窝沟封闭对辽宁省小学生第一恒磨牙患龋率影响

Effect of pit and fissure sealant on caries rate of first permanent molars among primary school students in Liaoning province:a cohort study survey

目的评估窝沟封闭对辽宁省小学生第一恒磨牙患龋率的影响,并分析第一恒磨牙龋齿发生的影响因素。方法选取2019年9月-2020年12月辽宁省8个市7~12岁在读小学生,采用多阶段分层随机抽样的方法,在每市区(城市)/县城(农村)各抽取2所小学校按照每所学校不少于60名、每个市不少于280名小学生的原则进行抽样。将满足窝沟封闭条件并做窝沟封闭的学生作为治疗组,将满足窝沟封闭条件未做窝沟封闭的学生作为对照组,对治疗组小学生进行第一恒磨牙窝沟封闭,计算2组小学生第一恒磨牙患龋率及窝沟封闭对小学生第一恒磨牙的保护率;对抽取的所有小学生及其学生家长进行问卷调查,并对学生第一恒磨牙龋齿发生的影响因素进行单因素和多因素logistic回归分析。结果本次共抽取7700名学生参加口腔检查,有2393名学生满足窝沟封闭条件,其中1254名学生选择窝沟封闭治疗(治疗组)、1139名学生拒绝窝沟封闭治疗(对照组)。检查结果显示,辽宁省2019年9月-2020年12月参加口腔检查的7~12岁在读小学生第一恒磨牙总患龋率为24.45%;治疗组小学生第一恒磨牙患龋率(22.57%)明显低于对照组(26.51%)(χ^(2)=5.034,P=0.025);窝沟封闭对小学生第一恒磨牙的保护率为14.86%。性别、是否进行过窝沟封闭治疗、对牙齿是否需要定期去医院检查的态度和家长帮助孩子刷牙情况为小学生龋齿发生的主要影响因素(P<0.05),其中做窝沟封闭为龋患发生的保护因素(P<0.05),而女生、认为不需要定期去医院检查口腔状况和家长不是每天帮助孩子刷牙为小学生龋齿发生的危险因素(P<0.05)。结论窝沟封闭对辽宁省在读小学生第一恒磨牙龋齿发生具有保护作用,可通过推广窝沟封闭来降低小学生第一恒磨牙龋齿的发生率。

Objective To explore the influence of pit and fissure sealant and other relevant factors on caries rate of first permanent molars among primary school students in Liaoning province.Methods The participants of the two-stage survey were 7770 students aged 7-12 years recruited with multi-stage stratified random sampling from 32 rural/urban primary schools in 8 municipalities of Liaoning province.In the first oral health examination conducted by dentists during2019 among all the participants,2393 were identified as having indications of fissure sealant;of them,1254 receiving fissure sealant were assigned into a observation group and 1139 not having fissure sealant were regarded as controls.Then the second oral health examination and a self-administered or parents-involved questionnaire survey were carried out among the 2393 students during 2020 to explore the prevalence and influencing factors of first permanent molars carries among the students of observation and control groups.Univariate and multivariate logistic regression analysis were adopted in data analysis.Results The overall prevalence rate of first permanent molar caries was 24.45%for the 2393 students and the prevalence rate was significantly lower in the students of the observation group than that in the controls(22.57%vs.26.51%,χ^(2)=5.034;P=0.025).The estimated protection rate of fissure sealant against first permanent molar caries was 14.86%.The results of multivariate logistic regression analysis revealed that gender,pit and fissure sealant,attitude towards regular dental clinic visit,and parental guidance on teeth-brushing were significant influencing factors of first permanent molar caries(all P<0.05);among those influencing factors,female gender,negative attitude towards regular dental clinic visit,and without daily parental guidance on teeth-brushing were risk factors of first permanent molar caries(P<0.05 for all)but having pit and fissure sealant was a protective factor against the caries(P<0.05).Conclusion Pit and fissure sealant has a protective effect on the occurrence of first permanent molar caries among 7-12 years old primary school students and the treatment needs to be promoted to reduce morbidity of first permanent molar caries among the students.