臺北市一般國小身心障礙學童口腔健康狀況與相關因素探討

Oral Health Status and the Related Factors of the Children with Disabilities in Taipei City Ordinary Primary School

黃維勳(Wei-Hsun 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(2005年)

摘要

研究背景：國小學童時期最常見的口腔疾病為齲齒和牙周疾
病，影響發育，人際關係、心理發展、和生活品質。
臺灣12 歲學童2000 年DMFT index 為3.31 顆，齲齒盛行率為
66.5%，治療率為54.3%。有關12 歲身心障礙學童口腔健康現有資料
DMFT index 為3.82、盛行率為71.05%、填補率為26.11%，顯示口腔
的健康狀況較一般的學童差。
研究目的：
一、 為探討比較臺北市一般國小身心障礙學童的口腔健康狀
況，飲食及生活習慣、口腔衛生習慣和就醫經驗。
二、 比較臺北市一般國小身心障礙學童健康狀況，和照護者的
口腔保健知識、態度、行為和就醫經驗的相關性。
研究方法：臺北市一般國小特教班學生總人數為979 人，由十
二行政區每區隨機抽取設有特教班的二分之一學校，得到554 人的樣
本數，完成口腔檢查和問卷的有339 人，完成率為61.19%。
研究工具為口腔檢查表及問卷調查表2 種，口腔檢查表係由高雄
醫學大學口腔衛生科學研究所，依照WHO 頒佈的口腔健康檢查診斷方
法與標準，修正成適合臺灣身心障礙學童的口腔健康狀況及醫療需求
調查的口腔檢查表。問卷調查表則包括飲食、潔牙及生活習慣，與照
護者對口腔健康知識的KAP。
檢查醫師做行前校正，以取得檢查標準的一致性。
檢查結果和問卷表輸入電腦後，用SPSS 10 和JMP 5.0 統計分析。
結果：
身心障礙學童平均年齡為9.32 歲，男性較多228 人〈佔67.3%〉，
女性111 人〈佔32.7%〉。障礙等級以中度99 人〈佔29.2%〉最多。
dft index 為2.65±3.45，乳牙盛行率為53.10%; 乳牙填補率為
41.53%； DMFT index 為1.97±2.49，恆牙盛行率為54.57%，恆牙填
補率為32.28%。
牙菌斑指數為1.51±0.99；牙齦炎指數為1.02±0.99；牙結石指
數為0.14±0.47。
照護者的口腔保健知識總分為10 分，平均得分6.57±2.70 分。
照護者的口腔保健態度總分為40 分，平均分數是30.69±3.98，顯示
態度都是正向的。
結論：本研究發現完成口腔檢查但是未填寫問卷的身心障礙學
童，與完成口腔檢查及填寫問卷的身心障礙學童，經檢定口腔健康狀
態，僅有恆牙齲齒盛行率有統計學上的差異，其他指標都沒有統計學
上的差異。
本研究發現12 歲學童的DMFT index、盛行率、填補率，介於一
般國小學童，和教養機構的學童之間，但較偏向教養機構的學童。
對於影響學童口腔健康狀況相關的因素包括：學童的性別、年
齡、障礙類別、有無甜食要求、潔牙次數、母親教育程度、母親口腔
行為和照護者知識、態度和行為。和國內的實證研究，發現父母親態
度正向的行為較好的，會影響其子女之口腔健康狀況的結果一致。

關鍵字

牙菌斑指數 ； 身心障礙學童

並列摘要

Background: The most commonly seen oral diseases in children are
dental caries and periodontitis. These two oral diseases influence the
physical developments, the establishment of interpersonal relationships,
mental developments, and the life quality of children.
The prevalence rate, DMFT index and treatment rate of the 12yeares
old children were 66.5% ,3.31 and 54.3%. According to the previous data
for the same age children with disabilities, the oral health is worse than
normal children.
Purpose:
a. To compare the health, the eating habits, oral hygiene, the
medical treatment experiences of children with both physical and mental
disabitites in primary schools with disable children in special education
institution.
b. To understand the situation of disable children’s oral health in
ordinary primary schools and the interrelation with the knowledge, the
attitud, the behaviors, and the medical treatment experiences of the
caretakers.
Method: About 50% of the schools that have special education
classes in each of the twelve administration divisions of Taipei City were
used in the present study. The apparatuses included the oral health
examination procedure and standard promulgated according to the
regulations of WHO, the oral examination form modified for examining
the oral health condition and the medical needs, as well as the
questionnaires regarding the oral health and the habits and customs of
eating and mouth cleaning.
In order to consistent examine criteria, the dentists were checked
before doing the examinations.
The results obtained from the oral examinations and the
questionnaires were inputted to the computer and analyzed statistically
through SPSS 10 and JMP 5.0.
Results: There were more males (228 people, 67.3% ) than females
(111 people, 32.7% ) in the disabled students. The average age was 9.32
years old. The majority of people were of middle level of disability (99
people, 29.2% ). Intellectually disabled students were the majority (127
people, 37.5% ).
The dft index for primary teeth was 2.65±3.45, with the prevalence
rate of 53.10%, and the filling rate of 41.53%; the DMFT index for
permanent teeth was 1.97±2.49, with the prevalence rate of 54.57%, and
the filling rate of 32.28%.
The index for dental plaque was 1.51±0.99; the gingivitis index was
1.02±0.99; the calculus index was 0.14±0.47.
The knowledge of the caretakers on oral health: The average score
for the knowledge of oral health in caretakers was 6.57±2.70, with 10 as
the full score. The full score of attitudes towards oral health was 40, and
the average score yielded from the caretakers was 30.69±3.98, which
suggests an overall positive attitude.
Conclusion: The present study found that the factors influencing the
oral health in children includes: the gender, age and type of disability of
the child, the demands for sweet foods, the frequency of teeth cleaning,
the education level of the mother, the oral health habits of the mother, as
well as the knowledge, attitude and behaviors of the caretakers. This is
consistent with the study results in Taiwan, which found that the attitude
of oral health and the oral cleaning habits in parents do have an effect on
the children’s oral health.

並列關鍵字

dft index ； disabled primary school students ； DMFT index ； dental plaque

參考文獻

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