Grocholewicz K
Zakładu Stomatologii Ogólnej, Pomorskiej Akademii Medycznej w Szczecinie.
Ann Acad Med Stetin. 1999;45:265-83.
The aim of the work was the continuation of the evaluation of the efficacy of three prophylactic-educational programs in the field of oral cavity hygiene, status of periodontium and dental caries, and their influence on the forming of pro-health awareness and correct hygiene habits among school children. The work under discussion is the second stage of observations of the above-mentioned programs as well as the complete evaluation of 4-years examinations. The clinical and questionnaire studies were carried out in two elementary schools in Szczecin. Two hundred and twenty-three pupils were randomly allocated to three test groups: I (45 children), II (71 children), III (60 children) and control group K (47 children). In both schools mentioned above the examinations started when children were 7-8 years old and all of them were receiving planned stomatological treatment and contact fluoridation. All programs of the second stage of studies were the same as those of the first stage [49], only with the modified frequency of meetings with children. Program I, carried out in group I, was based on individual, motivating instructions of oral cavity hygiene (total 10 meetings during second stage of research). Programs II and III (group II and III accordingly) were expanded by educational activity among children and their parents. Additionally program III was enriched by professional mechanical tooth-cleaning, the use of fissure sealants, intensive dental care and proximal surface cleaning with dental floss (Tab. 1). The above-mentioned programs were carried out in co-operation with school dentists, teachers, fifth year dentistry students and students from Medical College--Oral Hygienist Faculty. After 4-years-long studies the evaluation of the three above-mentioned programs in oral cavity hygiene was achieved by using OHI-S and PI(QH). The status of periodontium was evaluated by GI and the intensity of dental caries by DMFT and DMFS. The increase of caries during the second stage of examinations was additionally evaluated and analysed thoroughly. The questionnaire studies made it possible to estimate the changes in the pro-health awareness among examined children. Reduction of OHI-S after 4 years was about 23% to 26% (Fig. 1). The status of gums shows the state of oral cavity hygiene in a better way. In control group the state remained unchanged, but in groups I, II and III it improved considerably (reduction of GI about 46% to 79%--Fig. 2). The reduction of caries in examined groups obtained after 4 years of studies was about 25% to 77% (Fig. 3) however during the second stage of research if figured out from 17% up to 72% (Fig. 4). Extreme increase of DS observed in the second stage of studies was 2.0 in control group K, a little less--1.51 in group I and 0.38 in group III (Fig. 5). The DS in group III reached the value -0.27 which proved that program III was the most efficient. The results of questionnaire studies showed a distinct improvement of health awareness among examined children. However the value of GI indicated some discrepancy between children's health knowledge and pro-health behaviour. Also it was noticed that the level of parents' education and their socioeconomic status had influence on building up good hygiene habits and on the state of caries among the examined children. The studies proved that the implementation of the above-mentioned prophylactic-educational programs or similar ones in elementary school conditions is possible with the use of hygienist under the dentist's supervision.
这项工作的目的是继续评估三种预防教育项目在口腔卫生、牙周状况和龋齿方面的效果，以及它们对小学生健康意识形成和正确卫生习惯养成的影响。所讨论的工作是上述项目观察的第二阶段，也是对四年检查的全面评估。临床和问卷调查研究在什切青的两所小学进行。223名学生被随机分配到三个测试组：第一组（45名儿童）、第二组（71名儿童）、第三组（60名儿童）和对照组K（47名儿童）。在上述两所学校中，检查从儿童7 - 8岁时开始，他们都接受了计划中的口腔治疗和接触性氟化。研究第二阶段的所有项目与第一阶段相同[49]，只是与儿童会面的频率有所调整。在第一组实施的项目I基于口腔卫生的个性化激励指导（研究第二阶段共10次会面）。项目II和III（分别针对第二组和第三组）通过儿童及其父母之间的教育活动得以扩展。此外，项目III还增加了专业机械洁牙、使用窝沟封闭剂、强化口腔护理以及用牙线清洁邻面（表1）。上述项目是与学校牙医、教师、牙科专业五年级学生以及医学院口腔卫生专业的学生合作开展的。经过四年的研究，通过使用OHI - S和PI(QH)对上述三个口腔卫生项目进行了评估。牙周状况通过GI进行评估，龋齿强度通过DMFT和DMFS进行评估。对检查第二阶段龋齿的增加情况还进行了额外的全面评估和分析。问卷调查研究使得能够估计受检儿童健康意识的变化。4年后OHI - S降低了约23%至26%（图1）。牙龈状况能更好地反映口腔卫生状况。对照组状况保持不变，但在第一组、第二组和第三组中状况有显著改善（GI降低约46%至79%——图2）。经过4年研究，受检组龋齿减少了约25%至77%（图3），然而在研究的第二阶段，减少幅度为17%至72%（图4）。在研究的第二阶段观察到，对照组K的DS极端增加为2.0，第一组稍低——为1.51，第三组为0.38（图5）。第三组的DS达到了 - 0.27，这证明项目III是最有效的。问卷调查研究结果显示受检儿童的健康意识有明显提高。然而，GI的值表明儿童的健康知识与健康行为之间存在一些差异。还注意到父母的教育水平及其社会经济地位对受检儿童良好卫生习惯的养成和龋齿状况有影响。研究证明，在牙医监督下利用口腔卫生专业人员，在小学环境中实施上述预防教育项目或类似项目是可行的。
