Dargent-Paré C, Wolikow M, Brafman J, Letrait S, Boissonnat V, Espié J P
Faculté d'Odontologie, INSERM U472, Villejuif, France.
Rev Epidemiol Sante Publique. 1999 Mar;47(1):19-28.
The Seine-Saint-Denis Council planned in 1984 a prevention strategy program among schoolchildren which consisted in a health educational campaign and fluoridation therapy. The purpose of this paper was to present the evolution of dental caries among 11-year-old children from a low-income country after 8 years of prevention and to discuss further orientations in prevention.
Two cross-sectional surveys were conducted in 1984 and 1992 on, respectively, 1,907 and 2,771 schoolchildren attending primary schools of the department. The DMF index, summing up the total number of decayed, missing or filled permanent teeth was used to assess dentition status.
The DMF index ranged from 3.38 in 1984 to 1.99 in 1992, a 41% decrease. This decrease was associated with a change of the distribution in DMF, the percentage of caries-free children increasing from 19% to 42% after 8 years. 83% of the decayed teeth were first molars. In 1992, only 24% of children received comprehensive care. In both surveys, the prevalence of dental caries was related to socio-economic status.
Prevention strategy in this low-income county, led to improved dental health among children. However, the study design did not allow for evaluation of the impact of preventive measures on the evolution of dental caries prevalence. The community program contributed to improved dental health in most children even if it could not prevent the development of dental caries in very low-income children with severely decayed teeth and no access to dental care. Further steps in order to improve prevention, including use of sealants among these children, are under evaluation.
1984年，塞纳-圣但尼省议会制定了一项针对学童的预防策略计划，该计划包括健康教育活动和氟化治疗。本文旨在介绍一个低收入国家11岁儿童在经过8年预防后龋齿情况的演变，并讨论预防工作的进一步方向。
1984年和1992年分别对该省小学的1907名和2771名学童进行了两次横断面调查。采用龋失补牙指数（DMF指数），即已龋坏、缺失或充填的恒牙总数之和，来评估牙列状况。
DMF指数从1984年的3.38降至1992年的1.99，下降了41%。这一下降与DMF分布的变化相关，8年后无龋儿童的比例从19%增至42%。83%的龋坏牙为第一恒磨牙。1992年，只有24%的儿童接受了综合治疗。在两次调查中，龋齿患病率均与社会经济地位相关。
这个低收入县的预防策略使儿童的口腔健康状况得到改善。然而，研究设计无法评估预防措施对龋齿患病率演变的影响。社区项目使大多数儿童的口腔健康得到改善，尽管它无法预防牙齿严重龋坏且无法获得牙科护理的极低收入儿童患龋齿。包括在这些儿童中使用窝沟封闭剂在内的进一步预防措施正在评估中。
