Shulman Jay D, Maupome Gerardo, Clark D Christopher, Levy Steven M
Department of Public Health Sciences, Baylor College of Dentistry, Texas A&M University Health Science Center, Dallas 75246, USA.
J Am Dent Assoc. 2004 May;135(5):595-604; quiz 654-5. doi: 10.14219/jada.archive.2004.0247.
As part of a large-scale fluoridation cessation study, standardized examiners assessed 8,281 school-aged children for dental fluorosis using the Thylstrup Fejerskov index, or TFI, in which scores range from 0 (no fluorosis) to 9 (severe loss of enamel with change of anatomical appearance).
Dentists, parents and children were asked to respond to a statement, "The color of these teeth (mine or my child's) is pleasing and looks nice." Agreement or disagreement with the statement was indicated on a five-level scale, with a rating of 1 representing total agreement with the reference statement. The authors used repeated-measures analysis of variance to ascertain differences in satisfaction with the esthetic appearance of the subject's tooth color across dentists', parents' and subjects' perceptions.
Girls were more critical of their tooth color than were boys; however, parents and dentists were more critical of boys' tooth color than of girls'. While younger subjects were more critical than older subjects, parents of younger subjects were less critical than those of older subjects. Dentists' ratings were not significantly associated with subjects' age group. Subjects with a TFI score of 1 or 2 were not significantly more critical than subjects with a TFI score of 0, while those with a TFI score of 3 of higher were. Similarly, only parents of subjects with a TFI score of 3 of higher had significantly different ratings.
The three stakeholders in the esthetic treatment of children-parents, dentists and patients-appear to see the potential outcome of such treatment differently.
Dentists should ensure that parents and children agree about the course of treatment, the rationale for undertaking it and the results that could reasonably be expected.
作为一项大规模停止氟化研究的一部分,标准化检查人员使用蒂尔斯楚普-费耶斯科夫指数(TFI)对8281名学龄儿童的氟斑牙情况进行了评估,该指数的评分范围为0(无氟斑牙)至9(牙釉质严重缺失且解剖外观改变)。
要求牙医、家长和孩子对“这些牙齿(我的或我孩子的)颜色令人愉悦且看起来不错”这一陈述做出回应。对该陈述的同意或不同意程度通过五级量表表示,评分为1表示完全同意参考陈述。作者使用重复测量方差分析来确定在牙医、家长和受试者对受试者牙齿颜色美观度的满意度方面的差异。
女孩比男孩对自己牙齿颜色的要求更高;然而,家长和牙医对男孩牙齿颜色的要求比对女孩的更高。虽然年轻受试者比年长受试者要求更高,但年轻受试者的家长比年长受试者的家长要求更低。牙医的评分与受试者的年龄组没有显著关联。TFI评分为1或2的受试者并不比评分为0的受试者要求更高,而评分为3及以上的受试者则要求更高。同样,只有TFI评分为3及以上的受试者的家长评分有显著差异。
在儿童美学治疗中的三个利益相关者——家长、牙医和患者——似乎对这种治疗的潜在结果看法不同。
牙医应确保家长和孩子就治疗方案、进行治疗的理由以及合理预期的结果达成一致。