Valencia-Rojas Nancy, Lawrence Herenia P, Goodman Deborah
Department of Biological and Diagnostic Sciences, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
J Public Health Dent. 2008 Spring;68(2):94-101. doi: 10.1111/j.1752-7325.2007.00077.x.
The purpose of this study was to investigate the prevalence of early childhood caries (ECC) in a population of maltreated children in Toronto, Ontario, Canada.
The sample consisted of preschool-aged children (2 to 6 years) admitted to the care of the Children's Aid Society of Toronto (CAST) between 1991 and 2004. Data were collected by reviewing the dental and social workers' records of CAST ECC was determined using the decayed, missing, and filled deciduous teeth (dmft) index. The type and severity of maltreatment were obtained from the Eligibility Spectrum.
The study included 66 children: 37 (56 percent) boys and 29 (44 percent) girls, with an average age of 4.1 years [standard deviation (SD) = 1.2]. Four (6 percent) children had evidence of dental injury, and none had teeth filled or extracted as a result of decay ECC was observed in 58 percent of the abused children. Of these, the mean decayed teeth ("dt") value was 5.63 (SD = 4.17, n = 38) and 3.24 (SD= 4.21) for the whole sample (n = 66). The proportion of children with untreated caries was 57 percent among "neglected" children (n = 53) and 62 percent in physically/sexually abused cases (n = 13). Logistic regression revealed that children in permanent CAST care and those in its care more than once were significantly less likely to have experienced caries.
Abused and neglected young children had higher levels of tooth decay than the general population of 5-year-olds in Toronto (30 percent prevalence, mean dt= 0.42, SD = 1.20, n = 3185). However, this study did not find any difference in ECC prevalence between children with different types of maltreatment. The study did find that CAST services had a protective effect on children's oral health, which supports the recommendation that child protection services should investigate possible dental neglect in physical/sexual abuse and neglect cases.
本研究旨在调查加拿大安大略省多伦多市受虐待儿童群体中幼儿龋齿（ECC）的患病率。
样本包括1991年至2004年间被多伦多儿童援助协会（CAST）收留的学龄前儿童（2至6岁）。通过查阅CAST的牙科和社会工作者记录收集数据，使用乳牙龋失补牙面（dmft）指数确定ECC。虐待的类型和严重程度从资格谱中获取。
该研究纳入了66名儿童：37名（56%）男孩和29名（44%）女孩，平均年龄为4.1岁[标准差（SD）=1.2]。4名（6%）儿童有牙齿损伤的迹象，且没有儿童因龋齿而补牙或拔牙。在58%的受虐儿童中观察到ECC。其中，受虐儿童的平均龋牙（“dt”）值为5.63（SD = 4.17，n = 38），整个样本（n = 66）的平均龋牙值为3.24（SD = 4.21）。在“受忽视”儿童（n = 53）中，未治疗龋齿的儿童比例为57%，在身体/性虐待案例（n = 13）中为62%。逻辑回归显示，长期接受CAST照料的儿童以及多次接受其照料的儿童患龋齿的可能性显著降低。
受虐待和被忽视的幼儿龋齿水平高于多伦多市5岁儿童的总体水平（患病率30%，平均dt = 0.42，SD = 1.20，n = 3185）。然而，本研究未发现不同类型虐待儿童的ECC患病率存在差异。该研究确实发现CAST服务对儿童口腔健康有保护作用，这支持了儿童保护服务机构应在身体/性虐待和忽视案例中调查可能存在的牙齿忽视问题的建议。
