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

The Study of Dental Caries and Oral Health Related Knowledge, Attitude and Practice of 6-18 Year-Old Children and Adolescents in Central Taiwan

黃淑真(Shu-Chen Huang)

指導教授 ： 黃純德

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(2008年)

https://doi.org/10.6832/KMU.2008.00066

摘要

中文摘要
研究背景：
中部地區醫療資源雖充足，但縣市城鄉分佈明顯不均。為瞭解中部地區6-18歲人口之口腔健康狀況，與94-95年中部0-6歲兒童的高齲齒率結果有否差異。進而調查中部地區6-18歲兒童、青少年齲齒狀況並分析其口腔衛生知識、態度和行為差異及其相關性，以瞭解近年來齲齒盛行趨勢；並進一步瞭解在醫療資源充足環境中其齲齒填補率是否會增加，而醫療資源差距大的環境中是否會影響其齲齒盛行率的增加。

研究目的：
探討中部地區6-18歲兒童及青少年之口腔健康現況。中部四縣市兒童及青少年齲齒狀況與口腔衛生知識、態度與行為的相關性等。

研究方法：
依設籍於中部分區之四個縣市，年齡滿6-18歲的兒童及青少年為抽樣對象，採用分層多段隨機集束抽樣調查法，抽樣機率以等比隨機 抽樣(PPS design)。以口腔檢查及問卷方式進行調查，有效樣本共計1,524 份，完成率達99.48 %。資料使用Microsoft Access，以JMP 5.1.2軟體進行統計分析，資料均搭配6-18歲的年級數做加權處理。

研究結果：
國小學童在的乳齒與混合齒列均以7歲的口腔狀況最差，分別為 deft index（6.13）、乳齒齲齒率（70.54%）vs defs index（14.02）顆；混合齒列之DMFT index（6.86）、齲齒率(75.92%) vs DMFS index（15.04）顆。6-18歲年齡層之DMFT index、齲齒率vs DMFS index，皆以女生高於男生，12歲分別為（3.70、59.25% vs 5.38顆、SiC index 7.23）、15歲為（5.66、68.17% vs 9.73、SiC index10.59）、18歲為（6.19、66.92% vs 9.12、SiC index 10.43）。6-12歲學童乳齒在deft index、乳齒齲齒率與defs index皆隨著年齡增加而下降。12-18歲青少年恆齒在DMFT index 、恆齒齲齒率與DMFS index則隨年齡增加而有逐漸上升之趨勢。
中部地區6-18歲人口以彰化縣在齲齒顆數與面數口腔狀況最差，而南投縣的口腔狀況則優於其他三縣市。經由逐步迴歸發現有顯著相關因素有糖果類甜食、每天刷牙次數與時機、學校午餐後潔牙、清潔牙齒鄰接面(齒縫)工具、害怕或沒看過牙醫的主因、定期口腔檢查、口腔衛生態度得分等，皆為兒童、青少年齲齒的重要影響因素；而其中父親年齡與定期口腔檢查為6-18歲年齡層之齲齒共同影響因素。口腔衛生知識則無顯著性影響。

結論與建議：
南投縣醫療資源雖少，但不因縣市城鄉差距之問題而有齲齒率增加之現象，台中市雖有豐富的醫療資源，但填補率並未因此而增加。
整體而言，中部地區6-18歲恆齒齲齒率平均為46.50%、DMFT index平均為3.31，至今仍尚未達到2000年WHO DMFT index＜3的指標；對口腔衛生知識、態度和行為以及牙科就醫預防觀念尚未正向建立，因此，要達到2010年國際化新標準，日後更須努力加強口腔預防工作。建議可針對中部12-15歲年齡層的高齲齒指數進一步分析其原因，並對齲齒率偏高的彰化縣地區，未來嘗試作牙齒治療品質分析研究以助於瞭解問題所在之處。

關鍵字

6-18歲兒童 ； 青少年 ； 齲齒面數 ； 齲齒指數 ； 新齲齒指數 ； 齲齒率 ； 填補率 ； 口腔衛生知識 ； 態度和行為

並列摘要

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.

並列關鍵字

6-18 year-old children and adolescents ； DMFS index ； DMFT index ； SiC index ； filling rate ； oral health knowledge ； attitude and practice

參考文獻

參考文獻

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