- 學位論文
3－6歲兒童口腔健康、飲食與潔牙習慣之城鄉差距探討
Comparsion of dietary and tooth brushing habits to dental caries of 3-6 years old preschool children in urban and rural area
摘要
研究背景： 齲齒為臺灣兒童常見的口腔疾病，而相關研究證實，齲齒會嚴重影響兒童口腔健康、飲食習慣、睡眠習慣及生活品質。國內3-6歲兒童口腔健康狀況，是否在近年來有所改進或停滯或昇高，極需經由研究來加以探討分析。因此，本研究擬利用口腔檢查資料並配合問卷調查，來瞭解3-6歲兒童的齲齒狀況、飲食與潔牙習慣之城鄉差距探討，、並與國內黃純德(2006)所做臺灣地區3-6歲兒童口腔狀況調查做比較。 研究目的： 1.暸解城鄉地區3-6歲兒童口腔健康狀況、飲食及潔牙習慣現況。 2.探討城鄉地區兒童齲齒狀況與社會人口學間之相關性。 3.探討城鄉地區兒童齲齒狀況與飲食、潔牙習慣之相關性。 4.探討造成城鄉差距兒童齲齒狀況之重要影響因素。 研究方法： 本研究為橫斷面研究，取樣自台灣六歲以下兒童口腔及衛生狀況調查，該調查採分層多段隨機抽樣，抽樣機率以等比隨機抽樣調查法，以居住在台灣23縣市，具有中華民國國籍3-6歲兒童為研究對象，共調查3412位兒童。以Microsoft Access軟體設計資料庫建檔，利用統計軟體(SPSS 17.0)進行統計分析，以t-檢定、變異數分析(ANOVA)、卡方檢定(Chi-square test)等分析相關因子與地理區域之差異。 研究結果： 鄉村男生除dt 5.55±6.30、ds 4.11±4.66、deft index為5.88±0.57顯著高於城市男生dt 2.19±0.57、ds 4.00±6.40、deft index 4.02±0.19有顯著性差異（p＜.0001），在性別方面，女生齲齒率79.36﹪也顯著高於男生(63.31﹪)（p＜.0001）。而3-6歲兒童其平均dt、ds、deft index、defs index與齲齒率，隨年齡增加而顯著(p <.0001)；再甜食攝取及潔牙習慣來看，統計結果顯示，鄉村兒童喜歡吃點心、烘培類食物且無刷牙習慣deft index為9.87±8.45、5.27±2.88，高於城市兒童9.42±8.13、4.95±5.58，在統計上有顯著性差異（p＜0001）。 結論： 本研究與黃純德(2006)臺灣地區3-6歲兒童口腔狀況調查比較下，以deft index來看，結果顯示，3歲齲齒指數分別2.85±3.25、4歲齲齒指數分別4.16±5.12、5歲齲齒指數4.36±5.63、6歲齲齒指數5.37±6.26，而從齲齒率來看，本研究3歲齲齒率40.19﹪、4歲齲齒率57.80﹪、5歲齲齒率72.38﹪、6歲齲齒率73.43﹪，其齲齒指數及齲齒率都比黃純德(2006)研究下降許多，而從影響城鄉地區3-6歲兒童deft index迴歸分析中發現，造成兒童口腔健康狀況因素為城鄉地區、年齡、飲食（甜食攝取）及潔牙習慣（氟化物使用）及母親為外國籍，這些因素在3-6歲兒童的口腔健康及保健皆是有相關性的，其中以鄉村地區兒童口腔健康狀況遠比居住城市地區兒童嚴重，因此極需加強鄉村地區兒童口腔衛生保健及加強推廣家長及照護者口腔保健知識，以強化兒童口腔健康狀況。 關鍵字：齲齒經驗指數、齲齒率、城鄉地區、口腔健康狀況
並列摘要
Background: Dental caries of children in Taiwan is the most common oral disease; it can also severely affect children's eating habits, sleep habits and quality of life we surveyed and discuss whether the dental health status of children aged 3-6 years old, especially the rural-urban discrepancy has improved recently or not. Therefore, the purpose of this study was to examine the dental health status, diet and tooth cleaning habits of children aged 3-6 years old and their parents and compare their urban-rural discrepancy. Objectives: 1、To survey the oral health ststus diet and tooth brushing habits and caries prevalence of 3-6 year-old children in urban and rural areas. 2、To study the correlation between dental caries status and socio-demography of children in urban and rural areas. 3、To the study dental caries status , diet habits and the relevance of cleaning teeth of children in urban and rural areas. 4、To explore the important factors of dental caries in urban and rural areas. Material and methods: There were 4152 children aged less than 6 years old selected by the sampling method of Probability Proportional to Size (PPS). The final effective sample was 3,412 children aged between 3-6 years old for this cross-sectional study. The content of the study used an oral examination chart which contained dental health status, oral hygiene status, and a structured questionnaire related to diet, tooth cleaning and feeding which was obtained from the parents of the children who participated in this study. MS Access was used to design the data base. SPSS 17.0 software was used for statistical analysis which contained t-test, analysis of variance (ANOVA) and Chi-square test for analyses. Results: The 3-6 year old mean dental health index including dt, ft, deft index, ds, fs defs index and caries rates increased with age significantly (p <0.0001); The deft index of 6 year-old children in rural areas showed 6.60±7.51 which was statistically significantly higher than that of urban areas, 4.54±3.41.The rural children who liked to eat snacks and baked foods showed a higher deft index of 9.87±8.45 than that of urban children, 9.42±8.13 with a statistically significant difference (p <0.0001). The rural children who did not have tooth-brushing habits showed a higher deft index of 5.27 ± 2.88 than that of urban children of 4.95 ± 5.58 with a statistically significant difference (p <0.0001). Conclusion: This survey proved that the discrepancy of dental health status of 3-6 year-old children between urban and rural areas is severe and should be improved urgently. The important affect factors to cause the poor dental health status are age, tooth-brushing behavior, diet habits and the urban rural divide. KEY WORDS： Dental caries experience index, caries prevalence, rural and urban areas, dental health status