國內身心障礙兒童齲齒影響因素與改善方法

齲齒為身心障礙兒童口腔健康最主要的問題，如何降低身心障礙兒童的齲齒率與改善齲齒狀況成了重要的課題。本研究採用文獻回顧的方式，首先針對國內身心障礙兒童的齲齒狀況進行整理，其次了解身心障礙兒童齲齒的影響因素，最後探討國內、外身心障礙兒童齲齒之方法與改善成效。國內6到12歲的身心障礙兒童相較於一般兒童，有較高的齲齒率(71.05% vs. 69.32%)及齲齒經驗指數(4.17±1:3.31 vs. 1.45±2.13)，這表示身心障礙兒童的口腔健康狀況較差。由於身心障礙兒童受限於本身的障礙類型與程度，多數無法自我照護本身的口腔健康，加上照護者對口腔保健知識不足、就醫便利性低、牙醫師的治療意願低、病童不易合作及治療困難等，使得身心障礙兒童缺乏足夠的口腔健康照護，造成身心障礙兒童口腔狀況比一般兒童嚴重。而身心障礙兒童齲齒之改善方法與一般兒童相同，皆是透過飲食控制、建立良好的口腔衛生知識及習慣、刷牙訓練及氣化物使用等方式來進行改善。儘管衛生教育及氣化物的介入對身心障礙兒童齲齒問題的改善在過去研究中皆有成效，但因身心障礙兒童受限於本身的障礙類型與程度，多數無法自我照護本身的口腔健康，故身心障礙兒童的口腔健康，仍須仰賴家長、照顧者及牙醫師之協助來共同維持。

關鍵字

口腔健康；身心障礙兒童；健康促進；齲齒

並列摘要

Caries has become a main issue of oral health for disabled children. It is important to realize how to reduce the prevalence and improve the situation of caries among children with disabilities. Therefore, this research reviews the information about the caries status of domestic disabled children, trying to realize the impact factors of caries of disabled children, and finally to analyze the means and their performance for the disabled children. Compared to other children aged from 6 to 12, disabled children have more caries prevalence and caries experience index, which shows that the oral health of disabled children is poorer. Disabled children are limited to their own physical problem; most of them cannot take care of their own oral health well. Due to their limited knowledge of oral healthcare, access barrier to the hospitals, fewer care from dentists, and difficult to cooperate with dentists, the quality if oral health of them is limited. From the review, we found that caries prevention and improvement for disabled children are the same as general children by preventive strategies such as health education and fluoride are effective in previous studies. To improve the oral health of people with disabilities, it is necessary to involve the cooperation among parents, caregivers and dentists, to work together to initiate appropriate health promotion programs.