Narvai Paulo Capel, Frazão Paulo, Roncalli Angelo Giuseppe, Antunes José Leopoldo F
Universidade de São Paulo, Faculdade de Saúde Pública, São Paulo (SP), Brasil.
Rev Panam Salud Publica. 2006 Jun;19(6):385-93. doi: 10.1590/s1020-49892006000600004.
To examine the caries situation in Brazilian schoolchildren between 1980 and 2003 and to determine the distribution of caries and access to treatment in this population group.
We employed secondary data concerning the number of decayed, missing or filled teeth (DMFT). The studies whose data were used differed in terms of study type, study design, sampling methods, and diagnostic criteria, but yielded national estimates that are considered valid for the DMFT index. Therefore, a trend analysis based on these studies was thought to be feasible.
Analysis of DMFT values revealed a high frequency of dental caries in 1980 and a moderate frequency in the 1990s. In 2003, the DMFT index was still within the moderate range. Between 1980 and 2003, a 61.7% decrease in DMFT frequency was observed. The percentage of children with no DMFT increased from 3.7% in 1986 to 31.1% in 2003. On the other hand, in the segment of the study population least affected, the percentage of children who received care increased from 26.3 in 1986 to 34.7 in 2003, yet in the group with DMFT this percentage fell from 50.2 in 1986 to 39.3 in 2003. In the segment with DMFT >/=6, the percentage of those who received care remained stable (28%). During the study period, 60% of the dental caries were found in 20% of the study population.
An important decline in DMFT was observed between 1980 and 2003, perhaps as a result of increased access to fluoridated water and toothpaste and of changes in the goals of public oral health programs. Despite the improvement, caries is unevenly distributed in the pediatric population; a small proportion of individuals carries most of the disease burden. In addition, the proportion of teeth with caries that went untreated did not change between 1980 and 2003. Reducing socioeconomic disparities and adopting public health measures that target and reach the most vulnerable groups remain a challenge for policy makers in Brazil.
调查1980年至2003年间巴西学童的龋齿情况，并确定该人群龋齿的分布及治疗可及性。
我们采用了关于龋、失、补牙数（DMFT）的二手数据。所使用数据的研究在研究类型、研究设计、抽样方法和诊断标准方面存在差异，但得出了被认为对DMFT指数有效的全国性估计值。因此，基于这些研究进行趋势分析被认为是可行的。
对DMFT值的分析显示，1980年龋齿发生率较高，20世纪90年代为中度发生率。2003年，DMFT指数仍处于中度范围。1980年至2003年间，观察到DMFT发生率下降了61.7%。无DMFT的儿童比例从1986年的3.7%增至2003年的31.1%。另一方面，在受影响最小的研究人群部分，接受治疗的儿童比例从1986年的26.3%增至2003年的34.7%，但在有DMFT的组中，这一比例从1986年的50.2%降至2003年的39.3%。在DMFT≥6的部分，接受治疗的比例保持稳定（28%）。在研究期间，60%的龋齿见于20%的研究人群。
1980年至2003年间观察到DMFT有显著下降，这可能是由于获得含氟水和牙膏的机会增加以及公共口腔卫生项目目标的变化。尽管有所改善，但龋齿在儿童人群中分布不均；一小部分个体承担了大部分疾病负担。此外，1980年至2003年间未经治疗的龋齿比例没有变化。减少社会经济差距并采取针对且覆盖最弱势群体的公共卫生措施，对巴西政策制定者而言仍是一项挑战。
