Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (1): 50-56.DOI: 10.12016/j.issn.2096-1456.2021.01.008

• Prevention and Treatment Practice • Previous Articles     Next Articles

Effect assessment of caries management by risk assessment in children in the Minhang district of Shanghai

SHI Hongyan1,2(),HE Xiang1,2,HUANG Rui1,2,ZHANG Ying3()   

  1. 1. Dental Clinics of Minhang District, Shanghai 201103, China
    2. Minhang Branch, School of Public Health, Fudan University, Shanghai 201103, China
    3. Shanghai Stomatological Hospital, Fudan University, Shanghai 200031,China
  • Received:2020-05-13 Revised:2020-06-28 Online:2021-01-20 Published:2020-11-18
  • Contact: Ying ZHANG
  • Supported by:
    Minhang District of Shanghai Natural Science Research Project(2018MHZ032);Shanghai Shenkang Hospital Development Center to Promote Clinical Skills and Clinical Innovation Ability of Municipal Hospitals Three-Year Action Plan Project(16CR4018A)

龋风险评估在上海市闵行区儿童龋病分级管理中的效果评价

施宏燕1,2(),何翔1,2,黄蕊1,2,张颖3()   

  1. 1.上海市闵行区牙病防治所,上海(201103)
    2.复旦大学公共卫生学院闵行分院,上海(201103)
    3.上海市口腔病防治院,上海(200031)
  • 通讯作者: 张颖
  • 作者简介:施宏燕,主治医师,硕士,Email: 86259225@qq.com
  • 基金资助:
    上海市闵行区自然科学研究课题(2018MHZ032);上海申康医院发展中心促进市级医院临床技能与临床创新能力三年行动计划项目(16CR4018A)

Abstract:

Objective To assess the effect of caries management based on risk assessment in children and to provide the basis for the government to develop strategies to prevent and treat oral diseases. Methods From March 2018 to March 2019, 512 3-year-old children and 502 6-year-old children were selected by cluster sampling from kindergartens and primary schools, respectively, in the Minhang district of Shanghai, and oral examinations and questionnaires were carried out to assess baseline status. Then, the children were divided into 3 groups, including low-, middle- and high-risk groups, according to caries risk assessment. In each caries risk group, the children were randomly divided into an experimental group and a control group. The experimental groups were managed by risk assessment, and the control groups were provided basic oral public health services by the Shanghai government. The effect of caries prevention was evaluated 12 months later. Results Among the children with a high risk of caries, the incidence of caries was 51.22% in the 3-year-old control group, 34.17% in the experimental group, 51.27% in the 6-year-old control group and 33.15% in the experimental group, with statistical significance (P < 0.05). Among the children with a middle risk of caries, the incidence of caries was 38.71% in the 3-year-old control group and 7.32% in the experimental group, with statistical significance (P < 0.05). However, there was no significant difference in caries incidence between the control group and the experimental group for the children with low risk in the 3-year-old or 6-year-old groups and middle risk caries risk in the 6-year-old group. Both 3-year-old and 6-year-old children in the experimental group had a lower risk of caries than those in the observation group in 2019. Conclusion The caries prevention effect is remarkable in high-risk children, and caries management by risk assessment is probably recommended for children with high caries risk.

Key words: children, caries incidence, caries prevalence, risk assessment, grading management, prospective study, oral health education

摘要:

目的 探讨实施以风险评估为基础的儿童龋病分级管理的防龋效果,为制定儿童口腔疾病防治分级管理策略提供依据。方法 2018年3月至2019年3月期间,采用整群抽样法在上海市闵行区抽取512名3岁幼儿园儿童和502名6岁小学生,进行口腔检查和问卷调查,按照龋病风险评估标准分为高危、中危、低危人群。以学校为单位随机分为试验组和对照组,试验组根据龋病风险等级进行分级管理,低危试验组进行口腔健康教育干预;中危试验组半年涂1次氟,进行口腔健康教育;高危试验组3个月涂1次氟,进行口腔健康教育。对照组按照上海市政府为儿童提供的基本口腔公共卫生服务常规管理。12个月后开展口腔检查,评估防龋效果。结果 患龋高危儿童中,3岁对照组龋病发病率为51.22%,试验组为34.17%;6岁对照组为51.27%,试验组为33.15%,差异均有统计学意义(P < 0.05)。中危儿童中,3岁对照组龋病发病率为38.71%,试验组为7.32%,差异有统计学意义(P < 0.05)。但3岁儿童低风险组、6岁儿童低风险组和中风险组的两组龋病发病率差异无统计学意义。3岁、6岁儿童试验组干预1年后患龋风险等级升高比例低于对照组儿童。 结论 以风险评估为基础的儿童龋病分级管理在患龋高危儿童中防龋效果显著,值得推广应用。

关键词: 儿童, 龋病发生率, 龋病患病率, 风险评估, 分级管理, 前瞻性研究, 口腔健康教育

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