Abstract
BackgroundThe aim of this study is to explore the spatial heterogeneity of the retention of PFS in children aged 7–9 years in Shanxi Province, North China and investigate the risk factors associated with PFS retention.MethodsIn this study, 937 children aged 7–9 years from Shanxi Province, China were randomly selected, all of whom had at least one first permanent tooth sealed with PFS in 2016. The children were surveyed after 12 months (in 2017) and 24 months (in 2018). The Geo-detector model was used to explore the spatial heterogeneity of the retention rate of PFS and analyze the influence and interactions of the ecological factors on PFS.Results3299 teeth from 937 children were analyzed. The PFS full retention rates after 12 months (in 2017) and 24 months (in 2018) were 81.6% and 75.1%, respectively. The incidence of caries of the first molar was 2.1% after 12 months and 5.4% after 24 months. The spatial heterogeneity of the PFS retention rate after 24 months was significant, which was shown as the retention rate of PFS increased from north to south after 24 months. Remarkably, the natural environmental factors exerted greater influence than the socioeconomic and medical resources factors after 12 months, where the interaction of fluorine in water (FW) had the strongest explanatory power of 52% (P < 0.05). The medical resources were important ecological factors after 24 months, and the percentage of medical technicians (PMT) had the strongest explanatory power of 70% (P < 0.05).ConclusionThe natural environmental factors and medical resources factors are important ecological factors determining the spatial pattern. The government should strengthen medical and technician construction in North China, comprehensively control fluoride in water, optimize the allocation of medical resources, and promote the balanced development of regional medicine.
Highlights
The aim of this study is to explore the spatial heterogeneity of the retention of Pit-and-fissure sealants (PFS) in children aged 7–9 years in Shanxi Province, North China and investigate the risk factors associated with PFS retention
The results indicate that natural environmental factors are important ecological factors that determine the spatial pattern after 12 months, while medical resources factors are important after 24 months
After more than 20 years of practice in dental prevention and Conclusion In Shanxi Province, the total retention rate of PFS conducted under National Oral Disease Intervention Program for Children (NODIPC) was 95.06% after 12 months and 89.30% after 24 months
Summary
The aim of this study is to explore the spatial heterogeneity of the retention of PFS in children aged 7–9 years in Shanxi Province, North China and investigate the risk factors associated with PFS retention. Despite the widespread decline in the prevalence and severity of caries in permanent teeth in high-income countries over the past few decades [2, 3], the prevalence and burdens of caries are severe across the world [4]. 33.4% of adults aged 21–64 years had untreated coronal dental caries [5]. According to China’ s Fourth National Oral Health Epidemiological Survey (2017), 70.1% of 5-year-olds had primary dental caries and 34.5% of 12-year-olds had experienced dental caries in their permanent teeth [6]. Dental caries can result in pulpitis and pain, adversely affecting student quality of life. The treatment of oral diseases is costly, imposing a significant financial burden on both individuals and national health care systems [7, 8]
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