口腔衛生教育介入對牙菌斑移除之成效探討--以屏東縣國小中年級學童為例

The Reduction of Dental Plaque Index by Intervention of Oral Health Education in Middle- Grade of Elementary School Students in Ping-tung County

黃鈺婷(Yu-Ting Huang)

指導教授 ： 黃純德

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(2006年)

摘要

研究背景：
要維護好口腔健康，有賴正確的知識、態度及行為。特別是正確的潔牙行為。教育部為提昇學生健康，強調以加強口腔保健作為奠定學生健康發展的基礎(教育部，2000)。美國在2000年提出「健康國民2010」(Health People 2010)中更強調預防口腔疾病、增進口腔健康，對於實現國民的身體健康及增進生活品質有相當大的重要性(U.S. Department of Health and Human Service，2000) 。而日本為了因應高齡化社會的來臨，口腔保健方面於2000年推出「8020運動」，目標是希望每位80歲的老人仍然保有20顆以上的健康牙齒，以提昇老年生活品質。欲達成上述目標需擁有充分的口腔衛生知識以及良好之口腔衛生習慣為基礎。
研究目的：
主要探討口腔衛生教育介入後，學童牙菌斑移除之成效以及口腔衛生知識、態度與行為之改變。
研究方法：
本研究對象為屏東縣某國小中年級學童，共計164人為實驗對象。其中實驗組95人，對照組69人。實驗組與對照組在前測進行問卷和口檢，實驗組進行衛教介入，共上4個單元5堂課，於課程結束後再進行後測與後後測問卷調查及口檢，資料統整以Microsoft Excel建檔及JMP 5.1.2版套裝軟體統計分析。
結果：
全口牙菌斑指數平均值，實驗組與對照組前測指數差異不具統計意義 (p=0.3478)，但在教育介入後，後測指數與後後測指數平均值則有顯著差異 (p <0.0001) 實驗組均優於對照組。在知識、態度、行為方面，前測均無顯著性差異。在後測知識及後後測知識實驗組優於對照組呈現顯著差異(p <0.0001)，但態度和行為在後測及後後測實驗組和對照組則無統計學上之差異。在知識方面顯示實驗組對於上課內容能夠充分了解。但是態度和行為上則有待加強，雖然在態度及行為上並無顯著提升，不過從牙菌斑指數的下降，可推論刷牙技巧行為及刷牙品質的改善，經過口腔衛生教育課程介入後對學童的口腔衛生仍是具有改善效果。
結論：
本研究結果顯示，經過口腔衛生教育課程介入後，對牙菌斑移除成效是有效果的，從牙菌斑指數的下降，可推論刷牙技巧行為及刷牙品質，對學童的口腔衛生仍是具有改善效果。
口腔衛生教育計劃的實施，應以學童能夠持之以恆的形成良好口腔衛生習慣為主要目的，因此，從口腔衛生教育之理論到實踐，除充分掌握理論架構外，亦應從經驗與評價交互運用下，發展適應個別性之計劃，逐步階段性的推廣。一般學校老師均未特別受過有關口腔保健方面的專業訓練，建議可加強學校老師、校護的口腔衛生保健的健康教育，強化老師在口腔衛生教育中的角色。並規劃口腔衛生師相關制度及培訓口腔衛生師，建立本土化之口腔保健系統以提昇國人口腔健康水準。為強化口腔保健行為，其長期成效尚須後續的追蹤及持續督促。

關鍵字

牙菌斑指數 ； 口腔衛生教育介入 ； 國小學童

並列摘要

Background：It depends on correct knowledge, altitude and behavior to maintain good oral health, especially on the correct practice of tooth cleaning.
Objectives：The aim of this study is to evaluate the effect of the oral health education intervention for middle -grade primary schoolchildren on plaque control and the change KAP of oral hygiene.
Methods: The subjects in this study are the middle - grades- children of the elementary school in Ping-tung County, 164 persons in total. Among them, 95 persons belong to experiment group, 69 to control group. Both experiment group and control group were given questionnaires and oral check-up at baseline, and experiment group was intervened with oral hygiene education, namely 5 courses in 4 units. After the courses completed, both groups were conducted questionnaires and oral check-up again in post-test and post-post-test stages. The data were collected and organized with Microsoft Excel and were statistically analyzed with JMP 5.1.2 software package.
Results：There is no significant difference (p=0.3478) in the average value of full mouth dental plaque index at baseline between experiment group and control group. However, after the intervention of oral health education, the average score of full mouth dental plaque in post-test and post-post-test stages revealed significant difference (p <0.0001), the experiment group is superior to control group. In respect to knowledge, altitude and behavior of oral health, there is no obvious difference between both groups at baseline. There showed significant difference in knowledge part at post-test and post-post-test stages (p <0.0001), no significant difference in altitude and behavior parts at post-test and post-post-test stages. In respect to knowledge, it shows that experiment group who fully understands what taught in classes. In respect to altitude and behavior, however, they need further intensified. Although there is no obvious level-up in altitude and behavior, it can be deduced that, with the decrease of the dental plaque index , schoolchildren have improved their skill and quality of tooth brushing. The intervention of oral health education courses shows effective in improving the dental hygiene among schoolchildren.
Conclusion: This research showed that the most important factor in influencing the dental caries status. The implementation of oral hygiene education does not represent that schoolchildren will keep their good oral hygiene habit permanently. As the matter of fact, for the continuation of their altitude and behavior in oral health care, there shall be need subsequently follow-up and consistent supervision and urging.

並列關鍵字

Plaque index ； Oral health education intervention ； Schoolchildren.

參考文獻

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