高雄縣國小學童的口腔衛生習慣和 家長的口腔保健行為與學童齲齒狀況城鄉差異之探討

The Geographic Inequality of Dental Caries﹐Dental Hygiene of Primary School Children and their Parental Dental Awareness in Kaohsiung County

林雯君(Wen-Chun Lin)

指導教授 ： 黃純德 博士

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2006年)

摘要

中文摘要
背景：醫療資源的城鄉差距是台灣存在已久的事實，一般大眾對於城鄉資源分配不均感到不滿，先前有學者探討高屏地區學齡前兒童齲齒狀況存在有城鄉差距，但之前的研究對象為學齡前兒童，因此擬瞭解高雄縣國小學童口腔健康行為與學童的齲齒狀況，是否也存在著城鄉差距，因此進行此次調查。
研究目的：本研究針對不同城鄉地區的學童齲齒狀況與口腔衛生習慣作探討。
研究方法：本研究為橫斷面研究，研究對象為高雄縣國小991位1-6年級的學童及其家長，觀察其口腔齲齒狀況並實施問卷調查。採分層集束隨機抽樣調查法。並以Microsoft Access建檔，利用JMP 5.1.2版本做統計分析。
結果：在回收的問卷中，市區有80.74%的人一天至少刷牙兩次，以早上起床後和晚上睡覺前刷牙者最多佔55.24%。山地則以早晨起床後刷牙（55.24%）及刷牙次數一次（44.16%）最多。在使用氟化物的習慣方面；有使用氟化物習慣的學童以山地最少（79.56%）。使用含氟漱口水頻率每週一次的以鄉鎮最多有85.44%，山地最少有62.41%。受訪者中看過牙醫的比例高達95.76%。在山地有46.35%的人，倘若有齲齒的徵兆時，會去看牙醫，但也只是在牙痛的時候才會去。每3-6個月會定期作口腔檢查的學童以市區最高有26.63%。研究發現在口腔保健的習慣上，因為城鄉的不同，有很明顯的變化，大部分口腔照護習慣，在市區比鄉鎮及山地頻繁（p<0.0001）。
結論與建議：本研究調查結果顯示影響國小學童齲齒狀況最重要的因素為城鄉地區、學童年齡及性別、家中排行與使用含氟漱口水的頻率。如何減少學童口腔齲齒狀況因城鄉差異所衍生的問題，宜建議衛生主管機關針對不同的生活區域及兒童的需求，尤其是山地的兒童，擬定有系統的以部落或學校為導向促進口腔健康的計畫。以預防為導向的口腔健康照護政策，會比現行用治療的方法更有助益。

關鍵字

齲齒經驗指數 ； 齲齒盛行率 ； 城鄉 ； 口腔健康狀況 ； 口腔衛生知識與態度

並列摘要

Abstract
Background：The previous study showed that there were severe disparities existed in the oral health status for the preschool children for the rural and urban area in Kaohsiung area. We wondered that whether this situation was existed in the primary schools or not.
Objectives：To survey the relationship of the dental caries status and dental health behavior of primary school children between the urban and rural area in Kaohsiung area.
Methods：A total number of 991 children aged 7 to 12 years old participated in this study who were sampled by stratified cluster sampling design and Probability Proportional to Size (PPS). The dental status of children were examined by dentists. The dental health behavior and dental caries status were collected by the standardized questionnaires written by their parents or caregivers. Database was designed by MS Access and data were analyzed using SAS and JMP.
Results：In the urban area, 80.74% of students clean their teeth twice a day, among that, those students clean their teeth in the early morning and before sleeping occupied the most (55.24%). In the aboriginal area, 36.50% and 44.16% of the students clean their teeth in the morning and before sleeping respectively. In the usage behavior of fluoride supplements, the students in the aboriginal used the least (79.56%). In the rural area, most of the students (85.44%) had the usage of the 0.2% NaF fluoride containing mouth rinse program once a week. The aboriginal students used the least (62.41%). The students in the urban area had the highest frequency (26.63%) in visiting dentist every 3-6 month. The frequency of the oral health care behavior of the urban students was higher than that of rural and aboriginal students (p<0.0001).
Discussion and suggestions：This research showed that the most important factor in influencing the dental caries status of the primary school children are the geographic area, the age of children, the sex, the ranking in the siblings, the frequency of teeth cleaning and fluoride containing mouth rinse. A systemic oral health promotion program by the government in charge according to various life style and needs of children, especially in aborigines, may reduce the discrepancy of the dental health status between rural and urban area. A prevention oriented oral health care strategy may benefit more than treatment-oriented strategy.
Key word：deft index﹐DMFT index﹐caries prevalence﹐rural-urban, oral health condition, knowledge and attitude of oral health﹒

並列關鍵字

deft index ； DMFT index ； caries prevalence ； rural-urban ； oral health condition ； knowledge and attitude of oral health

參考文獻

參考文獻

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