Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Department of Human Nutrition and Home Economics, Kyambogo University, Kampala, Uganda.
Am J Trop Med Hyg. 2022 Sep 6;107(4):939-947. doi: 10.4269/ajtmh.22-0248. Print 2022 Oct 12.
The aim was to examine oral health among 5-6-year-old children whose mothers participated in a 6 months' cluster-randomized education trial in rural Uganda starting when their children were 6-8 months old. The education focused on nutrition, oral hygiene, and child stimulation. In the current follow-up study, 357/511 (70%) children from the original trial were available for data collection (200 in the intervention and 157 in the control group). Molar caries was assessed on intraoral photographs. Children and/or caregivers answered a WHO health questionnaire for collection of oral data. Dental practices were compared between the intervention and control group using multilevel mixed effect logistic regression accounting for clustering. The children in the intervention group had less caries compared with the control group: 41% versus 60% (odds ratio [OR] 0.46; 95% confidence intervals [CI] 0.24-0.86, P = 0.02). The use of toothbrush to clean teeth was more frequent in the intervention than in the control group: 66% versus 38% (OR 3.39; 95% CI 1.54-7.45, P = 0.003), as was high teeth-cleaning frequency: 74% versus 62% (OR 1.72; 95% CI 1.09-2.69, P = 0.02). Self-reported problems such as toothache (10% versus 19%), difficulty biting (12% versus 24%) and chewing food (8.5% versus 18%) were significantly less frequent among children in the intervention compared with the control group. No significant differences were found in dietary habits. Our data shows that an educational intervention adjusted to a low-resource setting, provided in infancy, resulted in improved oral hygiene and reduced development of dental caries among children aged 5-6 years.
目的是研究在乌干达农村地区，5-6 岁儿童的口腔健康状况。这些儿童的母亲参加了一项为时 6 个月的群组随机教育试验，从孩子 6-8 个月大时开始。该教育重点关注营养、口腔卫生和儿童刺激。在当前的随访研究中，来自原始试验的 511 名儿童中有 357 名（试验组 200 名，对照组 157 名）可用于数据收集。通过口腔内照片评估磨牙龋齿情况。儿童和/或照顾者回答了世界卫生组织的口腔健康问卷，以收集口腔数据。使用多级混合效应逻辑回归，考虑到聚类，比较干预组和对照组之间的牙齿护理习惯。干预组儿童的龋齿比对照组少：41%比 60%（比值比 [OR] 0.46；95%置信区间 [CI] 0.24-0.86，P = 0.02）。与对照组相比，干预组中使用牙刷清洁牙齿的频率更高：66%比 38%（OR 3.39；95%CI 1.54-7.45，P = 0.003），以及高刷牙频率：74%比 62%（OR 1.72；95%CI 1.09-2.69，P = 0.02）。报告的问题，如牙痛（10%比 19%）、咀嚼困难（12%比 24%）和难以咀嚼食物（8.5%比 18%）在干预组儿童中明显较少。饮食习惯方面无显著差异。我们的数据表明，在资源有限的环境中提供的调整后的教育干预措施可改善婴儿口腔卫生，减少 5-6 岁儿童的龋齿发生。
