国际口腔医学杂志 ›› 2020, Vol. 47 ›› Issue (4): 383-390.doi: 10.7518/gjkq.2020075

• 论著 • 上一篇    下一篇

西藏自治区城区和牧区儿童患龋情况与相关因素分析

邓晓宇1,仁青色格2,霍媛媛1,崔晨1,亓文婷1,韩轩1,黄睿洁1,周媛1,朱林2,邹静1,旦增念扎2()   

  1. 1.口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心四川大学华西口腔医院儿童口腔科 成都 610041
    2.西藏自治区人民医院口腔科 拉萨 850000
  • 收稿日期:2019-12-16 修回日期:2020-03-28 出版日期:2020-07-01 发布日期:2020-07-10
  • 通讯作者: 旦增念扎 E-mail:317586891@qq.com
  • 作者简介:邓晓宇,学士,Email:124281459@qq.com
  • 基金资助:
    西藏自治区科技计划项目(2016XZ01G38)

Caries status and relevant factor analysis among children in urban and pasture areas of Tibet Autonomous Region

Xiaoyu Deng1,Sege Renqing2,Yuanyuan Huo1,Chen Cui1,Wenting Qi1,Xuan Han1,Ruijie Huang1,Yuan Zhou1,Lin Zhu2,Jing Zou1,Nianzha Danzeng2()   

  1. 1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2. Dept. of Stomatology, Tibet Autonomous Regional People’s Hospital, Lhasa 850000, China
  • Received:2019-12-16 Revised:2020-03-28 Online:2020-07-01 Published:2020-07-10
  • Contact: Nianzha Danzeng E-mail:317586891@qq.com
  • Supported by:
    This study was supported by Scientific and Technological Projects of Tibet Autonomous Region(2016XZ01G38)

摘要:

目的 了解西藏自治区城区和牧区儿童患龋情况以及与相关生活、健康习惯的关系,为西藏自治区儿童龋病防治工作提供参考。方法 采用分层整群随机抽样的方法,抽取西藏自治区拉萨市(城区)280名儿童、那曲地区(牧区)376名儿童作为调查对象,检查并记录所有研究对象的口腔患龋情况;针对饮食、口腔卫生、健康习惯进行问卷调查,采用SPSS 21.0软件进行统计学分析。结果 拉萨市280名儿童中,乳牙列期124名(男性59名,女性65名),混合牙列期156名(男性81名,女性75名);那曲地区376名儿童中,乳牙列期190名(男性109名,女性81名),混合牙列期186名(男性97名,女性89名)。拉萨市儿童总体龋均为4.54;乳牙列期龋均4.59,其中男性龋均4.41,女性龋均4.86;混合牙列期龋均4.51,其中男性龋均4.16,女性龋均4.88。那曲地区儿童总体龋均为3.55;乳牙列期龋均3.31,其中男性龋均3.83,女性龋均2.61;混合牙列期龋均3.79,其中男性龋均3.68,女性龋均3.91。拉萨市儿童总体龋均及乳牙列期龋均高于那曲地区(P<0.05)。两地乳牙列期及混合牙列期最易发生龋坏的均为乳磨牙,乳牙列期最不易发生龋坏的是乳下切牙,混合牙列期最不易发生龋坏的是乳下切牙、恒上中切牙及恒下中切牙。不同性别儿童龋均的差异无统计学意义(P>0.05)。拉萨和那曲地区因非口腔疾病就诊频率高的儿童龋风险均明显升高(P<0.01)。拉萨地区81.4%受检儿童每天至少刷1次牙,但仅8.9%受检儿童使用含氟牙膏,56.1%受检儿童和36.4%受检儿童的家庭成员从未看过牙医。那曲地区59.6%受检儿童每天至少刷1次牙,仅18.6%受检儿童使用含氟牙膏,73.4%受检儿童以及51.3%受检儿童的家庭成员从未看过牙医。结论 西藏自治区城区和牧区群体对口腔保健的认识均不足,儿童患龋形势严峻,应针对儿童及其家长加大口腔保健宣传力度,加强开展龋病防治工作。

关键词: 儿童龋, 城区, 牧区, 少数民族

Abstract:

Objective This study aimed to investigate the caries status and the association between the caries status and the living habit and healthcare of children living in urban and pasture areas of Tibet. Methods A total of 280 and 376 children were recruited from Lhasa (urban area) and Nagqu (pasture area), respectively, through stratified cluster random sampling. The children’s caries status and their living habits and healthcare behavior were collected using questionnaires. Data were analyzed by SPSS 21.0 software. Results In Lhasa, 124 children (59 males and 65 females) of primary dentition and 156 children (81 males and 75 females) of mixed dentition were recorded. The overall mean decay-missedfilled-teeth (dmft) was 4.54. The mean dmft of children of primary dentition was 4.59, and the dmft values of males and females were 4.41 and 4.86, respectively. The overall mean dmft was 3.55. The mean dmft of children of mixed dentition was 4.51, and the dmft values of males and females were 4.16 and 4.88, respectively. In Nagqu, 190 children (109 males and 81 females) of primary dentition and 186 children (97 males and 89 females) of mixed dentition were recorded. The overall mean dmft was 3.55. The mean dmft of children of primary dentition was 3.31, and the dmft values of males and females were 3.83 and 2.61, respectively. The mean dmft of children of mixed dentition was 3.79, and the dmft values of males and females were 3.68 and 3.91, respectively. The overall dmft and primary dentition dmft of children in Lhasa were higher than those of children in Nagqu (P<0.05). Primary molars were the teeth with the highest caries rate, whereas mandibular incisors were the teeth with the lowest caries rate in both sampling areas. Gender had no significant contribution to the caries rate. Children who frequently visited doctors for non oral diseases had higher rates of caries in Lhasa and Nagqu, respectively (P<0.01). About 81.4% of children from Lhasa brushed their teeth at least once a day, but only 8.9% of the children used fluoride toothpaste. In addition, 56.1% and 36.4% of the children’s families had never consulted with a dentist. In Nagqu, the results were 59.6%, 18.6%, 73.4%, and 51.3%, respectively. Conclusion The children’s caries status in Tibet is still severe. Further studies should be conducted to strengthen oral healthcare education to control caries among children in Tibet.

Key words: childhood caries, urban area, pasturing area, minority

中图分类号: 

  • R788

表1

656名藏族儿童的性别、年龄和患龋情况"

项目 拉萨市 那曲地区
乳牙列 混合牙列 乳牙列 混合牙列
合计 合计 合计 合计
例数 59 65 124 81 75 156 109 81 190 97 89 186
年龄/月 58.81±1.58 55.17±0.33 56.92±11.34 103.19±14.35 102.41±12.40 102.81±13.41 55.52±5.07 55.70±5.49 55.60±5.24 102.98±6.29 100.39±6.52 101.75±6.51
患龋率/% 50.85 60.00 55.65 48.15 61.33 54.49 57.80 45.68 52.63 54.08 52.81 53.76
龋均 4.41±5.34 4.86±4.95 4.59±5.09 4.16±4.98 4.88±4.72 4.51±4.85 3.83±4.06 2.61±3.35 3.31±3.81 3.68±4.09 3.91±4.05 3.79±4.06
充填率/% 0 0 0 3.26 3.00 3.13 0 0 0 0 0 0

图 1

拉萨市受检儿童的牙面患龋情况 左:乳牙列;中:混合牙列中的乳牙;右:混合牙列中的恒牙。"

图 2

那曲地区受检儿童的牙面患龋情况 左:乳牙列;中:混合牙列中的乳牙;右:混合牙列中的恒牙。"

表 2

受检儿童口腔卫生习惯与患龋情况"

调查项目 拉萨市(n=280) 那曲地区(n=376)
无龋 患龋 合计 无龋 患龋 合计
刷牙频率 从不 2/0.7 9/3.2 11/3.9a 22/5.9 32/8.5 54/14.4
偶尔 25/8.9 16/5.7 41/14.6b 49/13.0 49/13.0 98/26.1
每天不少于1次 127/45.4 101/36.1 228/81.4c 105/27.9 119/31.6 224/59.6
牙膏 含氟 23/8.2 2/0.7 25/8.9 45/12.0 25/6.6 70/18.6a
不含氟 10/3.6 25/8.9 35/12.5 20/5.3 25/6.6 45/12.0b
不清楚 93/33.2 127/45.4 220/78.6 111/29.5 150/39.9 261/69.4c

表 3

受检儿童含糖食物摄入习惯和频率与患龋情况"

调查项目 拉萨市(n=280) 那曲地区(n=376)
无龋 患龋 合计 无龋 患龋 合计
含糖食物 从不 37/13.2 25/8.9 62/22.1a 29/7.7 29/7.7 58/15.4
三餐吃 30/10.7 30/10.7 60/21.4b 33/8.8 34/9.0 67/17.8
三餐之间偶尔吃 41/14.6 55/19.6 96/34.3c 75/19.9 71/18.9 146/38.8
经常 18/6.4 44/15.7 62/22.1d 39/10.4 66/17.6 105/27.9
睡前零食 36/12.9 49/17.5 85/30.4 47/12.5 94/25.0 141/37.5
90/32.1 105/37.5 195/69.6 129/34.3 106/28.2 235/62.5

表 4

家庭小孩数目与患龋情况"

家庭小孩数目/个 拉萨市(n=280) 那曲地区(n=376)
无龋 患龋 合计 无龋 患龋 合计
1 50/17.9 60/21.4 110/39.3 38/10.1 29/7.7 67/17.8
2 57/20.4 68/24.3 125/44.6 95/25.3 110/29.3 205/54.5
3~4 14/5.0 13/4.6 27/9.6 23/6.1 24/6.4 47/12.5
>4 5/1.8 13/4.6 18/6.4 37/9.8 20/5.3 57/15.2

表 5

受检儿童就医情况与患龋情况"

调查项目 拉萨市(n=280) 那曲地区(n=376)
无龋 患龋 合计 无龋 患龋 合计
就医情况(牙医) 从未 72/25.7 85/30.4 157/56.1 138/36.7 138/36.7 276/73.4
过去2年看过 18/6.4 33/11.8 51/18.2 5/1.3 12/3.2 17/4.5
过去1年看过 25/8.9 26/9.3 51/18.2 27/7.2 34/9.0 61/16.2
过去6个月看过 11/3.9 10/3.6 21/7.5 6/1.6 16/4.3 22/5.9
就医情况(除牙医外) 从未a 47/16.8 36/12.9 83/29.6 81/21.5 106/28.2 187/49.7
过去2年看过b 31/11.1 50/17.9 81/28.9 42/11.2 16/4.3 58/15.4
过去1年看过c 28/10.0 22/7.9 50/17.9 36/9.6 55/14.6 91/24.2
过去6个月看过d 20/7.1 46/16.4 66/23.6 17/4.5 23/6.1 40/10.6

表 6

受检儿童家人吸烟、就医情况与患龋情况"

调查项目 拉萨市(n=280) 那曲地区(n=376)
无龋 患龋 合计 无龋 患龋 合计
家人吸烟/(支·d-1 0(从不) 60/21.4 74/26.4 134/47.9 98/26.1 119/31.6 217/57.7
<5 28/10.0 33/11.8 61/21.8 30/8.0 33/8.8 63/16.8
5~10(含5) 18/6.4 18/6.4 36/12.9 34/9.0 39/10.4 73/19.4
10~20(含10) 8/2.9 17/6.1 25/8.9 8/2.1 9/2.4 17/4.5
≥20 12/4.3 12/4.3 24/8.6 6/1.6 0/0 6/1.6
家人就医情况(牙医) 从未 54/19.3 48/17.1 102/36.4 91/24.2 102/27.1 193/51.3
最近2年看过 30/10.7 50/17.9 80/28.6 42/11.2 42/11.2 84/22.3
最近1年看过 28/10.0 39/13.9 67/23.9 24/6.4 37/9.8 61/16.2
最近6个月看过 14/5.0 17/6.1 31/11.1 19/5.1 19/5.1 38/10.1
家人就医情况(除牙医外) 从未 26/9.3 32/11.4 58/20.7 74/19.7 101/26.9 175/46.5
最近2年看过 28/10.0 48/17.1 76/27.1 35/9.3 40/10.6 75/19.9
最近1年看过 35/12.5 33/11.8 68/24.3 31/8.2 38/10.1 69/18.4
最近6个月看过 37/13.2 41/14.6 78/27.9 36/9.6 21/5.6 57/15.2
家人就医原因 定期检查 21/7.5 7/2.5a 28/10.0 13/3.5 13/3.5 26/6.9
有点不舒服 65/23.2 95/3.9b 160/57.1 117/31.1 120/31.9 237/63.0
很不舒服 32/11.4 38/13.6c 70/25.0 29/7.7 38/10.1 67/17.8
重病 8/2.9 14/5.0d 22/7.9 17/4.5 29/7.7 46/12.2
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