台灣中部地區6-18歲兒童、青少年齲齒狀況及口腔衛生知識、態度和行為相關性研究

Abstract

Abstract Background: Though the medical resources in central Taiwan are sufficient, yet those resources in the cities, the counties and towns seem obviously unbalanced. We tried to find if there was any difference between the status of the oral health of 6-18 year-old children in central area and the high caries prevalence rate of 0-6 year-old children from 2005 to 2006, with a view to knowing if the caries prevalence rate is becoming more prevalent recently. We performed made a survey of 6-18 year-old children in central Taiwan to discover in the relationship between the oral health attitude, is practice and caries status of adolescents. And we hoped to realize if there is an increase in caries filling incidence under insufficient medical resource circumstances and if this is an influencing factor of caries prevalence rate when the diversity of the medical resources is sufficient. Objectives: Inquire into the current status of the oral health of 6-18 year-old children and adolescents in central Taiwan. Analyze the relationship between the caries status of 6-18 year-old children, oral health condition, attitude and practice in central areas. Methods: Sample 6-18 year-old children and adolescents living in the four cities and counties in central Taiwan by stratified cluster sampling design using Probability Proportional to Size (PPS). Make an investigation was performed by oral examination and questionnaire. The valid sample was 1,524 in total, and the return rate was 99.87%. The data were, analyzed by using Microsoft Access and JMP 5.1.2 software and handled by using the weighted mean according to the number of 6-18 year-old children. Results： The worst oral status of the primary and the mixed dentition of school children was in the group of 7 year-old children. The deft index (14.02), caries prevalence rate (70.54%) vs defs index (14.02); dmft+DMFT index of the mixed dentition was 6.86 the caries prevalence rate was 75.92% vs dmfs+DMFS index 15.04. The DMFT index, caries prevalence rate vs DMFS index of 6-18 year-old children was variable. The caries prevalence rate of the boys was higher than that of the girls. The DMFT, caries prevalence rate, DMFS index and SiC index of the 12 year-old children was 3.70, 59.25% vs 5.38, 7.23 respectively. The DMFT, caries prevalence rate, DMFS index and SiC index of the 15 year-old children was 5.66, 68.17% vs 9.73, 10.59 respectively. The DMFT, caries prevalence rate, DMFS index and SiC index of the 18 year-old children was 6.19, 66.92% vs 9.12, 10.43 respectively. The deft index, caries prevalence rate and defs index of the 6-12 year-old school children decreased gradually with age. On the other hand, DMFT index of the permanent dentition caries incidence and DMFS index of the 12-18 year-old adolescents increased gradually with age. The caries problems and the oral status in Changhua were the worst. And the oral status in Nantou was better than that in the other three counties or cities. It was found that in regression analysis there were some significant influencing factors of the caries prevalence of the children and adolescents, including eating sweet dessert, the frequency and the time of toothbrushing, after lunch toothbrushing, the methods and the tools of toothbrushing, being afraid of visiting a dentist or never seeing a dentist, regular oral examination, the scoring of the oral health and attitudes. The common influencing factors were the ages of the children’s fathers and seeing a dentist of the 6-18 year-old children and adolescents frequency of dental visits. There was no significant influence on oral health knowledge. Conclusion and suggestions: Though Nantou has limited medical resources, it dose not have the problem of caries increasing prevalence owing to these circumstances. Even through Taichung has sufficient medical sources, there was still no increase in filling incidence. Generally speaking, the average of permanent dentition caries prevalence rate was 46.50% and the average of DMFT index was 3.31. The target of the WHO DMFT index < 3 in 2000 has not been reached yet. It is because we do not have the correct idea of oral health knowledge, attitude and practice and because we have no habit of visiting a dentist regularly. In order to obtain an international level, we should put more emphasis on oral health precautionary measures against caries prevalence. It is suggested that we further analyze the reason for the high caries prevalence of 12-15 year-olds in central Taichung. We must also improve the quality of treating teeth and analyze the results to help solve the problems which exist in Changhua.