海口地区初中生恒牙龋患及影响因素分析

吴文智; 冯达兴; 陈垂壮; 周丽鹃

doi:10.16835/j.cnki.1000-9817.2023.06.026

海口地区初中生恒牙龋患及影响因素分析

doi: 10.16835/j.cnki.1000-9817.2023.06.026

海南医学院第二附属医院口腔科，海口 570100

详细信息

作者简介:
吴文智(1989-)，男，海南万宁人，大学本科，主治医师，主要研究方向为牙体牙髓病学

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中图分类号: R781.1 G478.2 R179
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出版历程
- 收稿日期: 2022-11-28
- 修回日期: 2023-02-21
- 网络出版日期: 2023-06-28
- 刊出日期: 2023-06-25

Prevalence and risk factors of permanent tooth caries among junior high school students in Haikou

Department of Stomatology, the Second Affiliated Hospital of Hainan Medical College, Haikou(570100), China

摘要

摘要: 目的了解海口地区初中生恒牙龋病流行状况及影响因素，为初中生龋病防治工作提供依据。方法 2022年3—9月采用分层整群抽样方法，分别在海口市城区和乡镇随机抽取4所初中共3 573名学生，进行问卷调查和口腔检查，计算分析患龋率、龋均、充填率和窝沟封闭率，应用Logistic回归分析恒牙患龋的影响因素。结果初中生患龋率为47.32%(1 691名)，龋均1.51，患龋率女生(49.59%)高于男生(44.95%)，乡镇(50.77%)高于城区(44.04%)，差异均有统计学意义(χ²值分别为16.25，7.72，P值均 < 0.05)。初中生恒牙龋补充填率为17.13%，窝沟封闭率为6.27%，均为城区(18.97%，7.17%)高于乡镇(15.76%，5.33%)，差异均有统计学意义(χ²值分别为9.57，5.13，P值均 < 0.05)。Logistic回归分析显示，女生、居住乡镇、每日进食甜食≥1次、每日喝饮料≥1次、经常/每晚睡前进食与初中生恒牙患龋呈正相关(OR值分别为1.41，1.45，2.63，2.09，1.53)，每日使用含氟牙膏，学校口腔健康宣教呈负相关(OR值分别为0.44，0.34)(P值均 < 0.05)。结论海口地区初中生恒牙患龋率处较高水平，龋补充填率和窝沟封闭率较低。应重点针对高危学生进行龋病防治，并在学校加强口腔健康宣教，提高初中生口腔健康水平。
- 牙列，恒 /
- 龋齿 /
- 口腔卫生 /
- 回归分析 /
- 学生
Abstract: Objective To describe the prevalence of permanent tooth caries and associated factors among junior high school students in Haikou, and to provide reliable evidence for prevention and control of caries. Methods A total of 3 573 students from 8 junior high school in Haikou City and towns were selected by the methods of clustered sampling survey. Questionnaire survey and oral health examinations were conducted to analyze the caries rate, mean decayed-missing-filled tooth (DMFT), filling rate, pit and fissure sealant rate. Logistic regression was used to analyze the influencing factors of caries in permanent tooth. Results Among the surveyed junior high school students, the caries rate was 47.32%(n=1 691), the mean DMFT was 1.51. The caries rate and mean DMFT were higher in female students (49.59%) than in male students (44.95%), and higher in towns (50.77%) than in urban areas (44.04%), the difference were statistically significant (χ²=16.25, 7.72, P < 0.05). The filling rate and pit and fissure sealant rate among junior high school students in Haikou were 17.13%, 6.27% respectively. The filling rate and pit and fissure sealant rate were higher in urban areas (18.97%, 7.17%) than towns (15.76%, 5.33%), the difference were statistically significant (χ²=9.57, 5.13, P < 0.05). The multivariate Logistic analysis showed that female student, town residence, daily consumption of sweets or sugary drinks (≥1 time), bedtime snack were risk factors for junior high school students suffering from permanent dental caries(OR=1.41, 1.45, 2.63, 2.09, 1.53), while using fluoride toothpaste daily, oral education in school were protective factors(OR=0.44, 0.34)(P < 0.05). Conclusion The caries rate of permanent teeth among junior high school students in Haikou is at high level, but the filling rate of caries and pit and fissure sealant rate are lower. The prevention and treatment of dental caries should be carried out in high risk students, and oral health education in school is also needed to improve the oral health level of junior high school students.
- Dentition, permanent /
- Dental caries /
- Oral hygiene /
- Regression analysis /
- Students
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表 1 海口地区不同人口学特征初中生恒牙患龋率比较

Table 1. The statue of permanent tooth caries among junior high school students in Haikou

人口学指标	选项	人数	患龋人数	χ²值	P值
性别	男	1 742	731(41.96)	16.25	< 0.01
	女	1 831	960(52.43)
居住地	城区	1 828	805(44.04)	7.72	< 0.01
	乡镇	1 745	886(50.77)
年龄/岁	12	919	419(45.59)	5.27	0.15
	13	968	447(46.18)
	14	930	441(47.42)
	15	756	384(50.79)
独生子女	是	2 429	1 121(46.15)	4.21	0.04
	否	1 144	570(49.83)
父母文化程度	高中以下	2 358	1 153(48.90)	6.86	0.01
	高中及以上	1 215	538(44.28)
注：()内数字为患龋率/%。

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表 2 海口地区不同人口学特征初中生恒牙龋齿充填率窝沟封闭率比较

Table 2. The statue of permanent tooth filling and pit and fissure sealant among junior high school students in Haikou

人口学指标	选项	窝沟封闭		龋补充填
人口学指标	选项	人数	封闭人数	牙数	充填牙数
性别	男	1 742	107(6.14)	2 271	405(17.83)
	女	1 831	117(6.39)	3 105	516(16.62)
居住地	城区	1 828	131(7.17)	2 304	437(18.97)
	乡镇	1 745	93(5.33)	3 072	484(15.76)
年龄/岁	12	919	53(5.77)	1 283	214(16.68)
	13	968	61(6.30)	1 386	228(16.45)
	14	930	58(6.24)	1 403	246(17.53)
	15	756	52(6.88)	1 304	233(17.87)
注：()内数字为窝沟封闭率或充填率/%。

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表 3 海口地区初中生恒牙龋病影响因素的单因素分析

Table 3. Univariate analysis of the influencing factors of per- manent tooth caries among junior high school students in Haikou

影响因素	选项	人数	患龋人数	χ²值	P值
每日进食甜食次数	< 1	2 419	1 084(44.81)	19.01	< 0.01
	≥1	1 154	607(52.60)
每日喝饮料次数	< 1	2 751	1 266(46.02)	8.20	< 0.01
	≥1	822	425(51.70)
每日食用新鲜水果次数	< 1	1 506	733(48.67)	1.89	0.17
	≥1	2 067	958(46.35)
睡前进食	从不/偶尔	2 501	1 146(45.82)	7.58	0.01
	经常/每晚	1 072	545(50.84)
每日刷牙次数/次	≤1	1322	651(49.24)	3.04	0.08
	≥2	1 040	1 211(46.20)
每次刷牙时间/min	< 2	1 464	713(48.70)	1.88	0.17
	≥2	2 109	978(46.37)
使用含氟牙膏	不用/偶尔使用	1 582	801(50.63)	12.44	< 0.01
	每天使用	1 991	890(44.70)
使用牙签/牙线	是	1 107	504(45.53)	2.08	0.15
	否	2 466	1 187(48.13)
定期口腔检查	是	893	402(45.02)	2.55	0.11
	否	2 680	1 289(48.10)
父母每日刷牙次数/次	≤1	1 607	776(48.29)	1.08	0.30
	≥2	1 966	915(46.54)
学校口腔健康宣教	是	1 619	718(44.35)	10.54	< 0.01
	否	1 954	973(49.80)
注：()内数字为患龋率/%。

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表 4 海口地区初中生恒牙龋病影响因素的Logistic回归分析(n=3 573)

Table 4. Logistic regression analysis of the influencing factors of permanent tooth caries among junior high school students in Haikou(n=3 573)

自变量	β值	标准误	Wald χ²值	P值	OR值(95%CI)
女生	0.34	0.11	9.27	< 0.01	1.41(1.13~1.76)
居住乡镇	0.37	0.13	8.63	< 0.01	1.45(1.13~1.86)
每日进食甜食≥1次	1.00	0.32	9.29	< 0.01	2.63(1.41~4.89)
每日喝饮料≥1次	0.74	0.30	6.23	0.01	2.09(1.17~3.74)
经常/每晚睡前进食	0.43	0.15	8.29	< 0.01	1.53(1.15~2.05)
每日使用含氟牙膏	-0.82	0.33	6.41	0.01	0.44(0.23~0.83)
学校口腔健康宣教	-1.07	0.45	5.79	0.02	0.34(0.14~0.82)

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参考文献(20)

[1]	MUBARAKI S, ALOLYAN R, ALBREKEIT J, et al. Prevalence of caries in first permanent molar among children in Saudi Arabia: a retrospective study[J]. Eur Rev Med Pharmacol Sci, 2022, 26(20): 7550-7555.
[2]	LAUDIER S, SOARES D N, MARSILLAC M W S, et al. Symmetry of carious lesions in primary and permanent teeth in children as a predictor of future caries patterns[J]. Gen Dent, 2022, 70(4): 23-27.
[3]	TAN S H X, TEO Y Y, TAN M H X, et al. Childhood factors and dental caries in the permanent dentition: findings of an 8-year study under a nationwide school dental service[J]. Int Dent J, 2021, 71(6): 508-515. doi: 10.1016/j.identj.2021.01.008
[4]	陈智, 陈瑞甜. 龋病再认识[J]. 口腔医学研究, 2020, 36(1): 1-6. https://www.cnki.com.cn/Article/CJFDTOTAL-KQYZ202001001.htm CHEN Z, CHEN R T. Dental caries revisited[J]. J Oral Sci Res, 2020, 36(1): 1-6. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-KQYZ202001001.htm
[5]	王兴, 冯希平, 李志新. 第四次全国口腔健康流行病学调查报告[M]. 北京: 人民卫生出版社, 2018: 1-34. WANG X, FENG X P, LI Z X. Report of the fourth national oral health epidemiological survey[M]. Beijing: People's Medical Publishing House, 2018: 1-34. (in Chinese)
[6]	肖滢, 刘怡然, 沈红, 等. 江苏省12~15岁中学生龋病流行现状及影响因素分析[J]. 口腔医学, 2020, 40(2): 135-140. https://www.cnki.com.cn/Article/CJFDTOTAL-KQYX202002014.htm XIAO Y, LIU Y R, SHEN H, et al. An epidemiological investigation of caries status and associated factors in students aged 12 to 15 years old in Jiangsu Province[J]. Stomatology, 2020, 40(2): 135-140. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-KQYX202002014.htm
[7]	李凤娟, 王丽茹, 王旭, 等. 河南省12~15岁儿童龋病流行状况及其影响因素分析[J]. 中国公共卫生, 2021, 37(8): 1241-1245. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202108015.htm LI F J, WANG L R, WANG X, et al. Permanent teeth caries among 12-to 15-year-old school children in Henan Province: prevalence and influencing factors[J]. Chin J Public Health, 2021, 37(8): 1241-1245. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202108015.htm
[8]	FELDENS C A, DOS SANTOS I F, KRAMER P F, et al. Early-life patterns of sugar consumption and dental caries in the permanent teeth: a birth cohort study[J]. Caries Res, 2021(5): 505-514.
[9]	吴静, 陈国平, 孟灿, 等. 安徽省12~15岁儿童恒牙患龋状况分析[J]. 现代预防医学, 2021, 48(3): 456-458. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202103018.htm WU J, CHEN G P, MENG C, et al. Caries status of permanent teeth in children aged 12 to 15 years old, in Anhui[J]. Mod Prev Med, 2021, 48(3): 456-458. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202103018.htm
[10]	谢奇, 廖天安, 谢莉莉, 等. 海南省12岁学生口腔健康状况流行病学调查[J]. 中国学校卫生, 2008, 29(9): 827-828. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS200809027.htm XIE Q, LIAO T A, XIE L L, et al. Epidemiologic survey of oral health status of 12-year-old children in Hainan Province[J]. Chin J Sch Health, 2008, 29(9): 827-828. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS200809027.htm
[11]	王媛媛, 谢莉莉, 郭冬梅, 等. 海南省12~15岁学生恒牙龋病抽样调查报告(2015—2016年)[J]. 河北医科大学学报, 2022, 43(4): 429-432, 438. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX202204007.htm WANG Y Y, XIE L L, GUO D M, et al. A sampling survey report of permanent tooth caries among students aged 12-15 in Hainan Province (2015-2016)[J]. J Hebei Med Univ, 2022, 43(4): 429-432, 438. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX202204007.htm
[12]	中共中央国务院印发"健康中国2030" 规划纲要[EB/0L].(2016- 10-25)[2023-01-22].http: //www.gov.cn/zhengce/2016-10/25/content_5124174. htm . Opinions of the CPC Central Committee and the State Couneil is-suedthe Outline of the Healthy China 2030 Plan[EB/OL].(2016-10-25)[2023-01-22]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm . (in Chinese)
[13]	黄少宏, 吴林梅. 龋病患病水平城市低于农村: 龋病流行特征城乡变化分析[J]. 口腔疾病防治, 2020, 28(5): 273-278. https://www.cnki.com.cn/Article/CJFDTOTAL-GDYB202005002.htm HUANG S H, WU L M. The prevalence of dental caries in urban areas is lower than that in rural areas: analysis of changes in the epidemiological characteristics of caries in urban and rural areas[J]. J Dent Prev Treat, 2020, 28(5): 273-278. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GDYB202005002.htm
[14]	徐敏, 蔡磊, 谢丽花, 等. 云南省安宁市12岁人群恒牙龋病调查及其影响因素[J]. 昆明医科大学学报, 2020, 41(5): 130-135. https://www.cnki.com.cn/Article/CJFDTOTAL-KMYX202005025.htm XU M, CAI L, XIE L H, et al. Investigation of permanent dental caries in 12-year-old population in Anning City, Yunnan Province and analysis of influencing factors[J]. J Kunming Med Univ, 2020, 41(5): 130-135. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-KMYX202005025.htm
[15]	HU Z, YAN X, SONG Y, et al. Trends of dental caries in permanent teeth among 12-year-old Chinese children: evidence from five consecutive national surveys between 1995 and 2014[J]. BMC Oral Health, 2021, 21(1): 467.
[16]	ZHU F, CHEN Y, YU Y, et al. Caries prevalence of the first permanent molars in 6-8 years old children[J]. PLoS One, 2021, 16(1): e0245345.
[17]	曾佩君, 陈延武, 肖冰莹, 等. 潮州市12~15岁青少年恒牙龋病流行特征分析[J]. 中国学校卫生, 2020, 41(3): 463-465. doi: 10.16835/j.cnki.1000-9817.2020.03.041 ZENG P J, CHEN Y W, XIAO B Y, et al. Epidemiological characteristics of permanent tooth caries in 12-15 years old adolescents in Chaozhou[J]. Chin J Sch Health, 2020, 41(3): 463-465. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2020.03.041
[18]	KOTHA S B. Prevalence and risk factors of early childhood caries in the middle east region: a systematic review[J]. J Popul Ther Clin Pharmacol, 2022, 29(3): e43-e57.
[19]	刘金刚. 珠海市12岁儿童恒牙龋病的发病率、影响因素及预防措施[J]. 中国妇幼保健, 2020, 35(15): 2822-2825. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202015029.htm LIU J G. Incidence, influencing factors and preventive measures of permanent dental caries in 12 year old children in Zhuhai[J]. Matern Child Health Care Chin, 2020, 35(15): 2822-2825. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202015029.htm
[20]	KOTHA A, VEMULAPALLI A, MANDAPATI S R, et al. Prevalence, trends, and severity of early childhood caries in the United States: national health and nutritional examination survey data 2013 to 2018[J]. Pediatr Dent, 2022, 44(4): 261-268.