偏远澳大利亚原住民社区儿童在接受被动和主动预防干预后的龋齿患病情况。
Dental caries experience in children of a remote Australian Indigenous community following passive and active preventive interventions.
机构信息
School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia.
出版信息
Community Dent Oral Epidemiol. 2019 Dec;47(6):470-476. doi: 10.1111/cdoe.12486. Epub 2019 Jul 21.
OBJECTIVES
To report on changes in dental caries experience in children of a remote Indigenous community following 6 years of passive preventive intervention (PPI) and 2 years of active preventive intervention (API).
METHODS
Five consecutive cross-sectional surveys were conducted on 4- to 15-year-old school going children between 2004 and 2017 following phases of Community Water Fluoridation (CWF), post-cessation of CWF and API. Following treatment of any cavities present, API included selective placement of fissure sealants (FS) and an annual application of povidone-iodine (PI) and fluoride varnish (FV). The World Health Organization's (WHO) "Oral Health Surveys - Basic Methods (4th Edition)" methodology was used in the first two and the International Caries Detection and Assessment System (ICDAS-II) in the latter three surveys. ICDAS-II codes of 3-6, representing advanced caries, were combined to allow comparison to the decayed component of the DMF caries index.
RESULTS
Age-weighted mean dmft decreased by 37.7% in the deciduous (DD) and DMFT by 35% in the permanent (PD) dentitions between the pre- and post-CWF surveys, followed by increases of 25% and 7.7%, respectively, between the 1-year and 4-year post-CWF surveys. After 2 years of API, mean dmft decreased by 14.3% and DMFT by 7.1%. Untreated dental caries however remained a concern in the DD and PD during both phases of PPI and of API. The decline in caries experience for both dentitions following 2 years of API exceeded that for the 6-year period of PPI.
CONCLUSIONS
The annual reductions in caries experience of 7.2% (DD) and 8% (PD) during the phase of API exceeded annual decreases of 4.7% (DD) and 4.6% (PD) during the phase of PPI. Due to remoteness, cost and logistics in ensuring long-term viability of API programmes, CWF remains necessary in this type of community.
目的
报告在偏远土著社区进行 6 年被动预防干预（PPI）和 2 年主动预防干预（API）后，儿童龋齿经历的变化。
方法
在社区氟化水（CWF）、CWF 停止和 API 之后，对 2004 年至 2017 年期间的 4 至 15 岁在校儿童进行了连续五次横断面调查。在治疗任何现有龋齿后，API 包括选择性放置窝沟封闭剂（FS）和每年应用聚维酮碘（PI）和氟化物漆（FV）。在前两次调查中使用了世界卫生组织（WHO）“口腔健康调查 - 基本方法（第 4 版）”方法，在后三次调查中使用了国际龋齿检测和评估系统（ICDAS-II）。将 ICDAS-II 代码 3-6（代表进展性龋齿）合并，以允许与 DMF 龋齿指数的龋齿成分进行比较。
结果
在 CWF 前和后两次调查之间，乳牙（DD）的年龄加权平均 dmft 减少了 37.7%，恒牙（PD）的 DMFT 减少了 35%，之后分别增加了 25%和 7.7%。在 CWF 后 1 年和 4 年的调查中。在 API 后 2 年，平均 dmft 减少了 14.3%，DMFT 减少了 7.1%。然而，在 PPI 和 API 的两个阶段，DD 和 PD 的未治疗龋齿仍然是一个问题。在 API 后 2 年，两种牙齿的龋齿经验下降超过 PPI 6 年期间的下降。
结论
在 API 阶段，DD（7.2%）和 PD（8%）的龋齿年减少率超过 PPI 阶段的年减少率（DD 为 4.7%，PD 为 4.6%）。由于偏远、成本和后勤保障 API 计划的长期可行性，在这种类型的社区中，CWF 仍然是必要的。
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