青海省两地区12岁儿童龋齿影响因素的多水平分析

Multilevel analysis of factors influencing dental caries in 12-year-old children in two regions of Qinghai province,China

目的了解青海省西宁市及海东市12岁儿童口腔健康状况及个体和学校水平上的影响因素,为制定和完善青海省儿童口腔干预政策提供依据。方法利用青海省2016年第四次口腔流行病学调查数据,采用多水平Logistic回归模型对813名12岁儿童口腔状况及影响因素进行分析。结果青海省两地区12岁儿童患龋率为29.90%,女性儿童患龋率(33.33%)高于男性(26.37%),差异有统计学意义(χ^(2)=4.71,P=0.030),农村儿童患龋率(30.49%)高于城市儿童(28.97%),差异无统计学意义(χ^(2)=0.21,P=0.644);儿童的口腔健康状况在学校水平呈现聚集性(σ_(μ)^(2)=0.002,P<0.001)。多水平Logistic回归分析发现,儿童性别为女性是儿童龋齿的危险因素,OR(95%CI)为1.48(1.08,2.02);儿童母亲最高学历为高中及以上是儿童龋齿的保护因素,OR(95%CI)为0.62(0.39,0.93);儿童自我口腔评价为差或者一般是儿童龋齿的危险因素,OR(95%CI)分别为1.94(1.21,3.16)、1.46(1.01,2.14);认为“定期口腔检查非常必要”是不正确或不知道是儿童龋齿的危险因素,OR(95%CI)为1.21(1.12,1.54)。结论青海省西宁市及海东市12岁儿童龋齿形势依旧严峻,应以女性儿童为重点人群,实施有效的口腔综合干预措施。以学校为平台针对性地设置口腔保健课程,定期开展儿童口腔检查及儿童父母的口腔知识宣教,促使儿童树立正确的口腔健康观、养成良好的口腔健康行为,降低儿童患龋率。

Objective To investigate the oral health status of 12-year-old children in Xining and Haidong,Qinghai province,China as well as the influencing factors at individual and school levels,and to provide a basis for developing and improving oral intervention policies for children in Qinghai province.Methods Using the data from the fourth oral epidemiological survey in Qinghai Province in 2016,a multilevel logistic regression model was used to analyze oral health status and related influencing factors among 813 children aged 12 years.Results The prevalence rate of dental caries among 12-year-old children in the two regions of Qinghai Province was 29.90%.The prevalence rate of dental caries was significantly higher in girls than in boys(33.33%vs.26.37%,χ^(2)=4.71,P=0.030).Rural children had a slightly higher prevalence rate of dental caries than urban children,which was not significant(30.49%vs.28.97%,χ^(2)=0.21,P=0.644).The oral health status of children was aggregated at the school level(σ_(μ)^(2)=0.002,P<0.001).The multilevel logistic regression analysis showed that female was a risk factor for dental caries in children(odds ratio[OR]=1.48,95%confidence interval[CI]:1.08-2.02);a high school diploma or higher of the mother was a protective factor against dental caries in children(OR=0.62,95%CI:0.39-0.93);poor or moderate self-rated oral health was a risk factor for dental caries(OR poor=1.94,95%CI:1.21-3.16;OR moderate=1.46,95%CI:1.01-2.14);believing that“regular oral examinations are necessary”is incorrect or having no idea was a risk factor for dental caries in children(OR=1.21,95%CI:1.12-1.54).Conclusion In Xining and Haidong of Qinghai province,dental caries is still a serious problem among 12-year-olds,and effective comprehensive oral intervention measures should be implemented,which are particularly important for girls.Schools should act as an effective platform to provide targeted oral health courses,regular oral examinations,and oral health education for parents,to help children establish a correct concept of oral health and develop good oral health behaviors to reduce the incidence of dental caries.