Department of Paediatric and Community Dentistry, Philipps-University Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
, Willingen, Germany.
Clin Oral Investig. 2018 Jul;22(6):2241-2249. doi: 10.1007/s00784-017-2318-5. Epub 2017 Dec 29.
Children in a German region took part in regular toothbrushing with fluoride gel during their time in primary school after having received a preventive program in kindergarten. The study aimed at determining the dental health of the students as a function of prevention in kindergarten and at school while taking into account their socioeconomic status and other confounders.
The subjects were in six groups: groups 1 and 2, intensive prevention in kindergarten with and without fluoride gel at school; groups 3 and 4, basic prevention in kindergarten with and without fluoride gel at school; groups 5 and 6, no organized prevention in kindergarten with and without fluoride gel at school. Two dental examinations were performed for assessing caries experience and calculating caries increment from second grade (7-year-olds) to fourth grade (9-year-olds). A standardized questionnaire was used to record independent variables. To compare caries scores and preventive measures of various subgroups, non-parametric tests and a binary logistic regression analysis were performed.
A significant difference was found in the mean decayed, missing, and filled tooth/teeth (DMFT) depending on socioeconomic status (no prevention in kindergarten, fluoride gel at school in children with low SES: DMFT = 0.47 vs. DMFT = 0.18 in children with high SES; p = 0.023). Class-specific differences were no longer visible among children who had taken part in an intensive preventive program combining daily supervised toothbrushing in kindergarten and application of fluoride gel in school.
Early prevention, focusing on professionally supported training of toothbrushing in kindergarten and at school, has a positive effect on dental health and is able to reduce class-specific differences in caries distribution.
Early training of toothbrushing and fissure sealing of first permanent molars are the most important factors for the dental health of primary school children.
在德国某地区，儿童在幼儿园接受预防项目后，于小学阶段定期使用含氟凝胶刷牙。本研究旨在确定学生的口腔健康状况，将幼儿园和学校的预防措施作为影响因素，同时考虑其社会经济地位和其他混杂因素。
研究对象分为六组：1 组和 2 组，幼儿园强化预防，同时在学校使用和不使用含氟凝胶；3 组和 4 组，幼儿园基础预防，同时在学校使用和不使用含氟凝胶；5 组和 6 组，幼儿园无组织预防，同时在学校使用和不使用含氟凝胶。在二年级（7 岁）和四年级（9 岁）进行两次口腔检查，以评估龋齿情况并计算龋齿增量。使用标准化问卷记录独立变量。为了比较不同亚组的龋齿评分和预防措施，进行了非参数检验和二元逻辑回归分析。
根据社会经济地位，平均患龋、失、补牙数（DMFT）存在显著差异（幼儿园无预防，低 SES 儿童学校使用含氟凝胶：DMFT=0.47，高 SES 儿童：DMFT=0.18；p=0.023）。对于参加过结合幼儿园每日监督刷牙和学校应用含氟凝胶的强化预防计划的儿童，班级间差异不再明显。
早期预防，重点是在幼儿园和学校专业支持的刷牙训练，对口腔健康有积极影响，能够减少龋齿分布的班级差异。
早期训练刷牙和第一恒磨牙窝沟封闭是小学生口腔健康的最重要因素。
