张家港市部分幼儿园患龋高风险儿童干预效果评价

  目的   探索张家港市部分幼儿园龋高风险儿童在不同管理模式下的防控效果，为相关部门制定口腔健康管理策略提供依据。  方法   2020年9月，采用整群抽样法在张家港市9个区镇抽取1 600名3岁新入园儿童进行基线调查，内容包括口腔检查、问卷调查和龋易感性检测。根据风险评估标准筛选出高风险儿童，以学校为单位分为两组，试验组涂氟频率为3个月1次，结合行为管理和口腔健康指导；对照组涂频率为6个月1次，结合行为管理和口腔健康指导，1年后复查口腔情况，评估干预效果。  结果   基线检查3岁儿童患龋率为50.9%，男女童患龋率分别为47.5%，54.5%，差异有统计学意义(χ2=9.64，P＜0.05)。筛选出高风险儿童共1 090名，其中试验组475名，对照组615名。基线检查时两组儿童患龋率分别为74.1%，75.1%，龋均为(2.98±3.33)(3.04±3.16)，差异均无统计学意义(χ2/t值分别为0.15，0.28，P值均＞0.05)；干预1年后，两组儿童患龋率为78.5%，83.0%，龋均为(4.22±3.97)(4.51±4.08)，差异无统计学意义(χ2/t值分别为3.17，0.05，P值均＞0.05)。试验组新龋发生率为3.7%，新增龋均为(1.26±1.69)，低于对照组的7.6%和(1.45±2.04)，差异均有统计学意义(χ2/t值分别为6.89，5.05，P值均＜0.05)。  结论  3个月1次的涂氟干预频率结合行为管理的模式对龋高风险儿童新发龋的控制更有效。

Effect of intervention on high caries-risk children in some kindergartens in Zhangjiagang

  Objective  To explore the prevention and control effects of different management modes on children with high risk of dental caries from some kindergartens in Zhangjiagang, and to provide a basis for relevant departments to formulate oral health management strategy.  Methods  In September 2020, 1 600 children aged 3 years old from 9 towns in Zhangjiagang were sampled by cluster sampling method for baseline survey, including oral examination, questionnaire survey and caries susceptibility test. According to the risk assessment criteria, high-risk children were screened out and divided into two groups. In the experimental group, the frequency of fluoride application was once every 3 months, combined with behavioral management and oral health guidance. In the control group, fluoride application was conducted once every 6 months, combined with behavioral management and oral health guidance. The effect of caries prevention was evaluated one year later.  Results  The prevalence of caries in three-year-old children was 50.9% at baseline, and the prevalence of caries in boys and girls was 47.5% and 54.5%, respectively, with statistical significance (χ2=9.64, P < 0.05). A total of 1 090 high-risk children were screened out, including 475 in experimental group and 615 in control group. The prevalence of caries in the two groups at baseline was 74.1% and 75.1%, respectively, and dmft were (2.98±3.33) and (3.04±3.16), respectively, with no significant difference (χ2/t=0.15, 0.28, P>0.05). One year after intervention, the prevalence of caries in the two groups was 78.5% and 83.0%, respectively and dmft were (4.22±3.97) and (4.51±4.08), respectively, with no statistical significance (χ2/t=3.17, 0.05, P>0.05). The incidence of new caries in the experimental group was 3.7%, and the incidence of new caries was (1.26±1.69), lower than 7.6% and (1.45±2.04) in the control group, with statistical significance (χ2/t=6.89, 5.05, P < 0.05).  Conclusion  The frequency of fluorination intervention once every 3 months combined with behavior management mode was more effective in controlling new caries in children with high risk of caries.