南投縣原住民和漢民族4-6歲學齡前兒童口腔狀況及口腔保健行為與兒童行為發展之相關性研究

中文摘要研究背景：學齡前期是幼童身心快速成長與發展的階段，幼年期的許多經驗與學習，有持續的傾向，往往會影響以後一生的態度與行為。由於學齡前兒童齲齒盛行率非常高，齲齒因與咀嚼、咬力、口腔保健行為有關，是否也會影響到一般行為發展非常值得幼教、流病等各界探討。目前尚無針對生活在相同環境、醫療、教育背景下，但不同族群的學齡前兒童，進行口腔齲齒狀況和口腔保健行為與一般行為發展三者間之探討。研究目的：主要為探討生活於同一教育、醫療環境但不同種族文化之學齡前兒童齲齒狀況和父母及幼童的口腔保健行為對於口腔狀況與兒童行為發展間之相關性。材料與方法：研究對象主要是以南投縣信義鄉境內21所公私立幼稚園、托兒所四至六歲原住民與漢民族學齡前兒童，進行口腔檢查與問卷調查。而問卷調查採用口腔保健行為問卷調查表與學齡前兒童行為調查小冊(Chinese Child Development Inventory，CCDI)。研究結果：參與本研究的個案共有401人，經過資料整理後完成所有檢查且填寫問卷者共有294人，就種族而言，原住民學齡前兒童有167人，佔了56.80％；漢民族兒童有127人，佔43.20％。就性別而言，原住民男生有162人，佔54.10％，研究結果：齲齒指數高的幼童（deft index＞6或7），在各項行為發展如粗動作、精細動作、溝通表達、概念理解、環境理解、身邊處理、人際社會行為及一般發展也較差，其中原住民兒童在概念理解與環境理解達顯著性差異，漢民族則在精細動作、溝通表達、概念理解等發展面向達顯著性差異。在口腔保健行為和行為發展之相關分析也發現，如果父母沒有幫孩子及早刷牙且刷牙頻率低、吃完甜食未潔牙習慣及父母沒有於3歲前教導孩子自行刷牙，則幼童行為發展也有較差的趨勢，並在環境理解、溝通表達、概念理解及人際社會等行為發展面向達顯著性差異。結論：由本研究結果瞭解不良的口腔保健行為不但會造成齲齒的發生，更進一步會造成行為發展的遲緩，所以父母對幼童口腔狀況，尤其是口腔保健行為問題的重視，絕不能等閒視之。

關鍵字

行為發展；口腔保健行為；齲齒狀況；原住民；漢民族

並列摘要

Background: Preschool age is when a child’s physical and mental development reaches a fast growing period. Experience and learning in childhood tend to last for a lifetime and affect the attitude and behavior throughout one’s life. Since dental caries is prevalent among preschool children, and given the effect of dental caries on the chewing, biting, and oral health behavior, whether it affects other behavior is worthy of discussion in the field of childhood education and epidemics. There is no research on the relationship of the condition of dental caries, oral health behavior and general behaviors of children who share the same environment, medical resources, and education background. Objective: This study objective was to probe into the condition of dental caries of children who share the same environment, medical resources, and education background, but of different races, as well as the relationship between parents’ and children’s oral health behavior on the oral condition and children’s behavioral development. Research method: The subjects were 4-6 years old Han Chinese and indigenous children from 21 public and private kindergartens and preschools in Sinyi Township, Nantou County. The research method included oral check and questionnaire survey, which used Oral Health Behavior Questionnaire and Chinese Child Development Inventory (CCDI). A total of 401 subjects partook in this study, 294 completed all the checks and questionnaires; of which 167 were indigenous children (56.80%). 127 were Han Chinese children (43.20%). In terms of gender, 162 were male indigenous children (54.10%). The results found that children with high dental caries index (deft index >6 or 7) showed slower development in fine and gross motor skills, verbal expression, conceptual comprehension, situation comprehension, social skills, social behaviors, and other behavioral development; of which indigenous children showed a significant difference on conceptual comprehension and situation comprehension, while Han Chinese children showed a significant difference on fine motor skills, verbal expression, and conceptual comprehension. Results: The analysis on the relationship between the oral health behavior and behavioral development showed that if parents fail to help the children brush their teeth of an early stage and brush frequently, developing the habit to clean the teeth after eating sweets, and teaching the children to brush their teeth before the age of 3, the children tend to show slower behavioral development, and a significant difference in situation comprehension, verbal expression, conceptual comprehension, and social skills. Conclusion: The results concluded that poor oral health behavior will lead to dental caries, and in turn, slow behavioral development. Therefore,parents should pay serious attention to the oral condition and oral health behaviors of their children.