青海省5岁儿童龋齿患病状况及影响因素分析

The analysis of dental caries prevalence and influencing factors among 5-year-old children in Qinghai Province

目的 分析青海省2017年5岁儿童龋齿患病状况及影响因素。方法 依据2017年第四次全国口腔健康流行病学抽样调查结果中青海省的数据,按地区、性别分别计算5岁儿童患龋指标,按地区分析5岁儿童家长对口腔健康的知识与态度、儿童饮食习惯及儿童口腔卫生服务利用情况,并与2007年第三次全国口腔流行病学调查结果中青海省的数据进行比较;采用多因素Logistic回归分析儿童龋齿的影响因素。结果 2017年青海省5岁儿童患龋率为77.75%,较2007年上升了6.34个百分点(χ^(2)=5.818,P<0.05);其中城市地区儿童患龋率上升了10.81个百分点(χ^(2)=7.880,P<0.05),女童患龋率上升了14.00个百分点(χ^(2)=13.530,P<0.05)。2017年青海省5岁儿童龋齿填充率为1.76%,较2007年下降了0.14个百分点,其中城市地区儿童龋齿填充率高于农村地区儿童(χ^(2)=12.859,P<0.05)。2017年青海省5岁儿童龋均为4.69,较2007年增加了1.39。2017年青海省5岁儿童家长口腔健康知晓率为36.47%,较2007年上升了20.58个百分点;儿童家长对口腔健康持积极态度的比例为60.78%,较2007年下降了17.57个百分点。2017年青海省5岁儿童在过去12个月内出现牙痛或不适的比例为35.78%,而有就医经历者仅占19.27%,城市地区儿童有就医经历的比例高于农村地区儿童(χ^(2)=10.795,P<0.05)。多因素Logistic回归分析显示,从来没去医院看过牙(OR=0.374,95%CI:0.141~0.993)是儿童发生龋齿的保护因素(P<0.05);对孩子牙齿和口腔状况评价为一般(OR=2.006,95%CI:1.174~3.425)或差(OR=8.236,95%CI:2.326~29.166)、儿童家长认为刷牙预防牙龈出血不正确/不知道(OR=1.648,95%CI:1.120~2.424)均是儿童发生龋齿的危险因素(P<0.05)。结论 2017年青海省5岁儿童患龋率仍较高,应重点关注城市地区及女童的龋齿状况。实施有效的口腔综合干预措施,定期开展儿童口腔检查及对儿童的父母进行口腔知识宣教,能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 analyze the prevalence and influencing factors of dental caries among 5-year-old children in Qinghai Province in 2017.Methods According to the data from the Fourth National Oral Health Epidemiological Survey conducted in 2017,the prevalence of dental caries among 5-year-old children in Qinghai Province were calculated by region and sex respectively.The study also analyzed the knowledge and attitudes of parents towards oral health,children's eating habits and utilization of oral health services among 5-year-old children by region,and compared the data with that of Qinghai Province from the Third National Oral Epidemiological Survey conducted in 2007.Furthermore,multifactorial regression analysis was employed to identify the influencing factors of dental caries among children.Results In 2017,the prevalence of dental caries among 5-year-old children in Qinghai Province was 77.75%,which increased 6.34 percentage points compared to 2007(χ^(2)=5.818,P<0.05).Specifically,the prevalence of dental caries among children in urban areas increased by 10.81 percentage points(χ^(2)=7.880,P<0.05),and the prevalence among girls increased by 14.00 percentage points(χ^(2)=13.530,P<0.05).In 2017,the filling rate of dental caries among 5-year-old children in Qinghai Province was 1.76%,which decreased by 0.14 percentage points compared to 2007.Specifically,the filling rate of dental caries among children in urban areas was higher than that among children in rural areas(χ^(2)=12.859,P<0.05).The mean dmft index for dental caries among 5-year-old children in Qinghai Province was 4.69 in 2017,an increase of 1.39 compared to 2007.In 2017,the oral health awareness rate among parents of 5-year-old children in Qinghai Province was 36.47%,which increased by 20.58 percentage points compared to 2007.The proportion of parents holding a positive attitude towards oral health was 60.78%,a decrease of 17.57 percentage points compared to 2007.The proportion of 5-year-old children in Qinghai Province who experienced toothache or discomfort in the past 12 months was 35.78%,while only 19.27%had sought medical treatment.The proportion of children with medical experience in urban areas was higher than that of children in rural areas(χ^(2)=10.795,P<0.05).Multivariate logistic regression analysis showed that never visiting a hospital for dental check-ups(OR=0.374,95%CI:0.141,0.993)was the protective factor against children's dental caries,while evaluating the child's dental and oral condition as fair(OR=2.006,95%CI:1.174,3.425)or poor(OR=8.236,95%CI:2.326,29.166),and parents incorrect or lack of awareness regarding tooth brushing to prevent gum bleeding(OR=1.648,95%CI:1.120,2.424)were the risk factors for children's dental caries(P<0.05).Conclusions The prevalence of dental caries among 5-year-old children in Qinghai Province remained relatively high in 2017,with particular attention needed for monitoring the dental condition of children in urban areas and girls.Implementing effective comprehensive oral interventions,regularly conducting children's dental examinations,and providing oral health education to parents can help foster correct oral health perspectives in children,cultivate good oral health behaviors,and reduce the prevalence of dental caries among children.