Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China.
Centre for Host Microbiome Interactions, King's College London, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK.
BMC Oral Health. 2021 Mar 19;21(1):137. doi: 10.1186/s12903-021-01507-1.
Dental caries is the most prevalent condition globally. Despite improvements over the past few decades, there remains a significant disease burden in childhood. Epidemiological surveys provide insight to disease patterns and trends, and have traditionally focused on obvious decay which are inconsistent with contemporary clinical criteria. This study examined the distribution of dental caries in 12- and 15-year-olds in England, Wales and Northern Ireland, by severity threshold, at surface, tooth and child level and explored its association with socioeconomic, psychological and behavioural factors.
Data from 12- and 15-year-olds in the 2013 Children's Dental Health Survey (CDHS 2013) were analysed at three levels, taking account of dental caries thresholds which involved recording both clinical decay [visual enamel caries (AV) and above] and obvious decay [non-cavitated dentine lesions (2V) and above]. Negative binomial regression was used to identify factors associated with dental caries experience at both thresholds.
The prevalence and severity of dental caries experience was higher among 15-year-olds at all levels. Visual change in enamel (AV) was by far the most common stage of caries recorded in both ages. The average number of surfaces with obvious decay experience, which has been the traditional epidemiological threshold, in 12- and 15-year-olds was 2.3 and 3.9 respectively. The corresponding values under the clinical decay threshold were higher, at 3.9 and 5.9 respectively. Visualisation of the distribution of dental caries at surface/tooth-level exhibited horizontal symmetry and to a lesser extent vertical symetry. In the adjusted models for both ages, country/region, school type, area deprivation, high frequency sugar consumption and irregular dental attendance were associated with greater caries experience in both groups. Dental anxiety was inversely associated with caries experience among 15-year-olds.
This research highlights the importance of recognising dental caries patterns by surface, tooth and child-level amongst adolescents and the value of reporting dental caries distribution by threshold in epidemiological surveys, including its relevance for clinical care. Inclusion of enamel caries reveals the extent of caries management required at a point when non-invasive care is possible, emphasising the importance of prevention through contemporary primary care, which includes supporting self-care.
龋齿是全球最普遍的疾病。尽管在过去几十年中有所改善，但儿童仍面临着重大的疾病负担。流行病学调查提供了对疾病模式和趋势的深入了解，传统上侧重于不一致的现代临床标准的明显龋坏。本研究通过严重程度阈值、表面、牙齿和儿童水平检查了英格兰、威尔士和北爱尔兰 12 岁和 15 岁儿童的龋齿分布，并探讨了其与社会经济、心理和行为因素的关系。
对 2013 年儿童口腔健康调查（CDHS 2013）中 12 岁和 15 岁儿童的数据进行了三个层次的分析，考虑到涉及记录临床龋坏（AV 及以上）和明显龋坏（2V 及以上）的龋齿阈值。采用负二项回归分析确定两个阈值下与龋齿经历相关的因素。
在所有水平上，15 岁儿童的龋齿患病率和严重程度均较高。在两个年龄段中，釉面视觉变化（AV）是迄今为止记录的最常见的龋齿阶段。12 岁和 15 岁儿童中明显龋坏经验的平均表面数分别为 2.3 和 3.9。在临床龋齿阈值下，相应的值更高，分别为 3.9 和 5.9。在表面/牙齿水平上龋齿分布的可视化表现出水平对称性，在较小程度上表现出垂直对称性。在两个年龄组的调整模型中，国家/地区、学校类型、地区贫困、高频糖消耗和不定期看牙与两组龋齿发生率较高相关。在 15 岁儿童中，牙科焦虑与龋齿发生率呈负相关。
本研究强调了在青少年中认识到表面、牙齿和儿童水平的龋齿模式的重要性，以及在流行病学调查中按阈值报告龋齿分布的重要性，包括其对临床护理的相关性。包含釉质龋揭示了在可能进行非侵入性治疗时需要进行的龋齿管理程度，强调了通过现代初级保健进行预防的重要性，包括支持自我保健。
