Lai Bien, Tan Wee Kiat, Lu Qing Shu
Paediatric Dentistry Unit, National Dental Centre Singapore, Singapore.
Department of Biostatistics, Singapore Clinical Research Institute, Singapore.
Singapore Med J. 2018 Feb;59(2):87-93. doi: 10.11622/smedj.2017045. Epub 2017 May 25.
Dental caries, which is prevalent in Singapore preschoolers, is a disease that has a major impact on children's health and places a high cost on the society and health services. Oral health programmes for young children implemented in some parts of the world have been shown to be effective in the prevention of dental caries. We aimed to examine the clinical efficacy of a two-year oral health programme for infants and toddlers in Singapore.
90 children and their caregivers participated in the programme, and 64 children, who were 24 months older than the intervention group at the initial visit, were recruited as controls in a quasi-experimental study design. We evaluated the presence of severe early childhood caries (SECC) and dmfs in the control group at the initial visit and in the intervention group after the completion of the two-year programme.
Some children in the intervention (7.8%) and control (31.3%) groups (p < 0.001) had SECC (difference 23.5%, 95% confidence interval 11%-36%). A higher percentage of children in the intervention group had dmfs = 0 and habits associated with low risk for caries. The odds of SECC in the control group were three times higher than that for the intervention group, and the effect was significant (p = 0.037) after adjustment for other significant risk factors.
The preventive oral health programme in Singapore was successful in reducing SECC among infants and toddlers when targeted behaviour modifications were implemented.
龋齿在新加坡学龄前儿童中很普遍，这种疾病对儿童健康有重大影响，并给社会和医疗服务带来高昂成本。世界上一些地区实施的针对幼儿的口腔健康项目已被证明在预防龋齿方面是有效的。我们旨在研究新加坡一项针对婴幼儿的为期两年的口腔健康项目的临床疗效。
90名儿童及其照顾者参与了该项目，在一项准实验研究设计中，招募了64名儿童作为对照组，这些儿童在初次就诊时比干预组大24个月。我们评估了对照组在初次就诊时以及干预组在完成两年项目后的严重早期儿童龋齿（SECC）和龋失补牙面数（dmfs）情况。
干预组（7.8%）和对照组（31.3%）中均有部分儿童患有SECC（差异为23.5%，95%置信区间为11%-36%，p<0.001）。干预组中dmfs = 0且具有低龋齿风险相关习惯的儿童比例更高。对照组患SECC的几率比干预组高两倍，在对其他显著风险因素进行调整后，该效应具有统计学意义（p = 0.037）。
当实施针对性的行为改变措施时，新加坡的预防性口腔健康项目成功降低了婴幼儿的SECC发生率。
