學童齲齒發生之相關因素及對日常生活影響程度之探討

The Related Factors of Caries Incidence and the Impact on Daily Performance of School Children

黃琳婷(Ling-Ting Huang)

指導教授 ： 楊奕馨

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(2009年)

摘要

背景：
目前國內學童齲齒率仍十分普遍，學齡期兒童階段口腔生長發育正處於一個多變與轉型時期，且齲齒形成具有複雜性與多成因的特質，相對地增加學童口腔疾病的問題，進而導致影響日常生活表現。因此，採用追蹤研究來分析新齲齒發生之相關因素，並探討學童口腔問題所造成生活上困擾的程度。
研究目的：
探討追蹤2年3個月後學童齲齒改變量與齲齒發生之相關因素及口腔問題對學童日常生活影響的程度。
研究方法：
本研究為追蹤研究（follow-up study），研究對象以高雄縣某公立國小一至五年級學童，從94年12月開始，每個年級各隨機選出3個班級，共選出15個班級，總計504人。經過10個月進行第二次口檢，於97年3月進行第三次口檢，針對先前研究的學生，扣除畢業及轉學者後餘354位，男生202位、女生152位作為此次研究的對象，完成率為70.23%。

研究結果：
在追蹤2年3個月研究發現DMFT指數增加了0.63顆；DMFS 指數增加了1.10面。隨著學童年齡的增加，其DMFT指數增加以8歲這組增量最多，直到學童年齡到達10、11歲時影響才漸趨緩。性別部分，雖然女生DMFT高於男生，但在2年3個月的改變量方面則未達統計上顯著差異，而在DMFS則女生改變量顯著高過男性。迴歸分析中發現乳牙及恆牙未治療齲齒數與DMFT指數及DMFS指數的增加顯著相關。目前口腔狀況對於日常生活影響以「吃東西」最多(41.93%)，其中「刷牙/牙齒清潔」出現「幾乎每天」頻率的比例最多；男生以自覺口內流血問題與七種日常生活表現有最多顯著相關性。女生則自覺口腔發炎紅腫問題與四種日常生活表現較多顯著相關。自覺牙齒不夠白問題在此階段雖然佔最多，但經過統計分析後發現性別、年段與日常生活表現並無顯著相關，可能與目前電視媒體行銷牙齒美白廣告、樹立外觀形象的重要性有關。
結論：
恆牙齲齒指數在學齡期階段是逐年在增加，且發現8歲這組增加最多。研究發現乳牙及恆牙未治療齲齒數為影響DMFT 指數與DMFS 指數重要因子，因此及早處理未治療的齲齒數是可減少齲齒的發生。且應加強學童齲齒填補率與正確潔牙技巧及時機。另外，此階段的學童不分男女、年段的差異皆自覺牙齒不夠白為最普遍注意到的口腔問題，且女生多於男生，可能與國內目前密集美白牙膏、美白牙齒媒體廣告有關。因此媒體影響力是不容忽視，可透過媒體傳播管道，讓學童了解要讓牙齒潔白先決條件是要從正確潔牙觀念開始而不只是流於商業廣告行為。

關鍵字

齲齒發生 ； 日常生活影響

並列摘要

Background:
Caries is a common problem among elementary school students in Taiwan. The development of caries is rather complex. Consequently, it results in more children’s oral disease problems, and these problems can influence behavior. So, we used the follow-up study to analyze the related factors inducing new caries and to discuss how oral cavity problems affect children’s daily life.
Aim：
The purposes of this study were to study and trace the change of children’s caries, related factors and the influence over school children’s daily life over a period of 27 months.
Methods:
A prospective follow-up was employed in this study. Study participants were recruited from the first to the fifth grade of an elementary school in Kaohsiung County. For each grade, 3 classes were randomly selected, with a total of 504 subjects. The study started from December 2005. We did the second oral examination 10 months later, and the third in March 2008. Finally, the number of subjects was reduced to 354 (including 202 boys and 152 girls) owing to school children graduation or transfer. The completion rate of this study was 70.23%.
Result:
In the study, we found the DMFT index increased by 0.63 (p<0.0001)； the DMFS index increased by 1.10 (p<0.0001). The DMFT index increased with the childrens’ age, and reached the maximum at age 8.The age effect was slowed down until age 10 or 11. For the sex dimension, we have found there’s no statistically significant difference in the change of the DMFT between boys and girls, even though the change of the girls’ DMFT index was greater. On the regression analysis, we have found the untreated caries on primary teeth or permanent teeth were the major factor which influenced the DMFT index and DMFS index. Oral health has the greatest influence (41.93%)on eating of daily behavior, tooth brushing /cleaning were the important factors in variable-“almost every day ”as to affect everyday behavior. Boys felt that oral cavity bleeding affected their 7 types of daily performances, while girls mostly felt that oral swelling affected 4 types of daily behavior. Although the majority of children in the study think that their teeth were not white enough, but the statistical analysis presented that there was no significant correlation between this problem with sex, grade and daily behavior. It was probably because of the “white teeth” advertisements that were on TV establish the importance of appearance.
Conclusion:
We found that the permanent teeth caries index increases with age in the school period and the increase was greatest at age 8. From the study we found the number of untreated primary teeth or permanent teeth caries was the major factor which influences both the DMFT index and DMFS index. Therefore, to deal with the untreated caries in time can reduce the caries incidence. We also have to enforce the rate of filling for school children and teach children correct skills and the right time of cleaning teeth. Moreover, either boys or girls at all ages think that their teeth were not white enough, Tooth-whiteness is the most noticed oral problem, and girls care more than boys. This probably concerns the concentrative white-beauty toothpaste ads or the white-beauty tooth media. Therefore we can not overlook the influence of the media .We can use the broadcasting or transmitting means of media to enforce the dental health ideas for the parents and children.

並列關鍵字

Caries incidence ； oral impact in daily performance

參考文獻

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