Analysis of caries status among children aged 3-6 years in Tongling City and investigation of parental oral health knowledge and behaviors
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摘要:
目的 了解铜陵市3~6岁在园儿童及家长对口腔保健的知晓程度、行为实施情况及儿童患龋情况，为有针对性地开展儿童口腔健康干预提供科学依据。 方法 采用分层随机整群抽样法，于2024年5—6月抽取铜陵市三区一县28所幼儿园5 941名3~6岁儿童及家长为调查对象。由家长在线填写“问卷星”电子调查问卷。调查内容包括人口学特征、口腔健康行为、口腔健康知识和儿童患龋情况。 结果 铜陵市3~6岁儿童家长口腔健康知识总知晓率为77.5%，城区高于非城区（P＜0.05）。单因素分析显示，不同年龄、地区、母乳喂养时间、睡前吃甜食的频率、日常进食甜食频率、开始刷牙时间、帮助刷牙的频率、检查刷牙效果的频率和涂氟防龋的类型儿童的龋齿率差异均有统计学意义（P＜0.05），不同性别和主要照顾人儿童患龋率差异均无统计学意义（P＞0.05）。多因素logistic回归分析显示，年龄[3~＜4岁（OR=0.273），4~＜5岁（OR=0.427），5~＜6岁（OR=0.738）]、城区儿童（OR=0.629）、开始刷牙时间＜1岁（OR=0.482）、母乳喂养时间[6月龄内（OR=0.607），6~12月龄（OR= 0.793）]、日常进食甜食频率[≤1次/周（OR=0.657），2~6次/周（OR=0.861）]均为儿童龋病发生的保护因素（P＜0.05），睡前吃甜食[经常（OR=3.093），偶尔（OR=2.084）]为儿童龋病发生的危险因素（P＜0.05）。 结论 儿童家长的口腔健康知识和行为是影响儿童龋齿发生的重要因素。应有针对性地开展口腔健康教育和行为干预，尤其是以非城区人群为重点。 Abstract:Objective To understand the level of oral health knowledge among parents of children aged 3-6 years in Tongling City, their implementation of oral health behaviors, and the prevalence of dental caries in children, thereby providing scientific evidence for interventions in children's oral health. Methods A stratified random cluster sampling method was employed to select 5 941 children aged 3-6 years and their parents from 28 kindergartens in three districts and one county of Tongling City during May to June 2024. Parents completed an online electronic questionnaire using "Wenjuanxing". The survey included demographic characteristics, oral health behaviors, oral health knowledge, and the prevalence of dental caries in children. Results The overall awareness rate of oral health knowledge among parents of 3-6 years in Tongling City was 77.5%, with a higher rate observed in urban areas than in rural areas (P < 0.05). Univariate analysis indicated that factors such as age, region, breastfeeding duration, frequency of consuming sweets before bedtime, frequency of daily sweet intake, timing of starting tooth brushing, frequency of assistance with brushing, frequency of checking brushing effectiveness, and type of fluoride treatment significantly affected the caries rate in children (P < 0.05). Gender and primary caregivers did not significantly influence the caries rate (P>0.05). Multivariate logistic regression analysis revealed that age (3- < 4 years: OR=0.273; 4- < 5 years: OR=0.427; 5- < 6 years: OR=0.738), living in urban areas (OR=0.629), initiating tooth brushing before 1 year of age (OR=0.482), breastfeeding duration (within 6 months: OR=0.607; 6-12 months: OR=0.793), and lower frequency of sweet consumption (≤ 1 time/week: OR=0.657; 2-6 times/week: OR=0.861) were negatively correlated with the occurrence of dental caries (P < 0.05). Conversely, consuming sweets before bedtime (frequently: OR=3.093; occasionally: OR=2.084) was positively correlated with the incidence of dental caries (P < 0.05). Conclusion Parents' oral health knowledge and behaviors are important factors influencing the occurrence of dental caries in children. Targeted oral health education and behavioral interventions should be implemented, with particular attention given to rural populations. -
Key words:
- Children /
- Oral health /
- Dental caries /
- Oral behavior /
- Ages 3-6 years
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表 1 城区和非城区儿童家长对口腔健康知识知晓率比较[例(%)]
Table 1. Comparison of the awareness rate of oral health knowledge among parents of urban and rural children[cases(%)]
项目 城区(n=3 667) 非城区(n=2 274) χ2值 P值 牙齿的好坏和自己保护关系大 3.425 0.064 正确 3 338(91.0) 2 037(89.6) 错误 329(9.0) 237(10.4) 乳牙迟早要换，坏了不用治 3.989 0.046 正确 3 315(90.4) 2 019(88.8) 错误 352(9.6) 255(11.2) 母亲牙齿不好会影响孩子的牙齿 6.475 0.011 正确 1 118(30.5) 623(27.4) 错误 2 549(69.5) 1 651(72.6) 刷牙时牙龈出血是正常的 24.961 < 0.001 正确 3 219(87.8) 1 891(83.2) 错误 448(12.2) 383(16.8) 刷牙对预防牙龈出血没有用 5.106 0.024 正确 2 670(72.8) 1 594(70.1) 错误 997(27.2) 680(29.9) 不刷牙容易患龋齿 1.431 0.232 正确 3 441(93.8) 2 116(93.1) 错误 226(6.2) 158(6.9) 经常吃甜食或零食易患龋齿 4.829 0.028 正确 3 552(96.9) 2 178(95.8) 错误 115(3.1) 96(4.2) 细菌可以引起龋齿、牙龈发炎等口腔疾病 7.253 0.007 正确 3 526(96.1) 2 153(94.7) 错误 141(3.9) 121(5.3) 氟化物对保护牙齿有用 0.219 0.640 正确 2 599(70.9) 1 628(71.6) 错误 1 068(29.1) 646(28.4) 窝沟封闭防龋 0.031 0.860 正确 1 876(51.1) 1 158(50.9) 错误 1 791(48.9) 1 116(49.1) 
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表 2 不同人口学及行为学的3~6岁在园儿童龋齿检出情况
Table 2. The detection of dental caries in kindergarten children aged 3-6 years based on different demographic and behavioral factors
项目 调查人数 患龋人数[例(%)] χ2值 P值 年龄 207.519 < 0.001 3~＜4岁 899 216(24.0) 4~＜5岁 1 953 628(32.2) 5~＜6岁 2 001 883(44.1) 6~＜7岁 1 088 551(50.6) 性别 2.837 0.092 男 3 058 1 141(37.3) 女 2 883 1 137(39.4) 地区 76.248 < 0.001 城区 3 667 1 247(34.0) 非城区 2 274 1 031(45.3) 主要照顾人 1.130 0.568 父母 4 521 1 746(38.6) 祖辈 1 368 515(37.6) 其他 52 17(32.7) 母乳喂养时间 44.668 < 0.001 6月龄内 1 425 455(31.9) 6~12月龄 2 638 1 009(38.2) ＞12月龄 1 878 814(43.3) 睡前吃甜食 121.374 < 0.001 经常 1 053 494(46.9) 偶尔 3 999 1 578(39.5) 从不 889 206(23.2) 日常进食甜食频率 56.303 < 0.001 ≤3次/月 4 301 1 525(35.5) 1次/周 868 387(44.6) 2~6次/周 591 280(47.4) ≥1次/d 181 86(47.5) 开始刷牙时间 83.153 < 0.001 ＜1岁 510 117(22.9) 1~＜2岁 1 334 477(35.8) 2~＜3岁 1 768 667(37.7) ≥3岁 2 329 1 017(43.7) 帮助刷牙 28.364 < 0.001 经常 3 863 1 426(36.9) 偶尔 1 717 703(40.9) 没有 361 149(41.3) 检查刷牙效果 32.444 < 0.001 经常 3 438 1 216(35.4) 偶尔 1 979 826(41.7) 没有 524 236(45.0) 涂氟防龋 55.158 < 0.001 自费接受 310 154(49.7) 免费接受 2 435 1 029(42.3) 没有 3 196 1 095(34.3)
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表 3 3~6岁在园儿童龋齿影响因素的logistic回归分析
Table 3. Logistic regression analysis of factors associated with dental caries in kindergarten children aged 3-6 years
变量 B SE Waldχ2 P值 OR(95% CI) 年龄 210.996 < 0.001 3~＜4岁 -1.297 0.105 153.228 < 0.001 0.273(0.223~0.336) 4~＜5岁 -0.850 0.082 107.382 < 0.001 0.427(0.364~0.502) 5~＜6岁 -0.304 0.078 14.970 < 0.001 0.738(0.633~0.861) 城区 -0.463 0.058 64.005 < 0.001 0.629(0.562~0.705) 开始刷牙时间 37.911 < 0.001 ＜1岁 -0.730 0.120 37.166 < 0.001 0.482(0.391~0.610) 1~＜2岁 -0.390 0.075 3.406 0.065 0.870(0.750~1.009) 2~＜3岁 -0.069 0.069 1.022 0.312 0.933(0.816~1.067) 母乳喂养时间 42.205 < 0.001 6月龄内 -0.499 0.077 41.911 < 0.001 0.607(0.522~0.706) 6~12月龄 -0.232 0.064 13.007 < 0.001 0.793(0.699~0.899) 睡前吃甜食 108.967 < 0.001 经常 1.129 0.108 108.419 < 0.001 3.093(2.501~3.826) 偶尔 0.734 0.090 66.079 < 0.001 2.084(1.746~2.487) 日常进食甜食频率 36.345 < 0.001 ≤1次/周 -0.420 0.074 32.424 < 0.001 0.657(0.568~0.759) 2~6次/周 -0.150 0.076 3.916 0.048 0.861(0.742~0.999) 注：年龄以6~＜7岁组为参照；开始刷牙时间以≥3岁组为参照；母乳喂养时间以＞12月龄为参照；睡前吃甜食以“从不”为参照；日常进食甜食频率以≥1次/d为参照。
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