1995 年至 2014 年间五次连续全国调查显示中国 12 岁儿童恒牙患龋状况变化趋势
Trends of dental caries in permanent teeth among 12-year-old Chinese children: evidence from five consecutive national surveys between 1995 and 2014.
机构信息
Institute of Child and Adolescent Health, School of Public Health, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.
Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Mentougou District, Beijing, China.
出版信息
BMC Oral Health. 2021 Sep 23;21(1):467. doi: 10.1186/s12903-021-01814-7.
BACKGROUND
Dental caries have a serious impact on general health and well-being; however, there is a lack of relevant data on the development trends of dental caries in permanent teeth among 12-year-old children in China. We aim to assess long-term trends of dental caries in permanent teeth among 12-year-old children in China and identify the susceptible subgroups based on five consecutive national surveys from 1995 to 2014.
METHODS
A total of 88 972 subjects were extracted from five consecutive national surveys (1995, 2000, 2005, 2010, 2014). Standardized dental examinations were conducted and the oral health status of each subject was recorded. The prevalence of Decayed, Missing and Filled teeth (DMF%), mean Decayed, Missing, Filled teeth score (DMFT) and Caries Filling Ratio (CFR) were used as measurement indicators. Cochran-Armitage trend test was used to evaluate the trends in DMF% and CFR, and multivariate linear regression was used to evaluate the trends in DMFT.
RESULTS
A V-shaped fluctuating upward trend in DMF% during 1995-2014 was observed (Z = - 13.124, P < 0.001), and the DMF% in 1995-2014 was 21.1%, 15.9%, 16.2%, 21.9% and 24.3%. The trend in DMFT was approximately consistent with DMF% (β = 0.057, P < 0.001), but the downward volatility appeared in 2014. The DMFT in 1995-2014 was 0.38, 0.28, 0.31, 0.66 and 0.54. A continuously fluctuant trend in CFR was observed during past two decades (Z = 1.927, P > 0.05), and the CFR in 1995-2014 was 17.4%, 22.8%, 19.3%, 23.4% and 15.6%. The DMF% and DMFT of rural children had a larger absolute increase than that of urban children during 1995-2014 (DMF%-urban: Z = - 0.242, P > 0.05; DMF%-rural: Z = - 19.036, P < 0.001; DMFT-urban: β = 0.035, P < 0.001, DMFT-rural: β = 0.077, P < 0.001). The DMF% and DMFT in girls were higher than that in boys at each survey year (P < 0.001). CFR of urban children was higher than that of rural children at each survey year (P < 0.001).
CONCLUSIONS
Over the past 20 years, DMFT and DMF% of 12-year-old children in China presented V-shaped fluctuant upward trends, with a decline trend from 1995 to 2000 and an upward trend from 2000 to 2014. CFR had no significant improvement. The rural children and girls are the more vulnerable groups in the development of dental caries and need to pay priority. Our study supports the continuation of policies to improve children' oral health.
背景
龋齿对整体健康和幸福感有严重影响；然而，中国关于 12 岁儿童恒牙龋齿发展趋势的相关数据却很缺乏。我们旨在评估中国 12 岁儿童恒牙龋齿的长期发展趋势，并根据 1995 年至 2014 年连续五次全国调查来确定易感亚组。
方法
从五次连续全国调查（1995 年、2000 年、2005 年、2010 年、2014 年）中提取了 88972 名受试者。进行了标准化的口腔检查，并记录了每位受试者的口腔健康状况。使用患龋、失牙、补牙数（DMF%）、平均龋、失、补牙数（DMFT）和龋补牙比（CFR）作为测量指标。Cochran-Armitage 趋势检验用于评估 DMF%和 CFR 的趋势，多变量线性回归用于评估 DMFT 的趋势。
结果
1995-2014 年间，DMF%呈现出 V 形波动上升趋势（Z=−13.124，P<0.001），1995-2014 年的 DMF%分别为 21.1%、15.9%、16.2%、21.9%和 24.3%。DMFT 的趋势与 DMF%大致一致（β=0.057，P<0.001），但在 2014 年出现了下降波动。1995-2014 年的 DMFT 分别为 0.38、0.28、0.31、0.66 和 0.54。过去二十年里，CFR 呈现出持续波动的趋势（Z=1.927，P>0.05），1995-2014 年的 CFR 分别为 17.4%、22.8%、19.3%、23.4%和 15.6%。1995-2014 年，农村儿童的 DMF%和 DMFT 绝对值增长大于城市儿童（DMF%-城市：Z=−0.242，P>0.05；DMF%-农村：Z=−19.036，P<0.001；DMFT-城市：β=0.035，P<0.001，DMFT-农村：β=0.077，P<0.001）。在每个调查年份，女孩的 DMF%和 DMFT 均高于男孩（P<0.001）。城市儿童的 CFR 高于农村儿童（P<0.001）。
结论
在过去的 20 年里，中国 12 岁儿童的 DMFT 和 DMF%呈 V 形波动上升趋势，1995-2000 年呈下降趋势，2000-2014 年呈上升趋势。CFR 没有明显改善。农村儿童和女孩是龋齿发展的更脆弱群体，需要优先考虑。我们的研究支持继续实施改善儿童口腔健康的政策。
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