Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Int Dent J. 2024 Feb;74(1):35-41. doi: 10.1016/j.identj.2023.08.001. Epub 2023 Oct 13.
The objective of this study was to investigate the relationship amongst early childhood caries (ECC), economic development, and dental public health programmes in Hong Kong. We searched exhaustively qualitative and quantitative data on the oral health policy, dental service, public health strategies of caries control and epidemiologic surveys on ECC. We then performed meta-regression to explore the impact of the Human Development Index (HDI), gross domestic product (GDP) growth, water fluoridation, oral health promotion, dental school establishment, free education, and dental workforce on ECC prevalence in 5-year-olds. We found that the first government oral health survey was conducted in 1960, when Hong Kong experienced significant growth, as the HDI indicated. The survey revealed that 97% of 6- to 8-year-old children experienced ECC. Water fluoridation was implemented in 1961 at 0.7 ppm (0.9 ppm in winter) to prevent caries. The government offered free 9-year education in 1978. In 1981, the government established a dental school to improve a low dentist-to-population ratio of 1:9000. The ECC prevalence amongst 5- to 6- year-old children was reduced from 84% in 1968 to 63% in 1986. The Department of Health created an oral health education division in 1989. The ECC prevalence for 5-year-old children was further reduced to 44% in 1997. The ECC prevalence amongst 5-year-old children was stabilised at 51% both in 2001 and 2011. However in 2021, the prevalence of untreated ECC increased to 57% during the outbreak of COVID-19. Meta-regression analysis showed that ECC prevalence was not linked to GDP growth but decreased with improvements in HDI, the provision of 9-year free education, the establishment of a dental school, fluoridation of water supply, and implementation of territory-wide oral health promotion. In conclusion, better education, living conditions, and dental public health programmes have improved children's oral health in Hong Kong.
本研究旨在探讨香港儿童早期龋（ECC）、经济发展和口腔公共卫生计划之间的关系。我们全面检索了有关口腔卫生政策、牙科服务、龋病控制的公共卫生策略以及 ECC 流行病学调查的定性和定量数据。然后，我们进行了元回归分析，以探讨人类发展指数（HDI）、国内生产总值（GDP）增长、水氟化、口腔健康促进、牙科学校设立、免费教育和牙医劳动力对 5 岁儿童 ECC 患病率的影响。我们发现，香港于 1960 年进行了第一次政府口腔健康调查，当时香港经历了显著的增长，正如 HDI 所显示的那样。调查显示，97%的 6-8 岁儿童患有 ECC。1961 年，香港开始实施水氟化，浓度为 0.7ppm（冬季为 0.9ppm）以预防龋病。政府于 1978 年提供了 9 年免费教育。1981 年，政府设立了一所牙科学校，以改善低牙医与人口比例（1:9000）。1968 年，5-6 岁儿童 ECC 患病率从 84%降至 1986 年的 63%。1989 年，卫生署成立了口腔健康教育科。1997 年，5 岁儿童 ECC 患病率进一步降至 44%。2001 年和 2011 年，5 岁儿童 ECC 患病率均稳定在 51%。然而，在 2021 年 COVID-19 爆发期间，未经治疗的 ECC 患病率上升至 57%。元回归分析显示，ECC 患病率与 GDP 增长无关，但随着 HDI 的提高、提供 9 年免费教育、设立牙科学校、供水氟化以及实施全港口腔健康促进，ECC 患病率呈下降趋势。总之，更好的教育、生活条件和口腔公共卫生计划改善了香港儿童的口腔健康。
