重庆市学龄前儿童龋病状况调查

目的 了解重庆市学龄前儿童乳牙龋患病情况,同时比较公办幼儿园和民办幼儿园学龄前儿童的乳牙龋患病情况。方法 以重庆市渝中区40所民办幼儿园和16所公办幼儿园的5 030名3~6岁儿童为调查对象,按照第3次全国口腔健康流行病学调查诊断标准进行口腔检查,提取龋病情况资料,包括患龋率、龋均、龋齿充填率等。采用SPSS 21.0软件进行统计学分析。结果 5 030名受检儿童中,最容易患龋的牙位为上颌乳中切牙和下颌乳磨牙。患龋率为54.08％（2 720/5 030）,龋均为2.58,龋齿充填率为0.98%（127/12 993）。随着年龄增长,儿童患龋率和龋均增加（P<0.05）。6岁年龄儿童的龋齿充填率最高（P<0.05）,不同性别的龋齿充填率无统计学差异（P>0.05）。民办幼儿园的患龋率、龋均和龋齿充填率分别为61.04%（1 656/2 713）、3.12和0.35%（30/8 465）,公办幼儿园的患龋率、龋均和龋齿充填率分别为45.92%（1 064/2 317）、1.95和2.14%（97/4 528）,民办幼儿园与公办幼儿园之间有统计学差异（P<0.05）。结论 重庆市学龄前儿童乳牙患龋率较高,龋齿充填率较低,其中民办幼儿园学龄前儿童的口腔健康状况明显差于公办幼儿园。     

上海市徐汇区学龄前儿童龋病状况调查

目的：了解上海市徐汇区学龄前儿童乳牙患龋状况,为龋病防治提供科学依据。方法：以上海市徐汇区75所公办幼儿园10401名3?6岁儿童为调查对象,按照第4次全国口腔健康流行病学调查诊断标准进行口腔检查,提取龋病情况资料,包括患龋率、龋均、龋齿充填率。采用SAS 9.4软件进行统计学分析。结果：10401名受检儿童中,最容易患龋的牙位为上颌乳中切牙和下颌乳磨牙。患龋率为46.62%（4849/10401）,龋均为2.14?3.34,龋齿充填率为15.87%（3529/22243）。随着年龄增长,儿童患龋率和龋均增加（P<0.05）。6岁年龄儿童的龋齿充填率最高（P<0.05）,不同性别的龋齿充填率无统计学差异（P>0.05）。结论：上海市徐汇区学龄前儿童乳牙患龋率较高,龋齿充填率较低,应加强对学龄前儿童龋病的早期防治。     

Prevalence of dental caries and toothbrushing habits among preschool children in Khartoum State,Sudan

Background: Dental caries in preschool children remains a major dental public health problem and affects significant numbers of children in developed and developing countries. The incidence is increasing in developing countries, such as Sudan, because of lifestyle changes, absence of oral health-preventive services and inadequate access to oral health care. Objectives: This study assessed the prevalence of dental caries and toothbrushing habits among 3- to 5-year-old preschool children in Khartoum State, Sudan, and described the correlation between the mean decayed, missing and filled tooth (dmft) score for primary teeth with toothbrushing and sugar consumption. Materials and Methods: The subjects were 553 preschool children with their mothers/guardians, selected by random sampling from the kindergartens of the seven localities of Khartoum State, Sudan. Data were obtained through clinical examination using a modified World Health Organization (WHO) examination data-capture sheet and through structured administered interviews with mothers/guardians. Results: The prevalence of dental caries was 52.4%, with a mean dmft score of 2.3. There was an increase in the dmft scores with increasing age. The frequency of children who brushed their teeth regularly at least once a day was high (83.4%), lower dmft scores were associated with starting toothbrushing earlier in life and with increased frequency of brushing per day. Eating sugar-containing food was significantly associated with dmft score. Conclusions: The prevalence of dental caries was found to be high among 3- to 5-year-old preschool children, and caries experience increased with age. This was mostly associated with sugar consumption and therefore calls for educational interventions to control sugar intake. The toothbrushing habit is well established in Khartoum State, Sudan, as a large number of children were found to be brushing their teeth regularly. No significant association was found between feeding habits and dmft score.Key words: Dental caries, preschool children, dmft, toothbrushing     

Exploring the association of dental caries with social factors and nutritional status in Brazilian preschool children

The main objective of this study was to assess whether dental caries status was related to nutritional status in preschool urban Brazilian children aged 12–59 months. Dental and anthropometric examinations were conducted on 1,018 12–59-month-old children during the National Day of Children Vaccination. Dental caries prevalence and severity were measured using the decayed, missing or filled surfaces (dmfs) index. The World Health Organization (WHO) Child Growth Standards Reference was used to evaluate nutritional status. Results on nutritional status were presented as Z-scores. The data collected included socio-economic conditions. Multilevel linear regression was applied to investigate the effect of nutritional, socio-economic, and demographic factors on the status of children's dental caries. Caries was present in 23.4% of children. The final hierarchical logistic model showed a significant association between nutritional status and caries experience. Children with low Z-scores in some indexes had an increased risk of having caries. In addition, children whose mothers had < 8 yr of education and were from lower-income families had an increased risk of high levels of dental caries. There was an association between nutritional and socio-economic factors, and dental caries. In conclusion, underweight children and those with adverse socio-economic conditions were more likely to have caries experience.     

学龄前儿童龋病高发的危险因素

龋病在我国是学龄前儿童的高发疾病,了解其发生的危险因素可以进行龋风险评估,降低龋高发儿童的龋病发生率。本文对学龄前儿童龋病高发的危险因素进行综述。     

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。     

应用氟化泡沫预防幼儿龋齿的防龋效果观察

目的：抽样调查东西湖区儿童使用氟化泡沫预防龋齿的效果。方法：对东西湖区8所幼儿园进行随机抽样,实验组儿童采用氟化泡沫护齿,每年2次,对照组儿童不做任何处理,2年后观察两组儿童之间患龋率及新龋发生率。结果：2年后实验组患龋率及新龋发生率均低于对照组,差异有统计学意义。结论：氟化泡沫能有效预防学龄前儿童龋病发展。     

Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression

The aim of this cross‐sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3–5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health‐related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio‐economic characteristics of the family. Statistical analyses were performed using the chi‐square test, Kruskal–Wallis test, Mann–Whitney U‐test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Child's age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children.     

Dietary determinants of dental caries and dietary recommendations for preschool children

OBJECTIVES: The purpose of this review, commissioned by the Administration for Children and Families, the Health Resources and Services Administration, the Health Care Financing Administration, and the Department of Agriculture's Food and Nutrition Service, was to update the evidence of the dietary factors that affect dental caries, and subsequently formulate dietary recommendations for preschool children based on principles of cariology. METHODS: Literature on the dental caries process, dietary factors affecting dental caries initiation and progression, and nutrition education and counseling were reviewed and synthesized. Dietary guidelines for children at various ages were then constructed based on the review. RESULTS: Dental caries in preschool children is due to a combination of factors, including colonization of teeth with cariogenic bacteria, type of foods and frequency of exposure of these foods to the cariogenic bacteria, and susceptible teeth. Caries risk is greatest if sugars are consumed at high frequency and are in a form that is retained in the mouth for long periods. Sucrose is the most cariogenic sugar because it can form glucan that enables firm bacterial adhesion to teeth and limits diffusion of acid and buffers in the plaque. There is emerging interest in the effects of tooth development and its role in the future dental caries risk of the child. CONCLUSIONS: Nutrition education and counseling for the purposes of reducing caries in children is aimed at teaching parents the importance of reducing high frequency exposures to obvious and hidden sugars. Guidelines include: avoiding frequent consumption of juice or other sugar-containing drinks in the bottle or sippy cup, discouraging the behavior of a child sleeping with a bottle, promoting noncariogenic foods for snacks, fostering eating patterns consistent with the Food Guide Pyramid, limiting cariogenic foods to mealtimes, rapidly clearing cariogenic foods from the child's oral cavity either by toothbrushing or by consumption of protective foods, and restricting sugar-containing snacks that are slowly eaten (e.g., candy, cough drops, lollipops, suckers). Along with nutritional factors, a comprehensive approach to preventing dental caries in preschool children must include improved general dietary habits, good oral hygiene, appropriate use of fluorides, and access to preventive and restorative dental care.     

颌骨囊肿刮除术并发症的预防与处理

 颌骨囊肿刮除术是牙源性颌骨囊肿的常规治疗手段，但囊肿刮除术中、术后的并发症常影响骨腔的愈合以及患者的生活质量。常见并发症有术后感染、囊肿复发、病理性骨折、感觉异常等。这些并发症的发生与囊肿大小、患病部位、手术方式、是否有植入物等有密切关系。避免或减少这些并发症对提高临床疗效、改善患者生活质量有非常重要的意义。文章结合该领域研究现状和笔者的经验，介绍颌骨囊肿刮除术相关并发症的预防与处理。     

Dental caries experience of preschool children from the North Brisbane region

BACKGROUND: To report the dental caries experience of preschool children within the north Brisbane region and to investigate the association between selected social and demographic variables and disease presence. METHODS: A cross-sectional sample of 2515 children aged four to six years was examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) and percentage caries free indices. A self-administered questionnaire obtained information regarding selected social and demographic variables. The data were analysed using the chi-square and one way analysis of variance procedures at the 5 per cent level of significance. RESULTS: Overall, 1668 (66.3 per cent) children were disease free at the examination and mean dmft was 1.4+/-2.77 and dmfs was 2.28+/-6.00. Dental caries occurred more frequently and severely in children from non-Caucasian background (p<0.000), family language other than English (p=0.001) and lower socio-economic status (p<0.000). CONCLUSIONS: Significant associations between child ethnicity, language spoken at home, socio-economic status and caries presence have been identified. Epidemiological data can be used for improved public oral health service planning and resource allocation within the region.     

Prevalence and severity of dental caries among American Indian and Alaska Native preschool children

Objectives: To describe the Indian Health Service (IHS) oral health surveillance system and the oral health status of American Indian and Alaska Native (AI/AN) children aged 1‐5 years. Methods: A stratified probability sample of IHS/tribal sites was selected. Children were screened by trained examiners at community‐based locations including medical clinics, Head Start, preschools, kindergarten, and Women, Infants, and Children (WIC). Data collection was limited to the primary dentition and included number of teeth present plus number of teeth with cavitated lesions, restorations, and extracted because of decay. Number of molars with sealants and urgency of need for dental care data were also obtained. Statistical analyses were performed with SAS (SAS Institute Inc., Cary, NC, USA). Sample weights were used to produce population estimates based on selection probabilities. Results: A total of 8,461 AI/AN children 12‐71 months of age were screened at 63 IHS/tribal sites, approximately 7 percent of the estimated IHS user population of the same age. Overall, 54 percent of the children had decay experience, 39 percent had untreated decay, 7 percent had primary molar sealants, 36 percent needed early or urgent dental care, and 6 percent needed urgent dental care. The mean of decayed, missing, or filled teeth was 3.5 (95 percent confidence interval, 3.1‐3.9). The prevalence of decay experience increased with age; 21 percent of 1‐year‐olds and 75 percent of 5‐year‐olds had a history of caries. When stratified by IHS area, there were substantial differences in the oral health of preschool children. Conclusions: The results confirm that in the United States, AI/AN children served by IHS/tribal programs are one of the racial/ethnic groups at highest risk of caries.     

Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia

OBJECTIVES: The objective of this study was to determine the prevalence of dental erosion in preschool children in Jeddah, Saudi Arabia, and to relate this to caries and rampant caries in the same children. METHODS: A sample of 987 children (2-5 years) was drawn from 17 kindergartens. Clinical examinations were carried out under standardised conditions by a trained and calibrated examiner (M.Al-M.). Measurement of erosion was confined to primary maxillary incisors and used a scoring system and criteria based on those used in the UK National Survey of Child Dental Health. Caries was diagnosed using BASCD criteria. Rampant caries was defined as caries affecting the smooth surfaces of two or more maxillary incisors. RESULTS: Of the 987 children, 309 (31%) had evidence of erosion. For 186 children this was confined to enamel but for 123 it involved dentine and/or pulp. Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). The mean dmft for the 987 children was 4.80 (+/-4.87). Of the 384 children who had caries but not rampant caries, 141 (37%) had erosion, a significantly higher proportion than the 72 (27%) out of 267 who were clinically caries free (SND=2.61, P<0.01). Of the 336 with rampant caries, 96 (29%) also had evidence of erosion. CONCLUSIONS: The level of erosion was similar to that seen in children of an equivalent age in the UK. Caries was a risk factor for erosion in this group of children.     

Socioeconomic inequalities in the distribution of dental caries in Brazilian preschool children

Objectives: This study assessed the inequality in caries distribution and the association between socioeconomic indicators and caries experience of preschool children in a city in Brazil. Methods: A cross‐sectional study in a multistage random sample of 455, 1‐5‐year‐old children was conducted on National Children's Vaccination Day in Santa Maria, Brazil. Calibrated examiners evaluated the prevalence of dental caries and parents provided information about several socioeconomic indicators by means of a semi‐structured questionnaire. Data were analyzed using Poisson regression model. Results: The caries prevalence was 23.5 percent and the means for the decayed, missing and filled primary teeth was 0.8. A high inequality in the caries distribution with Gini coefficient of 0.8 and Significant Caries Index of 2.8 was observed. The oldest children, non‐white, with mothers having low level of education and from low household income had the highest prevalence of dental caries. Conclusion: Socioeconomic factors are strong predictors for the inequality in caries distribution in Brazilian preschool children.     

Factors associated with prevalence and severity of caries experience in preschool children

Abstract – Objectives: The aim of the present study was to examine the prevalence and severity of caries experience in the primary dentition of preschool children and to assess the association of disease distribution with oral hygiene levels, reported oral health behaviours and socio‐demographic factors. Methods: Study samples comprised 1250 3‐year‐old and 1283 5‐year‐old pre‐school children from four distinct geographical areas in Flanders. Information on oral hygiene and dietary habits, oral health behaviours and socio‐demographic variables was collected using questionnaires completed by the parents. Clinical examinations were performed using standardized criteria. Caries experience was recorded at the level of cavitation (d₃ level). Simple as well as multivariable logistic regression analyses were performed in order to identify factors associated with prevalence and severity of caries experience. Results: Visible plaque was present in 31% of 3‐year‐olds and 37% of 5‐year‐olds. In 3‐year‐olds, 7% presented with caries experience while this was the case in 31% of 5‐year‐olds. Multivariable logistic regression revealed significant associations, in 3‐year‐olds, of caries experience with presence of dental plaque (OR = 7.93; 95% CI: 2.56–24.55) and reported consumption of sugared drinks at night (OR = 7.96; 95% CI: 1.57–40.51). In 5‐year‐olds, significant associations were seen with age (OR = 7.79; 95% CI: 2.38–25.43), gender (OR = 0.37 with 95% CI: 0.19–0.71 for girls), presence of visible dental plaque (OR = 3.36; 95% CI: 1.64–6.89) and reported habit of having sugar‐containing drinks in between meals (OR = 2.60 with 95% CI: 1.16–5.84 and OR = 3.18 with 95% CI: 1.39–7.28, respectively for 1×/day and > 1×/day versus not every day). In 5‐year‐olds with caries experience (30.8% of total sample), the severity of disease was further analysed (d₃mft between 1 and 4 versus d₃mft 5 or higher). Multivariable analyses showed a significant association with gender [girls more likely to have higher disease levels; OR = 4.67 (95% CI: 1.65–13.21)] and with presence of plaque (OR = 3.91 with 95% CI: 1.23–12.42). Conclusions: Presence of visible plaque accumulation and reported consumption of sugared drinks were associated with prevalence of caries experience in Flemish preschool children. Severity of disease was associated with gender and with presence of plaque. Results underline the importance of plaque control and diet management from very young age on.     

学龄前儿童参与治疗在牙科诊疗中的作用研究`

目的　探讨学龄前儿童参与疾病治疗在牙科诊疗中的作用。方法 选取2017年6月~2018年6月来我院口腔门诊首次就诊并需要复诊的3~6岁学龄前儿童90例为研究对象,根据随机数字法分为实验组和对照组,每组各45例。每次就诊对照组给予常规干预,实验组除常规干预措施外,让患儿参与疾病治疗。首诊和复诊治疗结束后采用CFSS-DS量表、Frankl量表和Houpt行为量表对两组患儿牙科畏惧程度、治疗依从性和治疗完成情况进行评定并比较其统计差异。结果 实验组复诊率为93.33%,高于对照组（77.78%）,差异具有统计学意义（?2=4.406,P<0.05）。实施参与疾病治疗的实验组患儿首诊和复诊CFSS-DS评分均低于对照组,Frankl治疗依从性和Houpt治疗完成情况均优于对照组,两组比较均具有统计学差异（P均<0.05）。和首诊比较,复诊后实验组患儿CFSS-DS评分降低,Frankl治疗依从性提高,差异具有统计学意义（P均<0.05）,但Houpt行为量表评定结果没有统计学差异（P>0.05）。结论 实施学龄前儿童参与疾病治疗能缓解患儿牙科畏惧程度,提高就诊率和治疗依从性。     

Parental smoking behavior and caries experience in preschool children

Abstract – Objectives: The study aimed to explore the association between parental smoking behavior and caries experience in young children, taking into account the socioeconomic status and oral health‐related behavior. Methods: Cross‐sectional data from 1250 3‐year‐old and 1283 5‐year‐old children from four geographical areas in Flanders (Belgium) were analyzed. Children were examined at school by trained dentist‐examiners, using standard criteria and calibrated examination methodology. Data on oral hygiene and dietary habits, oral health behavior, sociodemographic variables, and parental smoking behavior were obtained through structured questionnaires, completed by the parents. Results: Visible caries experience (i.e. d₃mft > 0) was seen in 7% of 3‐year olds and 31% of 5‐year olds. In both age groups, 30% of the parents reported smoking behavior. Univariable logistic regression analysis with caries prevalence as the dependent variable, revealed that parental smoking was a significant independent variable. After controlling for age, gender, sociodemographic characteristics, oral hygiene, and dietary habits, the effect of family smoking status was no longer significant in 3‐year‐old children (OR = 1.98; 95% CI: 0.68–5.76). In 5‐year olds the significant relationship between parental smoking behavior and caries experience persisted after adjusting for the other evaluated variables (OR = 3.36; 95% CI: 1.49–7.58). Conclusion: The results of this study illustrate the existence of a significant association between parental smoking behavior and caries experience in 5‐year‐old children.     

重庆市学龄前儿童乳牙龋状况及影响因素分析

目的 探讨重庆市3~5岁学龄前儿童乳牙患龋状况及相关影响因素,为学龄前儿童龋病的预防和干预提供相关资料。方法 参考第四次全国口腔健康流行病学调查,对重庆市4个区学龄前儿童进行抽样调查,同时对家长进行问卷调查。利用Epidata 3.1和SPSS 21.0软件进行结果录入和统计学分析。结果 共计1 350名学龄前儿童纳入调查分析,口腔检查相关数据显示乳牙龋好发牙位是上颌乳中切牙和下颌乳磨牙,乳牙患龋率为51.4%（694/1 350）,龋均为2.34,各年龄组间患龋率和龋均差异有统计学意义（P<0.01）,且二者随着年龄增长而上升（P<0.05）。除5岁组男、女龋均有统计学差异外（P<0.05）,其余患龋率和龋均在不同性别间差异均无统计学意义（P>0.05）。61.7%龋坏集中在36.1%个体口腔中。多因素Logistic回归分析显示年龄、家长的最高学历、甜饮料（包括碳酸饮料等）摄入频率、过去1年是否有牙痛或不适、是否看过牙、牙齿和口腔健康状况自评对乳牙患龋有重要影响（P<0.05）。结论 重庆地区3~5岁儿童超过半数患龋,多数龋齿集中发生在少数患儿口内。乳牙患龋与年龄、家长的最高学历、甜饮料（包括碳酸饮料等）摄入频率、过去1年是否有牙痛或不适、是否看过牙、牙齿和口腔健康状况自评有关。