Department of Life Style, TNO, Leiden, The Netherlands.
Community Dent Oral Epidemiol. 2014 Apr;42(2):178-84. doi: 10.1111/cdoe.12070. Epub 2013 Sep 23.
From 1 January 2006, the distinction between the health insurance fund and private insurance was abolished and a basic insurance package was agreed for everyone in the Netherlands. Dental treatment for young people below the age of 18 is reimbursed under the terms of this basic package. Dental treatment for adults is not covered in this basic insurance package. Basic principles for nonreimbursing dental care for adults were that any health and financial risks for individual citizens in the future should be acceptable for them with the corollary that the oral health of young adults when they make the switch - from collectively financed care to care to be paid for individually - should be at such a level that the needed oral health care is affordable. To meet this requirement, it is important to have knowledge of the prevalence of oral diseases and trends in oral health in young people from a public health perspective. The aim of this article is to describe trends in caries experience in young people in the Netherlands from 1990 to 2009, taking into account the challenge in methodology concerning this changing social context.
To describe caries experience in young people, a repeated cross-sectional study design was used. The study consisted of a clinical oral examination and a questionnaire survey. Data were sampled from 8, 14 and 20-year-olds in 1990 and 1996, and 9, 15 and 21-year-olds in 2003 and 2009, living in Alphen a/d Rijn, Gouda, Breda and 's-Hertogenbosch. The DMF index was used for describing caries experience. The trends were studied separately in high and low socioeconomic status (SES) groups. SES was operationalized as the dichotomous variable of educational level of the mother or the adolescent. Multiple imputation was applied to predict the DMFS for missing ages for certain years, which made it possible to test the trends. Linear and logistic regression analyses were used to study the trends through the years.
This study showed, according to different age- and SES groups, either declines or no statistically significant changes in caries experience over the last two decades.
No deterioration was shown. However, there is still room for further improvement in oral health in children. Dental professionals and politicians should develop a vision on to what extent caries experience is acceptable in a public health perspective in young people.
自 2006 年 1 月 1 日起，取消了健康保险基金和私人保险之间的区别，并为荷兰的每个人都达成了基本保险计划。根据该基本计划，18 岁以下的年轻人的牙科治疗费用可报销。该基本保险计划不涵盖成年人的牙科治疗费用。不报销成年人牙科护理的基本原则是，未来任何个人公民的健康和财务风险都应该是可以接受的，其必然结果是，年轻人从集体资助的护理转为个人支付的护理时，他们的口腔健康状况应该达到这样的水平，即需要的口腔保健费用是可以承受的。为了满足这一要求，从公共卫生的角度了解年轻人的口腔疾病流行情况和口腔健康趋势非常重要。本文的目的是描述 1990 年至 2009 年荷兰年轻人的龋齿发病情况，并考虑到这种不断变化的社会背景下方法学所面临的挑战。
为了描述年轻人的龋齿发病情况，采用了重复的横断面研究设计。该研究包括临床口腔检查和问卷调查。数据来自 1990 年和 1996 年的 8 岁、14 岁和 20 岁人群，以及 2003 年和 2009 年的 9 岁、15 岁和 21 岁人群，这些人群分别居住在阿尔芬 a/d Rijn、古达、布雷达和斯赫滕博斯。DMF 指数用于描述龋齿发病情况。在高和低社会经济地位（SES）组中分别研究了趋势。SES 被操作化为母亲或青少年的教育水平的二分变量。对于某些年份缺失年龄的 DMFS 进行了多次插补预测，这使得检验趋势成为可能。线性和逻辑回归分析用于研究多年来的趋势。
根据不同的年龄和 SES 组，过去二十年中，龋齿发病情况显示出下降或没有统计学意义的变化。
没有恶化的趋势。然而，在儿童的口腔健康方面仍有进一步改善的空间。牙科专业人员和政治家应制定一个愿景，以确定在公共卫生角度来看，年轻人的龋齿发病情况在多大程度上是可以接受的。
