台灣3-6歲幼童齲齒型態及其相關因素之探討

齲齒是兒童最常見的疾病之一，但學齡前兒童的口腔健康經常被忽視。國內有關的學齡前兒童的口腔衛生調查資料充足，但對齲齒型態的分析並不多見。學齡前兒童的口腔狀況調查有助於了解齲齒狀況、齲齒型態之演變與口腔衛生習慣之相關性，這些研究結果可以作為未來持續監測齲齒狀況之改變、評估醫療需求的基礎，並可作為口腔保健計劃推行之參考。本研究的目的即針對台灣地區3-6歲幼童的口腔健康狀況與齲齒型態及其相關因素進行探討。本研究採分層集束抽樣法，對全台灣21縣市及北高兩市共3990名3-6歲的學齡前兒童進行家戶調查與機構調查，收集口腔檢查與問卷調查資料。抽樣機率以等比隨機抽樣方式，家戶調查以村里為單位、機構調查以幼稚園為單位進行抽樣。資料收集完整者共3044人，完成收案比率為76.29％。統計資料經過適當的加權，使抽樣結果可以符合各地區與年齡層的人口分布狀況。研究結果發現，家戶調查與幼稚園調查在統計上並無顯著性的差異。早發性齲齒盛行率隨年齡增加而上升，3歲為61.35％，4歲為77.20％，5歲為81.65％。在齲齒型態的分布方面，無齲齒型隨著年齡的增加而所佔比率漸減，到5歲時僅有26.54％的幼童為無齲齒。唇舌面伴隨臼齒鄰接面型齲齒比率則隨著年齡而上升，從3歲時的13.60％增加到5歲時的34.32％。在影響早發性齲齒的相關因素方面，幼兒父母親的社經地位、幼兒的飲食習慣與口腔清潔習慣為主要之危險因子。在罹患早發性齲齒的幼童中，開始清潔牙齒的年齡、是否讓幼兒含奶瓶睡覺、飲用乳品後是否清潔口腔、有吃點心、糕餅類甜食的習慣等，是罹患早發性齲齒的幼兒惡化為嚴重早發性齲齒的關鍵因素。影響乳齒列齲齒型態的因素則包括幼兒父母親的社經地位、幼兒的飲食、潔牙習慣及三歲前飲用乳品的習慣。與衛生署（1997）六歲以下兒童口腔狀況調查報告比較，本研究結果在乳齒齲齒指數與齲齒盛行率有下降的趨勢，且填補率明顯增加，顯示衛生署、健保局與牙醫界在這近十年來，在幼兒口腔疾病的預防保健及醫療成效上確實有所改善。但與世界衛生組織期望在西元2010年時達到5-6歲兒童90％無齲齒的目標，仍有一段差距，因此在口腔衛生保健的推行的工作上仍有待政府機構、口腔衛生教育相關人員與牙醫師共同努力。

關鍵字

學齡前兒童；早發性齲齒；齲齒型態

並列摘要

Dental caries is a significant health issue for children. There have been sufficient surveys on the oral condition of preschool children in Taiwan, but studies about caries pattern are rare. Through the survey of the oral condition of preschool children, the database of the dental health status, its related oral habits and the changes of caries pattern of children can be established. The information will help in the future evaluation on treatment needs, making the strategies of caries prevention plans and promoting policies on oral health. The purpose of this study is to investigate the oral condition as well as caries pattern and its related factors of children aged 3-6 years in Taiwan. Stratified multi-stage cluster sampling and probability proportional to size (PPS) were used for sampling. A total number of 3990 children aged 3-6 years received oral examinations and questionnaires through home visiting and inquiry on the kindergartens. 3044 participants completed the oral health examinations and the questionnaires. Data collected were weight to fit the proper demographic data of each area. There was no significant difference between home visiting group and kindergarten group. No difference was found between boys and girls. The prevalence of early childhood caries (ECC) was 61.35％, 77.20％, and 81.65％ for three, four and five-year-old children respectively. The percentage of caries free pattern decreased as age increased. Only 26.54% remains caries free in children aged 5 years. On the contrast, the percentage of facial-lingual/molar-proximal pattern increased with age increase, which were 13.60％ and 34.32％ for 3 and 5-year-old children. The main contributing factors for ECC were related to the socio-economic status of the parents, breast/bottle feeding, the dietary habits of the children and the oral hygiene habits. For children with ECC, the age at which tooth brushing started, bottle feeding before bed time, snack habits are the significant variable associated with severe-ECC. Factors related to caries pattern include socio-economic status of the parents, breast/bottle feeding, dietary and oral health habits. Compared with the data surveyed in 1997, the oral health status of children aged 3-6 years old have improved remarkably. However, compared to the requirement suggested by WHO, we still have to work hard on the prevention tasks for children.

並列關鍵字

early childhood caries ； preschool children ； caries pattern

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