父母外出务工对玉林市玉州区留守儿童口腔健康相关指标的影响

Impact of parental migration on oral health indicators of left-behind children in Yuzhou district,Yulin city

目的探讨父母外出务工对广西壮族自治区玉林市农村低龄儿童口腔健康相关指标的影响,为玉林市农村低龄留守儿童口腔健康促进提供依据。方法于2021年9月在玉林市玉州区的乡镇中抽签随机抽取3个乡镇,对抽取的乡镇中的农村幼儿园编号,再在每个乡镇中抽取4所农村幼儿园,总共12所幼儿园,共抽取1300名3~5岁农村户口儿童进行口腔检查,对其家长进行口腔健康问卷调查,对比分析留守儿童和非留守儿童在人口学、社会经济学和口腔健康相关指标之间的差异,并采用多因素分析父母外出务工对儿童口腔健康相关指标的影响。结果广西壮族自治区玉林市玉州区留守儿童的患龋率(79.0%)、龋均(5.2±4.6)高于非留守儿童患龋率(62.9%)和龋均(3.6±4.3),差异具有统计学意义(χ^(2)患龋率=31.639,P患龋率<0.001;χ^(2)龋均=5.715,P龋均<0.001)。留守儿童进食甜食频率≥1次/天的比例(75.5%)高于非留守儿童(68.8%),差异有统计学意义(χ^(2)=6.163,P=0.013);留守儿童含糖类液体奶瓶入睡的比例(38.0%)高于非留守儿童(31.3%),差异有统计学意义(χ^(2)=5.496,P=0.019);留守儿童使用含氟牙膏的比例(14.9%)及家长的口腔健康态度得分[(5.5±1.8)分]分别低于非留守儿童使用含氟牙膏比例(19.9%)和家长的口腔健康态度得分[(5.8±1.6)分],差异具有统计学意义(χ^(2)使用含氟牙膏=4.474,P使用含氟牙膏=0.034;t口腔健康态度得分=-4.647,P口腔健康态度得分=0.008)。留守儿童中可视菌斑指数>20%者的比例为59.8%,高于非留守儿童(45.1%),差异有统计学意义(χ^(2)=23.137,P<0.001)。多因素回归分析显示,留守儿童进食甜食频率≥1次/天的比例较非留守儿童高(OR=1.368,95%CI=1.040~1.801);留守儿童的家长口腔健康态度得分比非留守儿童低(t=-2.168,P=0.030,95%CI=-0.406~-0.020);留守儿童可视菌斑指数>20%的比例较非留守儿童高(OR=1.658,95%CI=1.278~2.152);留守儿童的患龋风险是非留守儿童的1.958倍(OR=1.958,95%CI=1.378~2.781)。结论广西壮族自治区玉林市玉州区农村低龄留守儿童的口腔健康行为及口腔卫生情况较非留守儿童差,父母外出务工是玉林玉州区农村低龄留守儿童进食甜食频率高、家长口腔健康态度不积极、口腔卫生状况差及患龋率高的重要危险因素。

Objective This study aimed to explore the influence of migration on the oral health outcomes among the early childhood children in Yulin,and provide a basis for promoting rural left-behind children′s oral health in Yulin.Methods In September 2021,three townships were randomly selected in the townships of Yuzhou District,Yulin City.The rural kindergartens were numbered in the selected townships,then four rural kindergartens were randomly selected in each township,and a total of 12 kindergartens with 1300 rural children at the age of 3-5 years were recruited for oral examination.Their deciduous teeth were examined by dentists and oral health questionnaire survey was conducted for their parents.The differences between the left-behind and non-left-behind children were analyzed in demographic,socioeconomics and oral health related indicators.Multivariate logistic regression was used to analyze the influence of parental migration factors on oral health related indicators.Results The caries prevalence of the left-behind children(79.0%)was higher than that of the non-left-behind children(62.9%)with statistical significance(χ^(2)=31.639,P<0.001).The mean dmft of the left-behind children(5.2±4.6)was significantly higher than that of the non-left-behind children(3.6±4.3,χ^(2)=5.715,P<0.001).The proportion of the left-behind children taking sweetmeats more than once a day(75.5%)was statistically higher than that of the non-left-behind children(68.8%,χ^(2)=6.163,P=0.013).The proportion of the left-behind children sleeping with sugary liquid bottles(38.0%)was significantly higher than that of the non-left-behind children(31.3%,χ^(2)=5.496,P=0.019).The proportion of the left-behind children using fluoride toothpaste(14.9%)was significantly lower than that of the non-left-behind children(19.9%,χ^(2)=4.474,P=0.034).The oral health attitude scores of the parents in the left-behind children group(5.5±1.8)were statistically lower than those of the parents in the non-left-behind children group(5.8±1.6,t=-4.647,P=0.008).The proportion of the visible plaque index over 20%in the left-behind children group(59.8%)was significantly higher than that of the non-left-behind children group(45.1%,χ^(2)=23.137,P<0.001).The proportion of the left-behind children taking sweetmeats more than once a day was higher than that of the non-left-behind children(OR=1.368,95%CI=1.040-1.801).The oral health attitude scores of the parents in the left-behind children group were lower than those of the non-left-behind children group(t=-2.168,P=0.030,95%CI=-0.406--0.020).The proportion of the visible plaque index in the left-behind children group was higher than that of the non-left-behind children group(OR=1.658,95%CI=1.278-2.152).The risk of caries in the left-behind children was 1.958 times higher than that of the non-left-behind children(OR=1.958,95%CI=1.378-2.781).Conclusions The oral health behavior and oral hygiene of the rural left-behind children in Yuzhou District,Yulin,were worse than those of the non-left-behind children,and the caries prevalence of deciduous teeth in the former was higher than that of the latter.Parental migration might be a significant factor on the high frequency of sweets intake,low parental oral health attitude,low oral hygiene and high caries prevalence of the rural early childhood children in Yuzhou District.