辽宁省5岁儿童龋病流行病学抽样调查分析

目的:了解辽宁省5岁儿童患龋状况及影响因素,监测龋病的患病趋势,为儿童龋病预防提供科学依据。方法:按照第三次全国口腔健康流行病学调查的要求,对辽宁省城乡6个地区的792例5岁儿童进行了口腔健康状况调查。采用SPSS13.0软件包对数据进行分析。结果:792例受检者的患龋率和龋均分别为73.86%和4.38,农村和城市地区的患龋率分别为83.59%和64.14%,农村高于城市,经统计学检验具有非常显著的差异(χ2=16.07,P<0.01);男女之间患龋率无显著性差异(χ2=0.46,P>0.05)。辽宁省5岁儿童患龋率和龋均均显著低于10年前的调查结果。结论:应当重视辽宁省学龄前儿童的口腔健康状况,采取各种有效预防措施,降低龋病的发生。     

上海市12岁儿童患龋状况调查分析

目的 了解上海市12岁儿童恒牙患龋状况,为龋病预防提供科学依据。方法 采取随机抽样方法 按照WHO口腔调查基本方法 中的龋病诊断标准对全市19个区县2 519名12岁学生进行口腔检查。结果 2 519名12岁儿童的患龋率和龋均分别为36.64%和0.61。其中97.14%的龋齿发生于窝沟。男女患龋率之间有显著性差异。显著性龋均指数为1.77,龋齿充填率为24.58%,窝沟封闭率为0.52。结论 上海12岁儿童龋患呈两极化分布,龋齿主要发生于第一恒磨牙的牙合面窝沟。     

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目的了解福州市12岁学生龋病患病情况,为福州市口腔卫生保健工作及龋病的防治工作提供科学依据。方法于2010年10月,福州市第一医院口腔科按第六次全国学生体质健康调研工作的要求,随机抽调福州市城乡中小学12岁的学生共555名进行龋病的流行病学调查,以患龋率、龋均和龋齿充填率、显著性龋均指数为统计指标,采用SPSS17.0统计软件对结果进行统计分析。结果福州市12岁学生的患龋率为29.7%,受检者龋均为0.53,患龋者龋均为1.78,龋齿充填率为20.1%,显著性龋均指数为2.79。城区和乡镇的学生患龋率分别为25.3%和33.8%,差异有统计学意义(χ2=4.800,P=0.028);龋均分别为0.37和0.46,差异无统计学意义(t=-1.031,P>0.05);龋齿充填率分别为23.4%和17.5%,差异无统计学意义(χ2=1.605,P=0.205)。男生和女生的患龋率分别为26.9%和32.7%,差异无统计学意义(χ2=2.284,P=0.131);龋均分别为0.34和0.49,差异有统计学意义(t=-2.322,P<0.05);龋齿充填率分别为20.5%和19.8%,差异无统计学意义(χ2=0.023,P=0.879)。结论福州市12岁学生总体患龋率不高,但充填率低,乡镇学生的患龋率高于城区。今后预防保健工作应注意提高龋齿治疗率,特别是乡镇学生的龋齿预防和保健工作仍需加强。     

北京市5岁儿童乳牙龋病抽样调查报告

目的 了解北京市5岁儿童乳牙龋病状况,为北京市口腔卫生保健工作提供科学依据.方法 采用多阶段分层等容量随机抽样的方法,抽取北京市5岁城乡常住儿童共792名,男女各半,按<第三次全国口腔健康流行病学调查方案>中的方法,检查全口乳牙患龋情况.结果 在792名受检儿童中,北京市5岁儿童乳牙患龋率为58.59%,乳牙龋均为2.57,农村高于城市;龋齿充填率为17.96%,城市高于农村.结论 应进一步加强乳牙龋病的宣传和预防工作,提高儿童家长对乳牙龋病的重视程度,加强高危人群的监测和防治,加大对农村地区的口腔医疗及人力资源配置的扶持力度.     

广东省3~5岁人群乳牙龋病抽样调查报告(2015—2016年)

目的 了解广东省3~5岁人群乳牙龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省3、4、5岁城乡常住人口各864人,男女各半,城乡各半.按照第四次全国口腔健康流行病学调查方案牙列检查方法和标准,使用CPI探针检查全口乳牙牙冠龋病情况.计算患龋率、龋均、充填率等.结果 3、4、5岁人群乳牙患龋率分别为58.33%、68.40%、78.47%,龋均分别为3.03、4.34、5.69,龋齿充填率分别为0.92%、1.47%、1.26%.3、4、5岁人群患龋率和龋均在城乡及年龄组间的差异有统计学意义,农村高于城市,随年龄增长,患龋状况加重;患龋率在不同性别间的差异无统计学意义,3岁人群龋均女性高于男性(t=2.04,P=0.042),4岁人群(t=0.15,P=0.882)、5岁人群(t=1.00,P=0.317)龋均在不同性别间的差异无统计学意义;5岁儿童患龋率(x2=23.123,P<0.001)和龋均(t=6.290,P<0.001)高于2005年,龋齿充填率提升不明显(x2=0.481,P=0.488).结论 广东省3~5岁儿童乳牙龋病患病状况较严重,98%以上的龋齿未经治疗,是龋病预防的重点人群,特别是农村儿童.     

比较两种探针检查法对福建省12岁儿童龋病抽样调查的差异

目的:了解福建省12岁儿童龋病的患病现状,比较2种探针检查法对龋齿检出率的影响。方法:根据WHO《口腔健康基本调查方法》第3、4版,参照“第三次全国口腔健康流行病学调查”,采取多阶段分层、等容量随机抽样的方法对福建省792名12岁儿童分别以CPI探针和5号探针检查龋齿。结果:2种探针检查法得出福建省12岁儿童的患龋率分别为32.83%和56.06%。CPI探针检查法得出在不同性别及城乡之间差异均无统计学意义。5号探针检查法得出女性患龋率大于男性(P<0.01)。与福建省2000年对12岁儿童进行的口腔健康抽样调查所统计的结果相比较,患龋率降低0.13%,龋均上升为21.17%。5号探针检出的患龋率及龋均均高于CPI探针的检出率。患龋率之间的差异为23.23%。结论:5号探针的龋检出率高于CPI探针的龋检出率。     

江苏省5岁儿童乳牙龋病的流行病学及相关因素研究

目的了解江苏省5岁儿童乳牙龋病流行状况及相关因素,为开展儿童口腔预防保健提供基线资料。方法参考世界卫生组织(WHO)《口腔健康调查基本方法》(第4版)和全国第3次口腔健康流行病学调查方案,采用多阶段、分层、等容量、随机抽样的方法,抽取江苏省城乡5岁儿童共792人,并随机抽取其中1/2的儿童父母进行问卷调查。结果乳牙患龋率和龋均分别为69.15%和3.49,均低于1995年全国平均水平,龋齿充填率为2.24%。睡前吃甜食、父母文化程度、最近一次看牙间隔时间和由母亲照顾儿童日常生活与儿童患龋相关。结论应加强口腔健康教育,积极开展口腔预防保健工作,提高龋病的治疗率。     

2005年贵州省5岁儿童乳牙龋病抽样调查报告

目的了解贵州省5岁儿童乳牙龋病状况,为贵州省口腔卫生保健工作提供信息支持。方法采用多阶段分层等容随机抽样的方法,抽取贵州省5岁城、乡常住人口792人,男女各半。按照《第三次全国口腔健康流行病学调查方案》,使用社区牙周指数探针检查并记录全口乳牙龋病情况,统计患龋率、龋均。结果贵州省5岁儿童乳牙患龋率为50．38％,龋均为1．92,龋齿充填率为2．30％。患龋率（χ^2=6．915,P〈0．01）和龋均（t=-2．721,P〈0．01）的城、乡差异有统计学意义,患龋率（χ^2=0．611,P〉0．05）和龋均（t=-1．285,P〉0．05）的性别差异无统计学意义。结论2005年贵州省5岁儿童患龋率和龋均虽然处于较低水平,但仍不容乐观,学龄前儿童仍是龋病预防和治疗的重点人群,农村儿童更不容忽视。     

福建省5岁儿童龋病流行病学调查及相关因素分析

目的 了解福建省5岁儿童乳牙龋病状况及相关因素,为开展儿童口腔预防保健提供科学依据.方法 按照<第三次全国口腔健康流行病学调查方案>,采用多阶段、分层、等容量、随机抽样的方法 ,抽取福建省城乡5岁年龄组儿童共720名,使用CPI探针检查全口乳牙牙冠龋病情况.同时随机对其中1/2的儿童家长就儿童的生活习惯、口腔卫生习惯和就医情况等进行问卷调查,数据采用t检验、χ2检验和Logistic回归分析.结果 乳牙患龋率为75.8%,龋均4.92,龋齿充填率为0.34%.患龋率在城乡、性别间的差异无统计学意义;龋均城市高于农村,不同性别之间乳牙龋均差异无统计学意义;乳牙充填率城市高于农村,男、女性别差异无统计学意义.生活在城市、睡前吃甜点或喝甜饮料、过去12个月内有过牙痛或不适因素与儿童患乳牙龋有关.结论 应加强儿童乳牙龋的预防工作,增强口腔健康教育,减少睡前进食甜食,控制儿童龋病的流行.     

北京市老年人群龋病流行病学调查报告

目的了解北京市老年人群的龋病患病情况,为制定口腔卫生保健政策提供参考。方法采用多阶段分层等容量随机抽样方法,抽取北京市65～74岁城乡常住人口792人,男女各半,参照《第三次全国口腔健康流行病学抽样调查方案》检查龋齿情况,计算龋均和患龋率。结果北京市792名受检者恒牙患龋率为66.03%,龋均为2.37;根龋的患龋率为26.39%,龋均为0.46;龋齿充填率为23.88%,其中根龋充填率为5.81%,根龋充填率在城乡的差异有统计学意义（χ2=16.87,P〈0.01）。结论北京市老年人根龋的患龋率和龋均呈现上升趋势,充填率低,应合理配置城乡口腔医疗资源,采取综合防治措施。     

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.     

Clinical diagnosis of precavitated carious lesions

Abstract During the 20th century, dental caries was usually diagnosed using tactile-visual criteria that detected the presence of cavitation rather than measured the disease process as a continuum that starts from the appearance of micro-porosity, as a result of demineralization, to the occurrence of cavitation. With increasing understanding of the dental caries process and the role of primary and secondary prevention in arresting it, sensitive and specific diagnostic systems are needed that could enable dentists to detect signs of early demineralization and possible progression of precavitated carious lesions before the occurrence of cavitation. In this review of the literature, published validity studies of diagnosis of precavitated lesions were reviewed. Overall, the current clinical diagnostic systems have low sensitivity and moderate specificity. Good reliability of diagnosing precavitated carious lesions could be obtained for diagnosing pits and fissures but for smooth tooth surfaces the reliability is poor. As our diagnostic capability of precavitated lesions improves, there is a need for a significant change in dental education, dental insurance, and dental practice to reward dentists for promoting oral health and preserving tooth structure. In this paper, a new model for classifying carious lesions based upon the type of intervention strategies is proposed to assist in this new approach of caries management.     

Longitudinal Study of the Caries Susceptibility of Occlusal and Proximal Surfaces of First Permanent Molars

Ten- to 13-year-old children were examined annually for three years to determine the caries activity in the proximal and occlusal surfaces of first permanent molars. Almost every tooth with an unsound (carious or filled) proximal surface also had an unsound occlusal surface. Caries scores in proximal surfaces remained relatively constant and low. The percentage of teeth with occlusal caries or fillings increased throughout the study, even though the teeth had been erupted for seven to ten years by the end of the study. Within the age range studied, the time that teeth were in the mouth had little effect on the vulnerability of occlusal surfaces to caries attack.     

Study design to reduce biases in estimating the percentage of carious lesions that do not progress within a time period

Abstract Much of the available information on the rate of caries progression comes from studies in which two examinations have been done and the percentage of lesions that do not progress from a carious state between the examinations recorded. Extrapolation from this type of study is subject to two offsetting biases. On the one hand, slow progressing lesions that have been in a state for a long time before the first examination may progress between examinations. When these are counted as lesions that progress within the time period between the two examinations, there will be an underestimation of non-progressing lesions. On the other hand, slow progressing lessions will be over-represented in the sample of lesions detected at the first examination. This will result in an overestimation of non-progressing lesions. We suggest a three examination protocol to minimize these biases.     

The University of North Carolina Caries Risk Assessment study: further developments in caries risk prediction.

Over 4000 first and fifth grade children from the areas surrounding Aiken, South Carolina, and Portland, Maine, participated in a 4-yr study to develop caries risk assessment models. The predictors used at baseline included detailed clinical examinations, salivary microbiological tests, and sociodemographic and dental behavior data. Mean 3-yr caries increments in South Carolina were twice those in Maine. For the four risk assessment models (two grade cohorts at two sites) specificity values averaged 0.83 and sensitivity values averaged 0.60. Clinical predictors such as prior DMFS, pit and fissure morphology, and predicted caries risk status were the major contributors to the models.     

Carisolv技术治疗乳牙龋病的临床应用评价

目的:比较和评价Carisolv去龋技术和采用低速牙钻去龋治疗乳牙龋病的效果和患儿接受程度.方法:选择年龄6～10岁,双侧乳牙均患中龋的儿童100名,以自身半口为对照,分别用Carisolv和牙钻去龋,然后用复合体充填,记录去龋时间.采用问卷调查患儿对两种去龋方法的接受程度,1年后复查,观察修复体的情况.结果:Carisolv去龋时间(4.36±1.28)min长于低速牙钻去龋时间(2.60±0.84)min.82%的患儿认为Carisolv去龋疼痛轻于牙钻；多数患儿倾向使用Carisolv去龋.1年后复查表明Carisolv和牙钻去龋的修复体继发龋率、脱落率方面无显著性差异.结论:Carisolv去龋时患儿疼痛程度明显减轻,但去龋时间略长于牙钻去龋,多数患儿倾向于Carisolv去龋.Carisolv修复术后的继发龋率并未增加.     

上海蓬莱地区龋病调查

目的为了查清蓬莱地区居民口腔健康状况，为制订预防计划提供基线资料，为口腔保健措施及口腔健康教育的监测与效果提供依据。方法采用分层，等比整群随机抽样的方法，所采用的诊断标准为第二次全国口腔健康流行病学调查的标准。结果患龋率分别为：５岁组６３．１％，１２岁组２８．６％，１５岁组３１．８％，１８岁组４３．６％，３５～４４岁组４１．３％，６５～７４岁组６１．８％。结论本次调查发现：①不同年龄组居民患龋率有明显差异。②本地区居民患龋率，龋均与第二次全国流行病学调查上海地区调查结果相比较低     

Use of the Kaplan-Meier estimate to reduce biases in estimating the rate of caries progression

Abstract An important determinant of how often to perform dental radiography is how rapidly dental caries progress. Estimates of the rate of progression of dental caries have been biased by the elimination of filled lesions and non-progressing lesions (i.e. censored data) from the analysis. We illustrate the use of the Kaplan-Meier estimate to incorporate information from these cases and demonstrate the effect of using this information on estimates of the rate of progression of approximal caries.     

龋病再认识

随着对龋病研究的不断深化,龋病的病因、分类以及治疗计划的观念发生改变。通过对患者进行龋病危险性评估,分析并控制龋病发生的危险因素,制定基于龋危险性评估的个性化龋病管理和治疗计划,有针对性地实施无创、微创、有创的循序渐进式龋病防治技术,已成为现代龋病防治的趋势。