儿童口腔健康相关生存质量影响因素的系统综述

Systematic Review of Factors Influencing Oral Health-related Quality of Life in School-age Children

背景学龄期儿童的各类口腔问题发生率高,且处于自我认知发展的关键时期,其对自身口腔颌面部的变化更加敏感,口腔问题影响生存质量,而不良的口腔健康相关生存质量会对儿童智力、运动能力和社会社交能力的发展产生负面影响。确定儿童口腔健康相关生存质量的影响因素,对后期采取科学的预防性措施具有重要意义。目的探讨影响学龄期儿童口腔健康相关生存质量的影响因素,为提高学龄期儿童口腔健康提供理论依据和指导意见。方法于2019-12-18至2020-01-15,以“口腔健康”“学龄期儿童”“口腔健康相关生存质量”“Oral health”“school-age children”“Oral health-related quality of life”作为检索词,全面系统检索PubMed、the Cochrane Library、Web of Science、中国知网、万方数据知识服务平台。同时筛查纳入文献的参考文献,检索2010年1月—2020年1月的相关文献。两名研究者根据澳大利亚乔安娜循证护理中心(JBI)关于横断面研究的质量评价标准,独立地对文献进行质量评价。结果检索得1251篇文献,最终纳入24篇横断面研究。JBI偏倚风险评估显示所纳入文献偏倚风险较低。结果分析表明:口腔临床症状因素中,龋齿、错牙合畸形、牙创伤、健康状况不良的牙周与口腔健康相关生存质量呈负相关,填充物和裂缝密封剂的使用、治疗后的龋齿与口腔健康相关生存质量呈正相关;社会经济状况因素中,居住环境拥挤与口腔健康相关生存质量呈负相关,父母受教育程度较高、家庭收入较高、就读于私立学校与口腔健康相关生存质量呈正相关;个人信仰和行为习惯因素中,性别为女、牙科治疗恐惧、不良的口腔习惯等因素与口腔健康相关生存质量呈负相关。结论学龄期儿童口腔健康相关生存质量受口腔临床症状、社会经济状况、个人信仰和行为习惯等各方面的影响。学龄期儿童口腔健康和相关生存质量不仅是公共卫生政策问题,而且是社会和经济政策问题,需要社会各界的关注与支持。

Background Various oral problems prevalence remains higher in school-age children,furthermore,they begin developing their self-perception about the appearance of oral and maxillofacial in this crucial period.Oral health problems affect oral health-related quality of life(OHRQoL),what is more,poor OHRQoL has a negative impact on children's intellectual,athletic and social skills development.Therefore,it is important to identify the influencing factors of OHRQoL in children to develop scientific preventive measures.Objective To identify the influencing factors of OHRQoL of school-age children,to offer theoretical guidance for improving OHRQoL in this group.Methods From December 182019 to January 152020,5 databases of PubMed,the Cochrane Library,Web of Science,CNKI,and Wanfang Data were searched comprehensively for studies about OHRQoL in school-age children published from January 2010 to January 2020 using"oral health""school-age children"and"oral health-related quality of life"as search terms.References of the included studies were also screened.Quality assessment was conducted by two researchers independently according to JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies.Results 1251 studies were retrieved,and 24 cross-sectional studies of them were finally included.JBI risk of bias assessment revealed that the overall risk of bias was low.Analysis results showed that,clinical oral symptoms such as dental caries,malocclusion,traumatic dental injuries and periodontal disease were associated with decreased OHRQoL,while the use of fillers and fissure sealants and well-treated dental caries were associated with increased OHRQoL.In terms of socioeconomic factors,crowded living environment was associated with decreased OHRQoL,while high parental education level,high household income,and studying in a private school were associated with increased OHRQoL.Female gender,dental fear and bad oral habits and other factors related to personal belief and badly behavior habit were associated with decreased OHRQoL.Conclusion OHRQoL of school-age children is influenced by clinical oral symptoms,socioeconomic conditions and school types,belief and behavior habit.Oral health together with OHRQoL is not just a public health problem,but also a socioeconomic issue,which needs concerns and supports from all sectors of society.