补牙面数分别为（5.80±2.53）和（7.90±1.76）,差异显著（t=3.51,P<0.01）。ECC、S-ECC组中,4种致龋菌所占比例在基线和1 a后有显著差异（P<0.01）。1 a后ECC、S-ECC组中变形链球菌、远缘链球菌之和所占比例显著高于基线水平（P<0.01）。变异链球菌与远缘链球菌之和所占总菌的比例与dmfs指数的变化在基线和1 a后均具有良好的线性关系。结论:菌斑中致龋菌的比例变化与低龄儿童龋密切相关,致龋菌所占总菌的比例越高,低龄儿童龋易感性就越高。     

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。     

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。     

南京市低龄儿童龋相关危险因素初步研究

目的:研究南京市低龄儿童龋相关危险因素.方法:调查南京市某幼儿园共342例3～5岁儿童口腔健康状况,通过问卷调查收集基线资料,采用横断面研究方法探讨各因素的影响.结果:205例诊断为低龄儿童龋,患龋率为60.0％,其中119例诊断为重度低龄儿童龋,患病率为34.8％.简化软垢指数、菌斑指数、菌斑产酸能力、深点隙裂沟、母...     

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.     

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.     

Determinants of ECC in Sardinian preschool children

OBJECTIVE: The aim of the study was to assess the influence of determinants on the presence of caries in pre-school children. BASIC RESEARCH DESIGN: A matched case-control study (1:2) was designed: 55 children (32 males, 23 females) with at least one buccal or lingual caries lesion on one primary maxillary incisor were selected (caries affected=1) and compared to randomly selected controls (no caries=0) paired for age and gender. Several variables concerning oral hygiene habits, use of fluoride supplementation, dietary habits, socio-economic status of the family and lifestyle factors were considered as risk predictors for early childhood caries (ECC). A conditional logistic regression model was used to perform matched case-control analysis. RESULTS: Bottle feeding at night (OR=1.90; 95%CI=1.03-3.50) and socio-economic level (OR=1.69; 95%CI=1.01-2.81) were positively associated with case status. CONCLUSIONS: We conclude that ECC seemed to be associated with bottle feeding at night and a low socio-economic level.     

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.     

低龄儿童龋的临床管理专家共识

低龄儿童龋（ECC）影响儿童牙齿、牙列、颅颌面和全身健康发育,是目前世界范围内需要面对和解决的重要儿童公共卫生问题之一。ECC的临床管理应以维护儿童口腔健康为中心,从其致病因素入手,以龋病风险评估为基础,早期预防在先,预防和治疗相结合,医护人员、儿童及其监护人相互配合,周期性地持续进行,从而阻止ECC的发生发展。本共识从ECC的风险评估、早期预防管理、临床治疗及术后管理来阐述ECC的临床管理策略。     

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。     

Prevalence of Early Childhood Caries Among Very Young Urban Boston Children Compared with US Children

Objectives: The aims of this study were to compare prevalence of early childhood caries (ECC) in 1- to 3-year-old children seeing primary-care pediatricians at two urban medical centers in Boston to the prevalence of ECC in similarly aged US children surveyed as part of the Third National Health and Nutrition Examination Survey (NHANES III) and to assess risk factors for ECC among this cohort of children compared with risk factors among similarly aged US children. Methods: Characteristics of 787 1- to 3-year-old children from two urban Boston medical centers were compared with those of 3,644 similarly aged US children surveyed as part of NHANES III. Demographic and social characteristics and ECC prevalence by putative risk factors were compared. A multiple logistic regression model was fit to assess putative risk factors and difference between groups simultaneously. Results: Race, age, previous dental visit, parents' education, and household income were significantly associated with ECC prevalence. Parents' place of birth was a significant effect modifier with lower ECC among Boston children of immigrants than among US children of immigrants. Conclusions: Lower ECC prevalence among urban Boston children of immigrant parents compared with US children of immigrant parents may reflect changing immigrant composition in the United States since NHANES III or a different immigrant composition in the Boston area compared with the United States. This finding reinforces the need for further research of immigrants in order to understand cultural practices that may affect oral health. Finally, low ECC prevalence among very young children reinforces the importance of early intervention in reducing ECC.