Pitts N B, Boyles J, Nugent Z J, Thomas N, Pine C M
Dental Health Services Research Unit, University of Dundee's Health Informatics Centre, Dundee.
Community Dent Health. 2006 Mar;23(1):44-57.
This paper reports the results of standardized clinical caries examinations of 11-year-old children from across England and Wales, Scotland, Isle of Man, and Jersey in 2004/5. These co-ordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services.
The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating strategic health authorities (SHAs), primary care trusts (PCTs), health boards (HBs), and local health boards (LHBs). Caries was diagnosed at the caries into dentine threshold using a visual method without radiography or fibre-optic transillumination.
The results again demonstrated a wide variation in disease prevalence and care strategies across Great Britain. Mean values for D3MFT within the current English strategic health authorities ranged from 0.19 in Harlow to 1.32 in North Manchester and in Salford; in Wales mean values ranged from 0.69 in Vale of Glamorgan to 2.09 in Blaenau Gwent; while in Scotland they ranged from 0.59 in Orkney to 1.77 in Western Isles. Mean D3MFT across England was 0.64 (D3T = 0.32, MT = 0.06, FT = 0.25), across Wales it was 1.09 (D3T = 0.48, MT 0.11, FT = 0.50), and across Scotland values were 1.29 (D3T = 0.52, MT = 0.17, FT = 0.60). Overall, 31.3% of children in England & Wales and 47.1% of children inspected in Scotland had evidence of caries experience in dentine (D3MFT > 0, including visual dentine caries). As in previous surveys, the distribution of caries was highly skewed. Thus the mean caries experience for those with dentinal decay in England and Wales was 2.12, as opposed to the overall mean of 0.66; in Scotland the corresponding values were 2.74 and 1.29. Trends over time demonstrate an improvement in overall mean D3MFT for England and Wales since the 2000/2001 of 12-year-olds, although part of this difference is accountable to the younger age, at examination, in this survey. The mean value for those with dentine decay experience was also marginally less at 2.12 compared with 2.35 in the previous survey. (Figures for Scotland were not included in the 2000/2001 survey.) The care index was also found to be marginally lower than previously at 41% compared with 48% but again the younger age of the children would influence this value.
Dental health of 11-year-old children has been surveyed in Great Britain, Jersey, and the Isle of Man: being a slightly younger mean age than in previous BASCD surveys. Geographic variation in oral health is marked at both the local and national levels. Overall, the provision of operative care for those with dentinal decay is around 42%. While many children enjoy good oral health, sizable groups remain within the population of 11-year-old children who have a clinically significant burden of preventable dental disease.
本文报告了2004/2005年对来自英格兰、威尔士、苏格兰、马恩岛和泽西岛的11岁儿童进行标准化临床龋齿检查的结果。这些协调一致的调查是一系列调查中的最新一次,旨在监测儿童的口腔健康状况并评估牙科服务的提供情况。
采用了英国社区牙科研究协会的标准和惯例。从参与调查的战略健康管理局(SHAs)、初级保健信托基金(PCTs)、健康委员会(HBs)和地方健康委员会(LHBs)中抽取代表性样本。使用视觉方法在未进行X线摄影或光纤透照的情况下,将龋齿诊断为龋洞侵入牙本质的阈值。
结果再次表明,英国各地的疾病患病率和护理策略存在很大差异。目前英格兰战略健康管理局内D3MFT的平均值范围为哈洛的0.19至曼彻斯特北部和索尔福德的1.32;在威尔士,平均值范围为格拉摩根谷的0.69至布莱耐格温特的2.09;而在苏格兰,范围为奥克尼的0.59至西部群岛的1.77。英格兰的平均D3MFT为0.64(D3T = 0.32,MT = 0.06,FT = 0.25),威尔士为1.09(D3T = 0.48,MT = 0.11,FT = 0.50),苏格兰为1.29(D3T = 0.52,MT = 0.17,FT = 0.60)。总体而言,英格兰和威尔士31.3%的儿童以及苏格兰47.1%接受检查的儿童有牙本质龋经验的证据(D3MFT > 0,包括可见牙本质龋)。与之前的调查一样,龋齿的分布高度不均衡。因此,英格兰和威尔士有牙本质龋的儿童的平均龋经验为2.12,而总体平均为0.66;在苏格兰,相应的值分别为2.74和1.29。随着时间的推移,趋势表明自2000/2001年对12岁儿童调查以来,英格兰和威尔士的总体平均D3MFT有所改善,尽管这种差异部分归因于本次调查中接受检查的儿童年龄较小。有牙本质龋经验的儿童的平均值也略低于前一次调查中的2.35,为2.12。(2000/2001年的调查未包括苏格兰的数据。)护理指数也被发现略低于之前,为41%,而之前为48%,但同样儿童年龄较小会影响该值。
在英国、泽西岛和马恩岛对11岁儿童的口腔健康进行了调查:平均年龄比之前英国社区牙科研究协会的调查略小。口腔健康的地理差异在地方和国家层面都很明显。总体而言,为有牙本质龋的儿童提供的手术治疗约为42%。虽然许多儿童口腔健康良好,但在11岁儿童群体中仍有相当一部分人患有临床上有显著负担的可预防牙科疾病。