Neumann Ana S, Lee Katherine J, Gussy Mark G, Waters Elizabeth B, Carlin John B, Riggs Elisha, Kilpatrick Nicky M
Murdoch Childrens Research Institute, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2011 Jun;47(6):367-72. doi: 10.1111/j.1440-1754.2010.01988.x. Epub 2011 Feb 11.
Australian pre-school children living in rural areas experience higher levels of dental caries than those in metropolitan areas. This may be because of a lack of community water fluoridation. The aim of this study was to evaluate the effectiveness of a community-based intervention to improve the oral health of children in non-fluoridated rural Victoria, Australia.
The study was conducted across three local government areas in Victoria, with two receiving the intervention and one remaining with standard care. Although multifaceted, the primary strategy of the intervention was the promotion of early exposure to fluoridated toothpaste, including the distribution, by maternal and child health nurses (MCHNs), of an oral health starter kit including toothpaste, toothbrush and information to parents at their child's 7-8-month health check. Children were followed up annually to the age of three.
Infants in the intervention arm experienced less caries (cavitated and pre-cavitated lesions included) than infants in the control arm at the first and second examinations (3.1% with caries in the intervention vs. 6.9% in the control group at exam 1 (adjusted P= 0.07) and 10.8% vs. 19.5% at exam 2 (adjusted P= 0.11), respectively). However potential benefits disappeared at the third examination (29.5% vs. 28.9%, adjusted P= 0.67).
This study suggests that an oral health promotion intervention delivered via local MCHNs promoting early exposure to fluoride may be successful in reducing caries in the second year of life but less so in older children when participants have less contact with MCHNs.
生活在澳大利亚农村地区的学龄前儿童患龋齿的比例高于大城市地区的儿童。这可能是由于缺乏社区水氟化措施。本研究的目的是评估一项基于社区的干预措施对改善澳大利亚维多利亚州非氟化农村地区儿童口腔健康的有效性。
该研究在维多利亚州的三个地方政府区域进行，其中两个区域接受干预，一个区域维持标准护理。尽管干预措施是多方面的，但其主要策略是促进儿童尽早接触含氟牙膏，包括由母婴健康护士（MCHNs）在儿童7 - 8个月健康检查时向家长分发包含牙膏、牙刷和信息的口腔健康入门套装。对儿童进行年度随访直至3岁。
在第一次和第二次检查时，干预组的婴儿患龋齿（包括龋洞和前期龋损）的情况少于对照组婴儿（第一次检查时，干预组患龋率为3.1%，对照组为6.9%（调整后P = 0.07）；第二次检查时，分别为10.8%和19.5%（调整后P = 0.11））。然而，在第三次检查时，潜在益处消失（29.5%对28.9%，调整后P = 0.67）。
本研究表明，通过当地母婴健康护士实施的促进儿童尽早接触氟化物的口腔健康促进干预措施，可能在降低儿童出生后第二年的龋齿发病率方面取得成功，但在儿童年龄稍大、与母婴健康护士接触较少时效果较差。
