Mattila M L, Rautava P, Sillanpää M, Paunio P
Dept. of Child Neurology, University of Turku, Public Health Center, Finland.
J Dent Res. 2000 Mar;79(3):875-81. doi: 10.1177/00220345000790031501.
It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful.
人们普遍认为学龄前儿童的牙齿是健康的,但在工业化国家,dmft指数的改善已经停滞。少数患有龋齿的儿童比以前患龋更多。对于与这种龋齿两极分化相关的家庭因素知之甚少。一个具有代表性的基于人群的样本由1443名怀第一胎的母亲组成。这些孩子在母婴保健诊所和公共牙科保健诊所接受了五年多的跟踪。目的是研究五岁儿童龋齿的患病率及其预测因素,并评估儿童自身的牙齿健康习惯以及家庭相关因素在牙齿健康中的意义。研究结果基于父母的问卷数据以及101名公共卫生牙医对五岁儿童进行的临床牙科检查。在头胎五岁儿童中,发现72%的儿童牙齿健康状况良好,20%的儿童牙齿健康状况一般,8%的儿童牙齿健康状况较差。最终的多变量分析表明,dmft指数>0与母亲刷牙不规律(比值比2.2;95%置信区间1.4 - 3.5)、父亲每年出现几颗龋齿(比值比2.6;95%置信区间1.9 - 3.6)、18个月大时每日糖摄入量(比值比2.4;95%置信区间1.4 - 4.1)、儿童头痛的发生(比值比3.7;95%置信区间1.5 - 8.8)、父母同居(比值比3.3;95%置信区间1.5 - 7.6)、农村居住(比值比2.4;95%置信区间1.2 - 4.5)以及母亲年龄较小(比值比5.0;95%置信区间1.3 - 19.8)独立相关。研究结果表明,不仅应关注儿童的牙齿保健,还应关注整个家庭的牙齿保健。应支持父母的养育努力,并鼓励他们改善孩子的牙齿健康习惯。在日常生活中,父母是孩子的榜样,因此,父母自身的口腔卫生习惯非常重要。