2016—2018年上海市浦东新区儿童龋齿患病及防治情况分析

目的:了解2016—2018年上海市浦东新区儿童龋齿的整体患病情况和变化趋势,龋齿防治措施的开展情况和变化趋势,以及患龋儿童的人口学特征和影响因素。方法:2019年6月,在上海市浦东新区下辖4个社区(上钢社区、陆家嘴社区、三林社区、曹路社区)的社区卫生服务中心儿童保健科调取2016—2018年接受过口腔检查的25458例儿童数据资料并进行统计分析,包括其人口学信息、口腔检查结果和龋齿防治措施开展情况。结果:2016—2018年,被调查儿童的患龋率分别为60.47%、54.66%、48.95%,乳磨牙患龋牙数超过恒牙患龋牙数。居住在不同社区的儿童,患龋率差异有统计学意义(P<0.05);小学生的患龋率显著高于幼儿园儿童,差异有统计学意义(P<0.05);不同年龄儿童的患龋率差异有统计学意义(P<0.05),儿童患龋率随着年龄的增加先上升后下降,以7~9岁儿童的患龋率最高。2016—2018年,受检儿童接受涂氟措施的比例均为100%,接受窝沟封闭的比例分别为9.1%、8.5%、7.0%。年龄和窝沟封闭次数是儿童患龋的保护因素(P<0.05)。结论:上海市浦东新区自2015年开始开展幼儿园幼儿全覆盖涂氟防龋,收到阶段性效果,患龋率逐年下降。下一步防龋的关注焦点应提早到儿童乳牙萌出阶段,通过加强家长的口腔健康卫生宣传,进一步提高龋齿防治有效措施的接受度和开展率,将龋病防范于未然。

Prevalence and prevention of early childhood dental caries in Pudong New District of Shanghai from 2016 to 2018

Objective: To investigate the prevalence and trend of childhood dental caries, review implementation of dental caries prevention policies and to identify the demographic characteristics and influencing factors of children with dental cavities from 2016 to 2018 in Pudong New District of Shanghai. Methods: In June 2019, medical history data of 25 458 children who had oval examinations in child care division of four Community Health Service Centers during 2016 to 2018 in Pudong New District of Shanghai was collected, including demographic information, oral exam results, and dental caries prevention measures. Results: The prevalence of dental caries was 60.7%, 54.66%, and 48.95% in 2016, 2017, and 2018, respectively. The number of dental caries in primary molar teeth was higher than in permanent teeth. The dental caries rates in children were significantly different among four communities (P<0.05), and the dental caries rate was significantly higher in primary school children than in kindergarten children (P<0.05). The dental caries rate differed significantly by age (P<0.05) which initially increased but then decreased by age, with children aged 7-9 years having the highest rate for dental caries. From 2016 to 2018, the fluoride application in children surveyed was 100%, and the use of pit and fissure sealant was 9.06%, 8.54%, and 7.02% in 2016, 2017, and 2018, respectively. The age and number of pit and fissure sealant were the influencing factors of caries in children (P<0.05). Conclusions: Since 2015, Pudong New District of Shanghai has implemented preventative-fluoride-application program. The program has achieved desired results. The dental caries rate has been decreasing each year. Next step, the focus of caries prevention should be at the early stage of children teeth eruption. Through strengthening oral health publicity of parents, the acceptability and development rate of effective measures for prevention and treatment of dental caries should be further improved, so as to prevent dental caries in the future.