Kirkinen Tita, Naimi-Akbar Aron, Cederlund Andreas, Tranaeus Sofia, Klingberg Gunilla
Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden.
The Clinic of Pediatric Dentistry, Region Värmland, Malmö, Sweden.
BMC Oral Health. 2025 Aug 12;25(1):1320. doi: 10.1186/s12903-025-06389-1.
Children in out-of-home care (OHC) are at greater risk of ill health than other children in the community. The aim of this registry-based cohort study was to compare the oral health and dental care needs of children in OHC with those of other children in Sweden, by merging data from different Swedish registries. A further aim was to analyse whether children in OHC received more dental examinations after 2017, following implementation of a law requiring mandatory health evaluations prior to placement.
We identified an exposed cohort of Swedish children and young people, 0-19 years old, who had been placed in OHC 2010-2018 (N = 50,878), and an unexposed cohort, five times larger, matched for age, sex and county of residence (N = 254,380). During the study period, children in OHC received relatively fewer regular, scheduled dental examinations (4.21 vs. 4.88; p < 0.0001). More children entering OHC in 2018 received dental examinations (81.7%) compared with 2016 (76.6%) (p < 0.0001), but this was still lower than the proportion of controls. Moreover, during the study period, dental caries affected more teeth in children in OHC than in the controls (dft 6-year-olds 1.56 vs. 0.74; p < 0.0001, and DFT 12-year-olds 1.18 vs. 0.65; p < 0.0001), and they had more extractions and more emergency dental appointments than children who had never been in OHC.
Not only do children in OHC have poorer oral health than other children, they also receive less support from the dental health services. It seems that society has failed in its mission to ensure that children in OHC are not disadvantaged with respect to health and access to comprehensive healthcare. Thus, there is an urgent need for reappraisal of guidelines, legislation, and organizational models for providing dental care to children and adolescents in OHC.
与社区中的其他儿童相比，接受家庭外照料（OHC）的儿童健康状况不佳的风险更高。这项基于登记处的队列研究的目的是，通过合并瑞典不同登记处的数据，比较瑞典接受OHC的儿童与其他儿童的口腔健康状况和牙科护理需求。另一个目的是分析在2017年一项要求在安置前进行强制性健康评估的法律实施后，接受OHC的儿童是否接受了更多的牙科检查。
我们确定了一个暴露队列，即2010 - 2018年期间被安置在OHC的0至19岁瑞典儿童和青少年（N = 50,878），以及一个未暴露队列，其规模是暴露队列的五倍，在年龄、性别和居住县方面进行了匹配（N = 254,380）。在研究期间，接受OHC的儿童接受的定期、预定牙科检查相对较少（4.21次对4.88次；p < 0.0001）。与2016年（76.6%）相比，2018年进入OHC的儿童接受牙科检查的比例更高（81.7%）（p < 0.0001），但仍低于对照组的比例。此外，在研究期间，OHC儿童的龋齿累及的牙齿比对照组更多（6岁儿童的龋失补牙数1.56颗对0.74颗；p < 0.0001，12岁儿童的龋失补牙数1.18颗对0.65颗；p < 0.0001），并且与从未接受OHC的儿童相比，他们拔牙更多，牙科急诊预约更多。
接受OHC的儿童不仅口腔健康状况比其他儿童差，而且从牙科保健服务中获得的支持也更少。看来社会未能履行其使命，确保接受OHC的儿童在健康和获得全面医疗保健方面不处于不利地位。因此，迫切需要重新评估为接受OHC的儿童和青少年提供牙科护理的指南、立法和组织模式。
