Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia.
Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
Community Dent Oral Epidemiol. 2022 Dec;50(6):559-569. doi: 10.1111/cdoe.12710. Epub 2022 Feb 9.
This paper reports on the effect of 6-month dental home visits compared to no dental home visits on 24-month caries incidence in 5- to 6-year-olds.
5- to 6-year-olds attending kindergartens were randomized to receive either 6-month dental home visits and education leaflets (Intervention group) or education leaflets alone (Control group) over 24 months. To detect a 15% difference in caries incidence with a significance level of 5% and power of 80%, 88 children were calculated to be needed in the Intervention group and 88 in the Control. Baseline clinical data included oral examinations at the kindergartens. Follow-up visits were made on the 6th, 12th and 18th month. At the end of the 24 months, both the Intervention and Control groups were visited for oral examinations. The primary outcome was caries incidence, measured by the number and proportion of children who developed new caries in the primary molars after 24 months. The secondary outcome was the number of primary molars that developed new caries (d-pms). Frequency distributions of participants by baseline socio-demographic characteristics and caries experience were calculated. The chi-square test was used to test differences between the caries experience in the Intervention and Control groups. The t test was used to compare the mean number of primary molars developing new caries between the Intervention Group and the Control Group. The number of children needed to treat (NNT) was also calculated.
At the 24-month follow-up, 19 (14.4%) developed new caries in the Intervention Group, compared to 60 (60.0%) in the Control Group (p = .001). On average, 0.2 (95% CI = 0.1-0.3) tooth per child in the Intervention Group was observed to have developed new caries compared to 1.1 (95% CI = 0.8-1.3) tooth per child in the Control Group (p = .001). The number of children needed to treat (NNT) to prevent one child from developing new caries was 2.2.
The present study has demonstrated that 6-month home visits to families of 5- to 6-year-olds are effective in caries prevention in 5- to 6-year-olds of low-income families in a middle-income country where access to health services, including oral health promotion services, is limited.
本文报告了为期 6 个月的家庭访视与无家庭访视相比，对 5 至 6 岁儿童 24 个月龋齿发病率的影响。
5 至 6 岁入读幼儿园的儿童被随机分为接受为期 6 个月的家庭访视和教育传单（干预组）或仅接受教育传单（对照组）的两组，随访 24 个月。为了检测发病率有 15%的差异，设定了 5%的显著性水平和 80%的功效，需要在干预组和对照组中各纳入 88 名儿童。基线临床数据包括在幼儿园进行的口腔检查。随访在第 6、12 和 18 个月进行。24 个月结束时，干预组和对照组均进行口腔检查。主要结局是通过在 24 个月后新发生龋齿的儿童数量和比例测量的龋齿发病率。次要结局是新发生龋齿的第一恒磨牙数量（d-pms）。根据基线社会人口统计学特征和龋齿发生情况计算参与者的频率分布。卡方检验用于检验干预组和对照组的龋齿发生率差异。t 检验用于比较干预组和对照组新发生龋齿的第一恒磨牙平均数量。还计算了需要治疗的儿童数量（NNT）。
在 24 个月的随访中，干预组有 19 名（14.4%）儿童新发生龋齿，对照组有 60 名（60.0%）儿童新发生龋齿（p =.001）。平均而言，干预组每例儿童有 0.2 颗（95%CI=0.1-0.3）新发生龋齿的牙齿，而对照组每例儿童有 1.1 颗（95%CI=0.8-1.3）新发生龋齿的牙齿（p =.001）。预防一名儿童发生新龋齿所需的儿童数量（NNT）为 2.2。
本研究表明，在中低收入国家，向低收入家庭的 5 至 6 岁儿童家庭提供 6 个月的家庭访视，对预防儿童龋齿是有效的，在这些国家，获得卫生服务（包括口腔健康促进服务）的机会有限。
