改良口腔护理基本套餐对赞比亚青少年龋齿状况的影响；一项整群随机试验。
The effect of the modified basic package of oral care on adolescent dental caries status in Zambia; a cluster randomized trial.
作者信息
Anthony Severine N, Mbawalla Hawa S, Kahabuka Febronia K, Siziya Seter, Åstrøm Anne N
机构信息
Department of Dental Clinical Sciences, Michael Chilufya Sata School of Medicine, The Copperbelt University, Ndola, Zambia.
Department of Orthodontics, Paedodontics and Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
出版信息
Front Oral Health. 2025 May 7;6:1542337. doi: 10.3389/froh.2025.1542337. eCollection 2025.
BACKGROUND
The Basic Package of Oral Care (BPOC) was developed by the World Health Organization (WHO) in order to improve oral health care worldwide, yet evidence of its effectiveness is scarce. This study primarily assessed the outcome of applying modified BPOC on dental caries prevalence and secondarily on knowledge and behaviors related to dental caries among adolescents in Copperbelt Province, Zambia.
METHODS
A parallel arms cluster randomized field trial including 22 public secondary schools (11-intevention, 11-control) was carried out between January 2021 and March 2023 in Copperbelt Province, Zambia. A validated questionnaire collected data with respect to socio-demographics, knowledge, and dental caries-related behaviors. The caries assessment spectrum and treatment (CAST) instrument was used to examine the spectrum of carious lesions during the baseline, and the follow-up data collection phases. The 1st and 2nd follow up exams were conducted at 18 and 24 months after baseline, respectively. The intervention group received a six-month duration modified BPOC intervention while, the control group continued with their routine oral self-care. The analysis was based on the intention-to-treat protocol using generalized estimating equations (GEE), and the results were reported as OR (95% CI).
RESULTS
Out of 1,794 participants at baseline, 1,690 (94.2%) and 1,597 (89.0%) were examined at the 1st and 2nd follow up intervals, respectively. Dental caries models showed significant interaction at 18 and 24 months [OR (95% CI) = 0.7 (0.6, 0.8), < 0.001]. Adequate knowledge and use of fluoridated toothpaste models were the only secondary outcomes with significant interactions at 18 and 24 months follow up. Stratified analysis at 18 and 24 months showed that the intervention group had better outcomes for adequate knowledge, use of fluoridated toothpaste and dental caries.
CONCLUSION
The modified BPOC was effective in reducing the prevalence of dental caries, improving knowledge on dental caries, and increasing the frequency of using fluoridated toothpaste among Zambian adolescents.
CLINICAL TRIAL REGISTRATION
[https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24046], identifier [PACTR202210624926299].
背景
口腔保健基本包（BPOC）由世界卫生组织（WHO）制定，旨在改善全球口腔保健状况，但关于其有效性的证据却很少。本研究主要评估应用改良版BPOC对赞比亚铜带省青少年龋齿患病率的影响，其次评估对与龋齿相关的知识和行为的影响。
方法
2021年1月至2023年3月在赞比亚铜带省开展了一项平行组群随机现场试验，纳入22所公立中学（11所干预学校，11所对照学校）。通过一份经过验证的问卷收集有关社会人口统计学、知识和与龋齿相关行为的数据。在基线期以及随访数据收集阶段，使用龋病评估光谱及治疗（CAST）工具检查龋损情况。第一次和第二次随访检查分别在基线期后的18个月和24个月进行。干预组接受为期六个月的改良版BPOC干预，而对照组继续其常规口腔自我护理。分析基于意向性分析方案，使用广义估计方程（GEE），结果以OR（95%CI）表示。
结果
在基线期的1794名参与者中，分别有1690名（94.2%）和1597名（89.0%）在第一次和第二次随访时接受了检查。龋齿模型在18个月和24个月时显示出显著交互作用[OR（95%CI）=0.7（0.6，0.8），P<0.001]。充足知识和使用含氟牙膏模型是在18个月和24个月随访时仅有的具有显著交互作用的次要结局。在18个月和24个月时的分层分析表明，干预组在充足知识、使用含氟牙膏和龋齿方面有更好的结局。
结论
改良版BPOC在降低赞比亚青少年龋齿患病率、提高龋齿相关知识以及增加使用含氟牙膏频率方面有效。
临床试验注册
[https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24046]，标识符[PACTR202210624926299]
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