2020年河南省儿童口腔疾病综合干预项目地区恒牙患龋现状及影响因素分析

Prevalence of caries in permanent teeth and influencing factors in the area covered by Henan Comprehensive Intervention Project of Children’s Oral Diseases,2020

目的 了解儿童口腔疾病综合干预项目在河南实施4-5年后,项目学校与非项目学校五至六年级学生恒牙患龋现状及其影响因素。方法 采用随机整群抽样方法,在河南省2015年参与儿童口腔疾病综合干预项目的 8个县/区,共抽取五至六年级学生4 868名,按照第四次全国口腔健康流行病学调查的方法和标准进行口腔健康检查和问卷调查。结果 共调查4 868名学生,恒牙患龋率29.64%,龋均为0.55,龋补充填比23.65%。恒牙患龋率和龋均非项目学校学生(31.14%,0.59±1.11)高于项目学校学生(28.13%,0.50±0.98),差异均有统计学意义(P<0.05),二年级时第一恒磨牙未进行过窝沟封闭的学生(30.98%,0.59±1.10)高于进行过窝沟封闭的学生(27.64%,0.48±0.96),差异有统计学意义(P<0.05)。龋补充填比项目学校学生(30.33%)高于非项目学校学生(18.04%),差异有统计学意义(P<0.05),二年级时第一恒磨牙进行过窝沟封闭的学生(28.54%)高于未进行过窝沟封闭的学生(20.97%),差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,城市(OR=0.673,95%CI:0.594~0.762)、高频率摄入甜点心(OR=1.144,95%CI:0.986~1.327)是龋齿发生的危险因素,项目学校(OR=1.145,95%CI:1.011~1.297)、男性(OR=1.592,95%CI:1.405~1.803)是龋齿发生的保护因素。结论 河南省儿童口腔疾病综合干预项目取得了一定成效,在一定程度上降低了学生恒牙患龋率,提高了学生或家长的龋病治疗意识。

Objective To understand the prevalence of caries in permanent teeth and influencing factors among 5-6 grade students in project-covered schools and non-project-covered schools after 4-5 years of Henan Comprehensive Intervention Project of Children’s Oral Diseases.Methods A total of 4 868 students of grade 5-6 were selected from the eight counties/districts participating in the project in 2015 by stratified cluster random sampling.According to the basic methods and standards of the Fourth National Oral Health Epidemiological Survey,oral examination and a questionnaire survey were performed among these students.Results Of the 4 868 students,the prevalence of dental caries was 29.64% and the average Decay-Missing-Filled Teeth(DMFT) index was 0.55,and the filled rate was 23.65%.The prevalence of dental caries and the average DMFT index at project-covered schools(28.13%,0.50±0.98) were both lower than those at non-project-covered schools(31.14%,0.59 ±1.11),and the difference was statistically significant(P <0.05).The prevalence of dental caries and the average DMFT index among children whose first permanent molars were not sealed with pit-and-fissure sealants at grade 2(30.98%,0.59 ±1.10) were higher than that in those children who had sealed with pit-and-fissure sealants(27.64%,0.48 ±0.96),and the difference was statistically significant(P<0.05).The filled rate among the children at project-covered schools(30.33%) was higher than that among those at non-project-covered schools(18.04%),and the difference was statistically significant(P<0.05).The filled rate among children whose first permanent molars were sealed with pit-and-fissure sealants when at grade 2(28.54%)was higher than that in children who had not sealed with pit-and-fissure sealants(20.97%),and the difference was statistically significant(P<0.05).Multivariate logistic regression demonstrated that living in urban(OR=0.673,95%CI:0.594-0.762) and high frequent intake of sweet snacks(OR=1.144,95%CI:0.986-1.327) were the risk factors of dental caries,and project school(OR=1.145,95%CI:1.011-1.297) and boy(OR=1.592,95%CI:1.405-1.803) were the protective factors of dental caries.Conclusion The comprehensive intervention project of oral diseases has achieved certain results for reducing the caries rate of students’ permanent teeth,and improving students or parents’ treatment awareness of caries.