Zander Alexis, Sivaneswaran Shanti, Skinner John, Byun Roy, Jalaludin Bin
University of NSW, New South Wales Ministry of Health, Sydney, New South Wales, Australia.
Rural Remote Health. 2013;13(3):2492. Epub 2013 Aug 13.
Dental decay (caries) can cause pain, infection and tooth loss, negatively affecting eating, speaking and general health. People living in rural and regional Australian communities have more caries, more severe caries and more untreated caries than those in the city. The unique environmental conditions and population groups in these communities may contribute to the higher caries burden. In particular, some towns lack community water fluoridation, and some have a high proportion of Aboriginal people, who have significantly worse oral health than their non-Aboriginal counterparts. Because of these and other unique circumstances, mainstream research on caries risk factors may not apply in these settings. This study aimed to gather contemporary oral health data from small rural or regional Australian communities, and investigate caries risk factors in these communities.
A cross-sectional survey consisting of a standardized dental examination and questionnaire was used to measure the oral health of 434 children (32% Aboriginal) aged 3-12 years in three small rural or regional areas. Oral health was determined as the deciduous and permanent decayed, missing and filled teeth (dmft/DMFT), and the proportion of children without caries. Risk factors were investigated by logistic regression.
The dmft/DMFT for children in this study was 1.5 for 5-6 year olds and 1.0 for 11-12 year olds (index groups reported). Independent predictors of having caries (Yes/No) were age group, holding a concession card (OR=2.45, 95%CI=1.58-3.80) and tooth-brushing less than twice per day (OR=2.11, 95% CI=1.34-3.34). Aboriginal status also became a significant variable under sensitivity analyses (OR 1.9, CI 1.12-3.24) when the tooth-brushing variable was removed. Gender, water fluoridation and parental education were not significant predictors of caries in these communities.
The rural/remote children in this study had worse oral health than either state or national average in both the 5-6 year old and 11-12 year age group. Socioeconomic status, tooth-brushing and Aboriginal status were significantly associated with caries in these communities. To close the substantial gap in oral health outcomes between rural and metropolitan residents, approaches that target rural areas, Aboriginal people and those from low socioeconomic backgrounds are needed.
龋齿会引发疼痛、感染并导致牙齿脱落，对饮食、言语及整体健康产生负面影响。与城市居民相比，生活在澳大利亚农村和偏远地区社区的人们患龋齿的情况更严重，龋齿程度更深，且未经治疗的龋齿更多。这些社区独特的环境条件和人群可能导致了更高的龋齿负担。特别是，一些城镇缺乏社区水氟化措施，部分城镇的原住民比例较高，他们的口腔健康状况明显比非原住民差。由于这些及其他独特情况，关于龋齿风险因素的主流研究可能不适用于这些环境。本研究旨在收集澳大利亚农村或偏远小社区的当代口腔健康数据，并调查这些社区的龋齿风险因素。
采用一项横断面调查，包括标准化牙科检查和问卷调查，以评估三个农村或偏远小地区434名3至12岁儿童（32%为原住民）的口腔健康状况。口腔健康状况通过乳牙和恒牙的龋、失、补牙数（dmft/DMFT）以及无龋齿儿童的比例来确定。通过逻辑回归分析调查风险因素。
本研究中5至6岁儿童的dmft/DMFT为1.5，11至12岁儿童为1.0（报告的指标组数据）。患龋（是/否）的独立预测因素为年龄组、持有优惠卡（比值比=2.45，95%置信区间=1.58 - 3.80）以及每天刷牙少于两次（比值比=2.11，95%置信区间=1.34 - 3.34）。在敏感性分析中，当去除刷牙变量时，原住民身份也成为一个显著变量（比值比1.9，置信区间1.12 - 3.24）。在这些社区中，性别、水氟化措施和父母教育程度不是龋齿的显著预测因素。
本研究中的农村/偏远地区儿童在5至6岁和11至12岁年龄组的口腔健康状况均比州或全国平均水平差。社会经济地位、刷牙习惯和原住民身份与这些社区的龋齿显著相关。为缩小农村和城市居民口腔健康结果的巨大差距，需要针对农村地区、原住民和社会经济背景较低人群的方法。
