湖南韶山地区儿童口腔卫生干预效果评价

目的:了解湖南韶山地区3~12岁儿童的口腔健康状况,评价以社区为单位的口腔卫生宣教、含氟涂料应用等活动对改善地区儿童口腔健康的作用。方法:调查采用整群抽样,选取湖南省韶山市不同经济发展区域的3所幼儿园及2所小学,分别于2014年12月以及2016年9月对3~12岁的幼儿园及在校儿童进行口腔健康状况调查,并在此期间给予干预措施,分别比较两次普查中3~6岁及6~12岁儿童的平均软垢指数、龋均、患龋率,同时将5岁及12岁的儿童作为代表人群,单独比较其平均软垢指数,乳、恒牙龋失补牙数,患龋率,并比较12岁儿童的第一恒磨牙患龋率。结果:2014年及2016年的调查分别纳入儿童992名、896名,分别比较3~6岁以及6~12岁儿童,均显示2016年普查所得的软垢指数均数及乳牙龋失补牙数显著小于2014年,而恒牙龋失补牙数差异无统计学意义。2014年及2016年普查的5岁儿童分别为173名和179名,两者的乳牙龋失补牙数差异有统计学意义(P=0.038),患龋率差异无统计学意义(P=0.370);两年调查的12岁儿童分别为65名和104名,两者的乳牙龋失补牙数及恒牙龋失补牙数差异均无统计学意义(P=0.133,P=0.171)。两年调查的第一恒磨牙患龋率分别为36.9%和26.9%,差异无统计学意义(P=0.171)。结论:含氟涂料的应用合并口腔健康教育可以显著降低湖南韶山地区3~12岁儿童的乳牙龋失补牙数并显著改善口腔卫生状况,恒牙龋失补牙数、5岁儿童乳牙患龋率及12岁儿童第一恒磨牙患龋率均有一定程度的下降。

Evaluation of effect of oral health intervention on children in Shaoshan area of Hunan province

Objective: To understand the oral health status of children aged 3-12 in Shaoshan area of Hunan province and to evaluate the role of oral health educations based on community such as fluoride varnish, oral hygiene introduction in improving the oral health of children in the area so as to gain expe-rience. Methods: The study used cluster sampling to select 3 kindergartens and 2 primary schools in different economic development areas of Shaoshan. Oral health status survey and interventions were conducted in December 2014 and September 2016, respectively. The average debris index, decayed missing filled teeth (deciduous teeth: dmft; permanent teeth: DMFT), and caries prevalence rate of children aged 3-6 years and 6-12 years were compared. At the same time, children aged 5 and 12 were used as representative populations to compare the indices as listed before and the caries prevalence rate of the first permanent molar in 12-year-old children was compared as well. Finally, health economic analysis was carried out based on the 2 years’ result. Results: In this study, 992 children and 896 children in 2014 and 2016 were included respectively. As for children aged 3-6 years, the average debris index and dmft in 2016 were significantly less than that in 2014 (P<0.001, P<0.001), and the difference of DMFT was not significant (P=0.419). Children aged 6-12 years showed the same result, the average debris index and dmft in 2016 were significantly less than those in 2014 (P<0.001, P=0.013), and the difference in DMFT was not significant (P=0.674). 173 and 179 5-year-old children were included in 2014 and 2016 respectively, and the dmft showed significant difference (P=0.038); the caries prevalence rate was 75.7% and 71.5%, respectively, which was also not significant (P=0.370). With respect to the 12-year-old children, 65 and 104 children were included and the differences in dmft and DMFT were not significant (P=0.133, P=0.171). The caries prevalence of the first permanent molar in the 12-year-old children was 36.9% and 26.9%, whose difference was not significant (P=0.171). Conclusion: The application of fluoride varnish and oral health education can significantly reduce the dmft of children aged 3-12 years in Shaoshan area and significantly improve the oral hygiene status. DMFT, the caries prevalence rate of 5-year-old children’s deciduous teeth and 12-year-old children’s first permanent molar showed a decline.