Braun Patricia A, Widmer-Racich Katina, Sevick Carter, Starzyk Erin J, Mauritson Katya, Hambidge Simon J
Patricia A. Braun, Katina Widmer-Racich, and Carter Sevick are with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz School of Medicine, Aurora. Erin J. Starzyk and Katya Mauritson are with the Colorado Department of Public Health and Environment, Denver. Patricia A. Braun is also with and Simon J. Hambidge is with Denver Health and Hospital, Denver, CO.
Am J Public Health. 2017 May;107(S1):S97-S103. doi: 10.2105/AJPH.2017.303817.
To assess an oral health promotion (OHP) intervention for medical providers' impact on early childhood caries (ECC).
We implemented a quasiexperimental OHP intervention in 8 federally qualified health centers that trained medical providers on ECC risk assessment, oral examination and instruction, dental referral, and fluoride varnish applications (FVAs). We measured OHP delivery by FVA count at medical visits. We measured the intervention's impact on ECC in 3 unique cohorts of children aged 3 to 4 years in 2009 (preintervention; n = 202), 2011 (midintervention; n = 420), and 2015 (≥ 4 FVAs; n = 153). We compared numbers of decayed, missing, and filled tooth surfaces using adjusted zero-inflated negative binomial models.
Across 3 unique cohorts, the FVA mean (range) count was 0.0 (0), 1.1 (0-7), and 4.5 (4-7) in 2009, 2011, and 2015, respectively. In adjusted zero-inflated negative binomial models analyses, children in the 2015 cohort had significantly fewer decayed, missing, and filled tooth surfaces than did children in previous cohorts.
An OHP intervention targeting medical providers reduced ECC when children received 4 or more FVAs at a medical visit by age 3 years.
评估一项针对医疗服务提供者的口腔健康促进(OHP)干预措施对幼儿龋齿(ECC)的影响。
我们在8家联邦合格健康中心实施了一项准实验性OHP干预措施,对医疗服务提供者进行ECC风险评估、口腔检查与指导、牙科转诊以及氟化物涂漆应用(FVAs)方面的培训。我们通过就诊时的FVAs计数来衡量OHP的实施情况。我们在2009年(干预前;n = 202)、2011年(干预中期;n = 420)和2015年(≥4次FVAs;n = 153)这3个不同队列的3至4岁儿童中测量了该干预措施对ECC的影响。我们使用调整后的零膨胀负二项式模型比较了龋坏、缺失和充填牙面的数量。
在3个不同队列中,2009年、2011年和2015年的FVAs平均(范围)计数分别为0.0(0)、1.1(0 - 7)和4.5(4 - 7)。在调整后的零膨胀负二项式模型分析中,2015年队列中的儿童龋坏、缺失和充填牙面的数量明显少于前几个队列中的儿童。
当儿童在3岁就诊时接受4次或更多次FVAs时,针对医疗服务提供者的OHP干预措施可降低ECC。