Department of pediatrics dentistry, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No.44-1 Wenhua Road West, Jinan, 250012, Shandong, China.
Center of Evidence-based Medicine, the Second Hospital of Shandong University, Jinan, China.
BMC Oral Health. 2020 May 12;20(1):139. doi: 10.1186/s12903-020-01104-8.
The high prevalence of early childhood caries (ECC) is widespread around the world, and oral health education (OHE) plays a vital role in preventing ECC. Numerous studies on ECC risk factor assessment have assisted us in enriching the content of OHE. The objective of this study was to further assess independent risk factors for ECC at different ages to provide evidence and insights for OHE.
Children aged 3-5 years old (N = 1301) in Shandong Province were enrolled in this cross-sectional study. Data about oral health status and caregivers' oral health knowledge, attitude, and practice (KAP) were extracted from the 4th National Oral Health Survey of China. The associations between ECC prevalence and various KAP variables were tested with chi-square tests, bivariate analysis and multivariable logistic regression analyses.
The ECC prevalence in Shandong Province was 64.6%, and the dmft mean was 3.15. The independent variables with an increased risk for ECC were age, feeding method within 6 months of birth, bedtime sugar frequency, experience of toothache over the past year and dental visits (P < 0.05, chi-square tests). Complete breastfeeding within 6 months of birth primarily contributed to the high ECC risk of the 3-year-old group (OR: 3.39, 95% CI: 1.41-8.17), while high frequency bedtime sweet consumption mainly contributed to that of the 5-year-old group (OR: 3.22, 95% CI: 1.03-10.06; logistic regression analysis). Tooth brushing was not associated with ECC in this study, and some positive knowledge and attitude variables were positively correlated with a high risk of ECC.
These data provide evidence to suggest that the ECC-related risk factors at different ages are inconsistent, which provides some insights for OHE. We should highlight the effects of feeding methods in the early stages of deciduous dentition and sugar habits in the late stages of deciduous dentition on ECC, as well as encourage preventive dental visit and supplemental training for oral health practices.
全世界范围内，婴幼儿龋（ECC）的高发率普遍存在，口腔健康教育（OHE）在预防 ECC 中起着至关重要的作用。大量关于 ECC 危险因素评估的研究帮助我们丰富了 OHE 的内容。本研究旨在进一步评估不同年龄段 ECC 的独立危险因素，为 OHE 提供证据和见解。
本横断面研究纳入了山东省年龄在 3-5 岁的儿童（N=1301）。从中国第四次全国口腔健康调查中提取了口腔健康状况以及照顾者口腔健康知识、态度和实践（KAP）的数据。采用卡方检验、二变量分析和多变量逻辑回归分析检验 ECC 患病率与各种 KAP 变量之间的关联。
山东省 ECC 患病率为 64.6%，dmft 均值为 3.15。ECC 的独立危险因素为年龄、出生后 6 个月内的喂养方式、睡前吃糖频率、过去一年的牙痛经历和牙科就诊（P<0.05，卡方检验）。出生后 6 个月内的纯母乳喂养主要增加了 3 岁组的 ECC 高风险（OR：3.39，95%CI：1.41-8.17），而睡前高频率吃甜食主要增加了 5 岁组的 ECC 高风险（OR：3.22，95%CI：1.03-10.06；logistic 回归分析）。在本研究中，刷牙与 ECC 无关，一些积极的知识和态度变量与 ECC 的高风险呈正相关。
这些数据表明，不同年龄段的 ECC 相关危险因素不一致，为 OHE 提供了一些见解。我们应该强调在乳牙萌出早期喂养方式和在乳牙萌出晚期糖的习惯对 ECC 的影响，并鼓励进行预防性牙科就诊和口腔健康实践的补充培训。
