Cho Hyun-Jae, Lee Heung-Soo, Paik Dai-Il, Bae Kwang-Hak
Department of Preventive and Public Health Dentistry, School of Dentistry, Seoul National University, Seoul, Korea; Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea; Bucheon Apple Tree Dental Clinic, Bucheon, Korea.
Community Dent Oral Epidemiol. 2014 Dec;42(6):536-42. doi: 10.1111/cdoe.12110. Epub 2014 May 30.
The aim of this study was to assess the prevalence of dental caries in 11-year-old children, related to water fluoridation and family affluence scale (FAS), as an indicator of socioeconomic status (SES) in Korea.
A total of eight areas were selected for study: four areas with fluoridated piped water (WF areas) and four areas with nonfluoridated piped water (non-WF areas). Non-WF areas had a similar economic level and population size compared with the WF areas. A total of 1446 elementary school students, 11 years of age, were included. They were examined, and questionnaires completed by their parents were analyzed. In the questionnaire, information about gender, FAS as an indicator of SES, occasions of daily cariogenic snack intake, occasions of daily cariogenic beverage intake, drinking of piped water, cooking with piped water, and usage of oral hygiene supplemental measures were surveyed. The bivariate association between the characteristics of the subjects and the number of decayed, filled, and missing permanent teeth (DMFT score) was analyzed through an independent samples t-test. The difference in the mean DMFT score between different FAS groups was analyzed by DMFT ratio, after adjusting for gender, oral health behaviors, and usage of piped water variables. The DMFT ratio was calculated from a Poisson regression model, because the DMFT score was not normally distributed.
There was no significant association between FAS and the mean DMFT score in both areas, by bivariate analysis. After adjusting for each group of confounders, a significant association (95% CI: 1.032-1.513) was found between the FAS and mean DMFT scores in non-WF areas; however, no significant difference was observed in the WF areas (95% CI: 0.766-1.382).
This study supported that water fluoridation could not only lead to a lower prevalence of dental caries, but also help to reduce the effect of SES inequalities on oral health.
本研究旨在评估韩国11岁儿童的龋齿患病率，以及与水氟化和家庭富裕程度量表（FAS）的关系，FAS作为社会经济地位（SES）的一个指标。
总共选择了八个地区进行研究：四个有管道氟化水的地区（WF地区）和四个没有管道氟化水的地区（非WF地区）。非WF地区与WF地区的经济水平和人口规模相似。总共纳入了1446名11岁的小学生。对他们进行了检查，并分析了由他们父母填写的问卷。在问卷中，调查了有关性别、作为SES指标的FAS、每日致龋性零食摄入次数、每日致龋性饮料摄入次数、饮用管道水、用管道水烹饪以及口腔卫生补充措施使用情况的信息。通过独立样本t检验分析受试者特征与恒牙龋、补、失牙数（DMFT评分）之间的双变量关联。在调整性别、口腔健康行为和管道水使用变量后，通过DMFT比率分析不同FAS组之间平均DMFT评分的差异。由于DMFT评分不呈正态分布，因此从泊松回归模型计算DMFT比率。
通过双变量分析，两个地区的FAS与平均DMFT评分之间均无显著关联。在调整每组混杂因素后，在非WF地区发现FAS与平均DMFT评分之间存在显著关联（95%CI：1.032 - 1.513）；然而，在WF地区未观察到显著差异（95%CI：0.766 - 1.382）。
本研究支持水氟化不仅可以降低龋齿患病率，还有助于减少社会经济地位不平等对口腔健康的影响。
