上海市黄浦区3~6岁儿童乳牙涂氟防龋效果评价

Effect of fluoride varnish on primary teeth in children aged 3-6 years in Huangpu District of Shanghai

【目的】评价上海市黄浦区3~6岁儿童乳牙涂氟防龋项目的防龋效果和成本效益,为学龄前儿童群体涂氟项目作为社区卫生服务龋病防治的基本措施推广提供依据。【方法】在2016—2017年间,对黄浦区12所幼儿园3~6岁儿童实施每半年一次的涂氟。按照基线调查结果将12所幼儿园的3岁儿童分为干预组和对照组,干预组按照制订的规范实施,对照组按照常规要求实施,分别在涂氟前和第4次涂氟后进行患龋状况调查,并进行统计学分析。【结果】2018年3、4、5、6岁儿童患龋率、龋均和显著性龋均指数有所下降,其中5岁乳牙患龋率从2016年的58.8%降低到2018年的45.0%;干预组患龋率低于对照组,人均涂氟次数高于对照组,差异有统计学意义(P<0.05),但两者的涂氟覆盖率和龋均差异无统计学意义(P>0.05)。项目的直接投入产出比为1:5.16。【结论】学龄前儿童涂氟防龋项目能有效降低乳牙龋齿发病率,具有较好的经济学效益;学龄前儿童群体乳牙涂氟规范的应用影响防龋效果。

[Objective]To evaluate the implementation process,and cost-effectiveness of fluoride varnish in preventing primary caries project for children aged 3-6 years in Huangpu District.This would provide the basis for the popularization of fluoride varnish project in preschool children as a basic measure of caries prevention in community health service.[Methods]From 2016 to 2017,children aged 3-6 years old from 12 kindergartens in Huangpu District were varnished by fluoride twice a year.Three-years-old children in 12 kindergartens were divided into intervention group and control group according to the baseline survey results.The intervention group was implemented according to the established norms,while the control group was implemented according to the routine requirements.Follow-up examinations were conducted after 4 interventions to monitor primary caries increment among these children.[Results]Caries rate,average caries index and SiC in children aged 3,4,5 and 6 years were all dropped after fluorination in year of 2018.The caries rate of 5-year-old deciduous teeth decreased from 58.8%in 2015 to 45.0%in 2018.The dental caries rate in the intervention group was lower than that in the control group,and the frequency of fluoride application per capita was higher than that in the control group,showing a statistically significant difference(P<0.05),but there was no significant difference in the rate of fluoride application and average caries index between the two groups(P>0.05).The direct input-output ratio of the project is 1∶5.16.[Conclusion]Fluorinated caries prevention project using fluoride varnish for preschool children can effectively reduce the incidence of dental caries in deciduous teeth and has good economic benefits.The application of standard fluorine coating on preschool children′s deciduous teeth can affect caries prevention.