Master Programme in Public Health, University of Zurich, Zurich, Switzerland.
Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
BMC Oral Health. 2021 Nov 30;21(1):609. doi: 10.1186/s12903-021-01969-3.
With the goal of reducing the prevalence of early childhood caries, the city of Zurich, Switzerland, started a specific prevention programme in 2010. All 2-year-olds are invited to a free dental check-up at a local public dental health service before the first legally mandated yearly dental check-up for school children between 4 and 5 years of age (at kindergarten). However, for the success of this prevention programme, it is of particular importance that children at high risk of caries are reached. The objective of our study was to assess the effectiveness of the prevention programme in (1) reaching the children who needed it the most and (2) improving subsequent oral health.
This retrospective cohort study included all children born between July 1, 2013 and July 15, 2014 who had lived in Zurich between the ages of 23 and 36 months. Socio-economic data were extracted from official school records, and dental health data from public dental clinic records. Binomial and quasi-binomial generalised linear models were used to identify the socio-economic factors associated with toddler check-up attendance and to assess the associations between attendance and caries experience (dmft [Formula: see text] 1) as well as degree of treatment (proportion m+f out of dmft) at the kindergarten check-up, adjusting for socio-economic factors.
From a total of 4376 children, 2360 (54%) attended the toddler check-up (mean age 2.4 years) and 3452 (79%) had a dental examination at kindergarten (mean age 5.3 years). Non-Swiss origin of the primary caretaker, presence of older siblings, low amount of savings and allocation to certain public dental clinics were associated with a lower odds of attendance. Factors associated with a higher odds of caries experience were similar to those associated with a lower odds of attendance at the toddler check-up, but additionally included low income. Attendance at the toddler check-up was non-significantly associated with a lower odds of caries experience at kindergarten (adjusted OR 0.84, 95% CI from 0.70 to 1.01), but was significantly associated with a higher degree of treatment at this stage (adjusted OR 2.41, 95% CI from 1.79 to 3.24).
Our study suggests that children with a high caries risk are less likely to attend the toddler check-up. Greater effort should be put into reaching these children.
为了降低儿童早期龋齿的患病率，瑞士苏黎世市于 2010 年启动了一项专门的预防计划。所有 2 岁儿童在 4 至 5 岁（幼儿园）儿童法定每年牙科检查之前，都可在当地公共牙科保健服务处免费接受牙科检查。然而，为了使这项预防计划取得成功，特别重要的是要让那些患龋齿风险高的儿童参与进来。我们的研究目的是评估预防计划在以下两方面的效果：（1）使最需要的儿童参与其中；（2）改善后续的口腔健康。
这是一项回顾性队列研究，纳入了 2013 年 7 月 1 日至 2014 年 7 月 15 日期间在苏黎世居住、年龄在 23 至 36 个月之间的所有儿童。社会经济数据从官方学校记录中提取，牙科健康数据从公共牙科诊所记录中提取。采用二项式和拟二项式广义线性模型来确定与幼儿检查参与相关的社会经济因素，并评估参与情况与幼儿园检查时龋齿经历（dmft [Formula: see text] 1）以及治疗程度（dmft 中 m+f 的比例）之间的关联，同时调整社会经济因素。
在总共 4376 名儿童中，有 2360 名（54%）参加了幼儿检查（平均年龄 2.4 岁），有 3452 名（79%）在幼儿园接受了牙科检查（平均年龄 5.3 岁）。主要照顾者非瑞士籍、有兄弟姐妹、储蓄金额低以及分配到特定的公共牙科诊所与较低的参与几率相关。与幼儿检查参与几率较低相关的龋齿经历较高的因素与幼儿检查参与几率较低的因素相似，但还包括低收入。在幼儿园时的参与检查与较低的龋齿经历几率相关（调整后的比值比 0.84，95%置信区间为 0.70 至 1.01），但与治疗程度较高显著相关（调整后的比值比 2.41，95%置信区间为 1.79 至 3.24）。
我们的研究表明，患龋齿风险较高的儿童不太可能参加幼儿检查。应该加大力度让这些儿童参与进来。
