臺灣北部地區0-6歲兒童齲齒狀況及相關因素之探討

研究背景：根據2004年內政部統計資料指出﹐北部在牙科醫療資源佔52.32%為最高，在牙科醫療資源充沛的情況下﹐學齡前兒童齲齒狀況是否有得到更好的照顧﹐值得做進一步探討。研究目的﹕1.瞭解北部地區兒童的口腔健康狀況。2.探討兒童潔牙行為與齲齒之關係。3.探討兒童齲齒數與照顧者的口腔衛生習慣之相關。4.探討兒童齲齒的相關影響因素。研究方法︰研究對象取材高雄醫學大學口腔衛生科學研究所執行的[臺灣六歲以下兒童口腔健康狀況調查]研究計畫。利用標準化問卷來進行照顧者與兒童口腔衛生習慣、飲食習慣、潔牙習慣等的調查。抽樣方法為採分層多段隨機集束抽樣調查法(Stratified multi-stage cluster sampling)，抽樣機率以等比隨機抽樣(Probability proportional to sizes, PPS design)機率，來進行抽樣,共抽樣1,344人,實際完成人數1,213人,完成率90.25%。以MS Access 設計資料庫，並以JMP5.1.2進行統計分析。研究結果﹕男生619人,女生594人﹔北部地區平均齲齒指數3.67±4.33﹐乳牙齲齒盛行率61.48%,乳牙填補率25.58%±35.30。父親教育程度﹕國中以下有齲齒佔71.23%,乳牙齲齒盛行率67.66%為最高﹔母親教育程度︰國中以下有齲齒佔64.86%﹐乳牙齲齒盛行率67.66%為最高,父母親口腔保健知識以父親職業為專業人員分數80.63(±7.84)為最高﹐父母親口腔保健態度分數以大專以上程度29.52(±12.59)為最好,口腔清潔能力以幼兒自己刷deft index 4.29(±4.53)，乳牙齲齒盛行率69.13%為最高﹐兒童吃完甜食無潔牙deft index 3.82(±4.49)為最高，兒童有喝飲料習慣, deft index 4.06(±4.57)﹐乳牙齲齒盛行率65.45%為最高﹔喝飲料加糖deft index4.01(±4.56) ﹐乳牙齲齒盛行率65.11%為最高。研究結論﹕本研究顯示,北部地區兒童口腔健康狀況普遍不佳, 因受到兒童年齡､照護者的年齡､教育程度及職業､飲食習慣､飲食種類､口腔清潔能力等因素的影響而有所不同﹔乳牙齲齒指數､乳牙齲齒盛行率隨年齡增長而增加。雖然北部地區醫療資源豐富﹐兒童口腔健康狀況並沒有預期的好﹐期待政府衛生單位及相關機構能正視這個問題。以落實WHO 2010年口腔保健所訂5歲兒童90%以上無龋齒之目標。

關鍵字

主要照顧者；潔牙行為；齲齒經驗指數

並列摘要

Background: According to the statistics of the Ministry of the Interior in 2004, the dental medical resources was 52.32% of the total budget in northern Taiwan, with such extensives resources; we want to know if the caries status of preschool children living there is better.than the rest of Taiwan. Purpose: The aims of this study were 1. to assess the oral health status of children in northern Taiwan, 2. to evaluate the relationship between oral hygiene behavior and caries status in children, 3. to find the relationship between caries index of children and oral health behavior of care-givers, 4. to find out the risk factors of caries of children. Methods: This study is a part of the【Oral Health Survey of Children Under 6 Years Old in Taiwan】performed by the Graduate Institute of Oral Health Sciences of Kaohsiung Medical University. A structured questionnaire was used to collect information about the oral health behavior, diet habits and dental health behavior of children and their care-givers. The sample was collected by stratified multi-stage clustering method, and the selection probability was proportional to population size.The sample number were 1,344 children, 1,213 children had completely surveyed, the respond rate was 90.25%.all data were coded by Microsoft Access, and analyzed by JMP version 5.12 . Results: There were 619 boys and 594 girls enrolled in the study; the mean caries index was 3.67±4.33, with a prevalence rate of 61.48%, and filling rate 25.58%(±35.30) in primary teeth. For the education of the father: 71.23% of the children had caries if under junior high school, and the highest prevalence (67.66%) of caries of primary teeth; for the education of the mother: 64.86% of the children had caries if under junior high school, and the highest prevalence (67.66%) of caries of primary teeth. As for the oral health knowledge, the professional fathers had the highest scores 80.63(±7.84); the oral health behavior scores were best 29.52(±12.59) if the parents had on education level of college or above. The prevalence of caries of primary teeth was highest (69.13%) if the child brushes his/her teeth by themselves with deft index 4.29(±4.53). The highest caries index 3.82 (±4.49) appear in children who didn’t clean their teeth after sweets. If they drink beverages the deft index was 4.06 (±4.57)﹐and the highest prevalence (65.45%) of caries of primary teeth。to drink sweeterved beverages, the deft index was 4.01 (±4.56)﹐and the highest prevalence (65.11%) of caries of primary teeth. Conclusions: Our study revealed universally poor oral health of children in northern Taiwan, which was affected by age of children age, education level ,occupation, diet habit, kind of food, and oral health activity of care givers; the caries index and prevalence of primary teeth increased with age. In spite of the substontial medical resource in northern Taiwan, the oral health of children was not as good as it should be, to reach the aim of no caries in 90% of children aged over 5-years-old in 2010 set by the WHO, the underlying causes should be evaluated by the government and related bureaus.