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促进幼儿口腔和牙齿健康——以色列儿科医生的知识、观点和当前做法

Promoting oral and dental health in early childhood - knowledge, views and current practices among paediatricians in Israel.

作者信息

Shmueli Aviv, Assad-Halloun Aida, Fux-Noy Avia, Halperson Elinor, Shmueli Einat, Ram Diana, Moskovitz Moti

机构信息

Faculty of Dental Medicine, Hebrew University and Hadassah, Jerusalem, Israel.

Paediatric Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach tikva, Israel.

出版信息

Front Pediatr. 2023 Jan 6;10:956365. doi: 10.3389/fped.2022.956365. eCollection 2022.

Abstract

UNLABELLED

Early childhood dental caries is the most prevalent disease in childhood. Paediatricians are considered by parents as the main authority on prevention and treatment of all the health requirements of their infants.

AIM

The aim of this study was to evaluate the knowledge and practice of paediatricians in promoting oral and dental health among young patients (under age 36 months) and their parents.

MATERIALS AND METHODS

145 anonymous questionnaires were distributed among paediatricians, 130 of them were 90% or above answered and were suitable for analysis for this study.75% of the questionnaires were distributed during the national convention of the Israeli Association of Clinical Paediatrics, 10% in paediatric ambulatory clinics and 15% in paediatric departments in hospitals. Questionnaires were distributed between 2018 and 2020. The inclusion criteria were physicians specialists in paediatrics or residents in paediatrics, all have Israeli licences to practice in Israel. exclusion criteria were partially filled questionnaires. The questionnaire was validated in a pilot study during the years 2010-2012. In addition to demographic variables that included medical training, post-graduate education and clinical practice the questionnaire included 42 questions. Eleven questions on demographics and amount of dental training during academic and clinical training 31 questions belonged to several sections that referred to the participants' awareness of the AAP guidelines regarding oral and dental health and knowledge of oral health. In each section paediatricians were asked to answer or give an opinion on a specific issue, their answers were coded to scores on a scale of 0-5 and summed per section. Correlations between different variables were analysed. The -test and Mann-Whitney test were performed for comparing two variables. For comparing more than two variables, we used the Kruskal-Wallis one-way analysis of variance test or ANOVA.

RESULTS

The response rate was 89% (130 questionnaires out of 145). The survey showed that most paediatricians (80%) recognized their role in maintaining the oral and dental health of their young patients. Nevertheless, most admitted that they do not perform simple procedures on a regular basis, like dental examinations (64.6%), or asking parents about feeding habits (59.2%) or teeth brushing (75.4%). Only 21% of the participants expressed adequate knowledge of dental care for children younger than age 3 years. Fifty-eight percent of the participants never had any dental training during their entire paediatric medicine training, including medical school. Paediatricians in private or baby clinics received higher scores in practicing caries prevention, 24.15 ± 5.17 (SD), than paediatricians in hospitals, 2.79 ± 0.54 (SD) ( = 0.006). Caries prevention practice was not found to correlate with paediatricians' knowledge or attitudes regarding oral and dental caries prevention.

CONCLUSION

Oral and dental knowledge should be incorporated into the paediatric medicine curriculum. With their heavy workload, paediatricians generally do not implement dental caries risk assessment and counselling.

摘要

未标注

幼儿龋齿是儿童时期最常见的疾病。在家长看来,儿科医生是其婴儿所有健康需求预防和治疗方面的主要权威。

目的

本研究的目的是评估儿科医生在促进年轻患者(36个月以下)及其父母口腔和牙齿健康方面的知识与实践。

材料与方法

向儿科医生发放了145份匿名问卷,其中130份回答率达到或超过90%,适合本研究分析。75%的问卷在以色列临床儿科学会全国大会期间发放,10%在儿科门诊发放,15%在医院儿科科室发放。问卷发放时间为2018年至2020年。纳入标准为儿科专科医生或儿科住院医师,均拥有在以色列行医的执照。排除标准为部分填写的问卷。该问卷在2010 - 2012年的一项试点研究中得到验证。除了包括医学培训、研究生教育和临床实践等人口统计学变量外,问卷还包括42个问题。11个关于人口统计学和学术及临床培训期间牙科培训量的问题,31个问题属于几个部分,涉及参与者对美国儿科学会关于口腔和牙齿健康指南的认识以及口腔健康知识。在每个部分,要求儿科医生就一个特定问题回答或发表意见,他们的回答按0 - 5分进行编码,并按部分求和。分析了不同变量之间的相关性。采用t检验和曼 - 惠特尼检验比较两个变量。为比较两个以上变量,我们使用了克鲁斯卡尔 - 沃利斯单因素方差分析检验或方差分析。

结果

回复率为89%(145份问卷中的130份)。调查显示,大多数儿科医生(80%)认识到他们在维护年轻患者口腔和牙齿健康方面的作用。然而,大多数人承认他们没有定期进行简单的程序,如牙科检查(64.6%),或询问家长喂养习惯(59.2%)或刷牙情况(75.4%)。只有21%的参与者对3岁以下儿童的牙齿护理有足够的知识。58%的参与者在整个儿科医学培训期间,包括医学院,从未接受过任何牙科培训。私人诊所或婴儿诊所的儿科医生在预防龋齿实践方面的得分更高,为24.15±5.17(标准差),高于医院的儿科医生,为2.79±0.54(标准差)(P = 0.006)。未发现预防龋齿实践与儿科医生对口腔和龋齿预防的知识或态度相关。

结论

口腔和牙齿知识应纳入儿科医学课程。由于工作量大,儿科医生一般不进行龋齿风险评估和咨询。

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