Warren John J, Blanchette Derek, Dawson Deborah V, Marshall Teresa A, Phipps Kathy R, Starr Delores, Drake David R
Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA, USA.
Dows Institute for Dental Research, University of Iowa, Iowa City, IA, USA.
Community Dent Oral Epidemiol. 2016 Apr;44(2):154-61. doi: 10.1111/cdoe.12200. Epub 2015 Nov 6.
Early childhood caries (ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This article reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study.
Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children, and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28, and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary, and behavioral factors. Nonparametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts).
Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only noncavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added-sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant (P < 0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts.
By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size, and maternal factors, but further analyses are needed to better understand caries in this population.
幼儿龋齿（ECC）在美国印第安儿童中十分猖獗，但针对这一问题的研究相对较少。本文作为一项纵向研究的一部分，报告了一组36个月大的美国印第安儿童的龋齿风险因素。
招募了来自北部平原部落社区的孕妇参与龋齿及龋齿风险因素的纵向研究。对儿童进行了标准化的牙科检查，并由母亲在基线时以及儿童4、8、12、16、22、28和36个月大时填写问卷。检查针对龋齿的特定表面，问卷收集了人口统计学、饮食和行为因素的数据。使用非参数双变量检验和逻辑回归模型来确定36个月时的龋齿风险因素，并使用负二项回归来确定与龋齿严重程度（dmf计数）相关的因素。
在232名儿童中，有龋洞病变的龋齿患病率为80%，另有15%仅有无龋洞病变。平均dmfs为9.6，在总的dmfs中，近62%的患龋表面是龋坏的，31%是缺失的，7%是已充填的。逻辑回归确定，较高的添加糖饮料消费量、基线时母亲年龄较小、基线时母亲的DMFS较高以及家庭人口较多是显著（P<0.05）的风险因素。负二项回归发现只有母亲的DMFS与儿童的dmf计数相关。
到36个月大时，龋齿在这群美国印第安儿童中几乎普遍存在。龋齿风险因素包括含糖饮料消费、家庭规模较大和母亲因素，但需要进一步分析以更好地了解该人群的龋齿情况。
