Institute of Hospital Management, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, China.
Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
BMC Oral Health. 2022 Apr 29;22(1):150. doi: 10.1186/s12903-022-02190-6.
Limited information is known about preventive dental visits (PDVs) before seven years of age among children in China. This study aimed to examine the early PDV rate, identify the impact of PDV on dental caries and untreated dental caries, and explore the factors related to PDV among Chinese sampled children under seven years old.
A cross-sectional survey was conducted in five selected primary health care facilities in Chengdu, China, from May to August 2021. Parent-child dyads during regular systematic medical management were recruited to participate. Children's dental caries were identified through dental examinations and documented as decayed, missing and filled teeth index (dmft) by trained primary care physicians. Dental-related information was collected through a questionnaire. Zero-inflated negative binomial (ZINB) regression was used to test the effect of early PDV on the dmft value, and logistic regression was used to analyse impact factors on the early PDV.
A total of 2028 out of 2377 parent-child dyads were qualified for analysis. Half of the children (50.4%) were male, with a mean age of 4.8 years. Among all the children, 12.1% had their first dental visit for preventive purposes, 34.4% had their first dental visit for symptomatic purposes, and more than half had never visited a dentist. The results showed that a lower dmft value (adjusted OR: 0.69, 95% CI: 0.48-0.84), a higher rate of caries-free (aOR: 6.5, 95% CI: 3.93-10.58), and a lower rate of untreated dental caries (aOR: 0.40, 95% CI: 0.21-0.76) were associated with early PDV utilization. Children who had a higher rate of PDV were positively associated with living in a family with better parental behaviours (aOR: 2.30, 95% CI: 1.71-3.08), better parental oral health perception (aOR: 1.23, 95% CI: 1.06-1.32), fathers who had no untreated caries (aOR: 0.68, 95% CI: 0.47-0.97), families with higher socioeconomic status (aOR: 1.09, 95% CI: 1.04-1.16), and dental health advice received from well-child care physicians (aOR: 1.47, 95% CI: 1.08-2.00).
Early PDV was associated with a lower rate of dental caries prevalence and untreated dental caries among sampled children younger than seven in Western China. Underutilization and social inequities existed in PDV utilization. Public health strategies should be developed to increase preventive dental visits and eliminate social disparities that prevent dental care utilization.
在中国,关于 7 岁以下儿童的预防性牙科就诊(PDV)的信息有限。本研究旨在检查早期 PDV 率,确定 PDV 对龋齿和未治疗的龋齿的影响,并探讨中国抽样 7 岁以下儿童 PDV 相关因素。
2021 年 5 月至 8 月,在中国成都的五家选定的基层医疗保健机构进行了一项横断面调查。招募定期接受系统医疗管理的母婴对参与。由经过培训的初级保健医生通过牙科检查识别儿童的龋齿情况,并通过龋齿、缺失和补牙指数(dmft)记录。通过问卷调查收集与牙齿相关的信息。零膨胀负二项式(ZINB)回归用于检验早期 PDV 对 dmft 值的影响,逻辑回归用于分析早期 PDV 的影响因素。
共有 2377 对母婴对中的 2028 对符合分析条件。一半的儿童(50.4%)为男性,平均年龄为 4.8 岁。在所有儿童中,有 12.1%的儿童因预防目的而首次进行牙科就诊,34.4%的儿童因症状而首次进行牙科就诊,超过一半的儿童从未看过牙医。结果表明,dmft 值较低(调整后的 OR:0.69,95%CI:0.48-0.84)、无龋率较高(aOR:6.5,95%CI:3.93-10.58)和未治疗的龋齿率较低(aOR:0.40,95%CI:0.21-0.76)与早期 PDV 的利用有关。接受 PDV 率较高的儿童与父母行为较好的家庭(aOR:2.30,95%CI:1.71-3.08)、父母口腔健康认知较好(aOR:1.23,95%CI:1.06-1.32)、父亲无未治疗的龋齿(aOR:0.68,95%CI:0.47-0.97)、社会经济地位较高的家庭(aOR:1.09,95%CI:1.04-1.16)和接受儿童保健医生的口腔健康建议(aOR:1.47,95%CI:1.08-2.00)呈正相关。
在中国西部,7 岁以下儿童的早期 PDV 与龋齿患病率和未治疗的龋齿率较低有关。PDV 的利用存在利用率低和社会不平等的情况。应制定公共卫生策略,增加预防性牙科就诊次数,消除阻碍牙科保健利用的社会差异。