龋病风险评估与管理在小学口腔公共卫生项目中的应用研究

发布时间：2018-03-10 18:01

本文选题：龋风险评估　切入点：龋病管理　出处：《遵义医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:为使有限的口腔卫生资源得到优化利用,本课题将探索龋病风险评估与管理在小学口腔公共卫生项目中的应用,为今后口腔公共卫生服务提供参考。方法:通过检索文献、咨询专家和结合我市儿童龋病流行特点,确定小学口腔公共卫生中应用的龋病风险评估与管理标准。在遵义市汇川区通过分层整群抽样法抽取遵义市汇川区7所小学一至五年级学生,共3591人。按照本研究中的龋病风险评估内容,对儿童进行口腔检查和龋危险因素调查,评估儿童龋病风险性:低风险、中风险或高风险。按风险评估等级对儿童进行管理:高风险儿童给予口腔健康教育、局部涂氟、窝沟封闭(pit and fissure sealant,PFS)和非创伤性修复治疗(atraumatic restorative treatment,ART)干预;中风险儿童给予口腔健康教育、局部涂氟和ART干预;低风险儿童随机分为A组和B组,A组给予口腔健康教育;B组给予口腔健康教育、局部涂氟和PFS。通过对所有研究儿童在口腔健康教育前后的口腔健康知识掌握情况、一年后龋病发病率情况和各项口腔预防干预措施所花费的成本进行分析,评价龋病风险评估与管理在小学口腔公共卫生项目中应用的效果。结果:1、本次研究的遵义市汇川区7所小学一至五年级学生共3591名,男1886人,女1705人,患龋儿童有2343人,患龋率达65.25%,龋均为2.79,龋齿充填构成比为4.07%。2、3591名研究对象低风险人数为906人,中风险人数为1281人,高风险人数为1404人。在不同患龋风险等级中,低、中、高风险的龋失补牙数分别为0、1876和8150,龋均分别为0、1.46和5.80。经统计分析,龋风险分布不存在性别差异(P0.05);不同年级和是否为农民工子女在各龋风险分组中的分布均有差异(P0.05),一至三年级和农民工子女儿童龋高风险人数所占比例较高。3、一年后复查低风险A组、低风险B组、中风险组和高风险组儿童的龋病发病率分别为5.99%、5.57%、6.59%和8.03%,其差异无统计学意义(P0.05);新发龋均分别为0.08、0.08、0.09和0.12,无统计学意义(P0.05)。4、口腔健康教育前患龋低风险A组、B组、中风险组和高风险组儿童的口腔健康知识掌握率分别为72.22%、72.08%、56.62%和47.44%,各组间存在差异(P0.05);正确刷牙率分别为75.35%、75.13%、47.96%和36.13%,各组间存在差异(P0.05)。口腔健康教育后低风险A组、低风险B组、中风险组和高风险组儿童的口腔健康知识掌握率分别为88.40%、89.20%、87.66%和87.78%,差异无统计学意义(P0.05);正确刷牙率分别为81.67%、82.41%、81.74%和83.02%,差异无统计学意义(P0.05)。5、对本研究进行成本分析得出口腔检查及风险评估、口腔健康教育、局部涂氟、窝沟封闭和ART的平均每人成本分别为5.26元、1.44元、32.71元、35.63元和46.40元。低风险A组、低风险B组、中风险组和高风险组儿童平均成本分别为6.70元/人、76.18元/人、57.30元/人、115.40元/人。结论:1、龋病风险评估中,龋高风险主要集中在一至三年级和农民工子女儿童,提示对这部分儿童应进行重点防治。2、龋病风险评估与管理在小学口腔公共卫生项目中的应用,对口腔医疗资源有一个合理的分配作用,使龋高风险儿童得到重点防治,从而控制儿童龋病的发生与发展,值得在口腔公共卫生项目中推广。
[Abstract]:Objective: to make the oral hygiene of limited resources to optimize use, this paper will explore the application of caries risk assessment and management in primary school dental public health project, for the future of dental public health service to provide the reference. Methods: through literature retrieval, expert consultation and combined with the epidemic characteristics of dental caries of children in our city, to determine the application of primary school dental public health the caries risk assessment and management standard. In Zunyi City, Huichuan District 7 primary school by stratified cluster sampling method in Zunyi city of Huichuan District to the fifth grade students, a total of 3591 people. According to the study of caries risk assessment, oral examination and caries risk factors of children were investigated: low risk assessment of dental caries in children risk, risk or high risk. According to the level of risk assessment for the management of children: children at high risk for oral health education, topical fluoride, sealant (pit and fissure s Ealant, PFS) and atraumatic restorative treatment (atraumatic restorative treatment, ART) intervention; risk in children given oral health education, topical fluoride and ART intervention; low risk children were randomly divided into A group and B group, A group received oral health education; B group received oral health education, and topical fluoride PFS. of all study children to grasp the situation in oral health knowledge and oral health education, analysis of the cost for a year after the incidence of dental caries and the oral preventive interventions cost, application evaluation and management of caries risk assessment in primary school oral in public health project. Results: 1, one to the fifth grade students the study of the 7 primary school in Zunyi city of Huichuan District a total of 3591 patients, male 1886, female 1705, Cary children have 2343 people, the caries rate was 65.25%, DMFT was 2.79, the filling ratio of 4.07 subjects with low%.23591 The risk for the number 906, the risk for the number 1281, the high risk population of 1404 people. The risk level of different caries, low risk, high DMFT score were 01876 and 8150, DMFT were 0,1.46 and 5.80. by statistical analysis, the distribution of caries risk there is no gender difference (P0.05) in different grades; and whether the children of migrant workers are the distribution of differences in the caries risk in a group (P0.05), one to the third grade and the children of migrant workers children caries in high risk population accounted for a higher proportion of.3, a year after the review of low risk and low risk group A, B group, middle risk group and high risk children the incidence of caries was 5.99%, 5.57%, 6.59% and 8.03%, the difference was not statistically significant (P0.05); new caries were 0.08,0.08,0.09 and 0.12 respectively, without statistical significance (P0.05).4, oral health education before the low caries risk in A group, B group, middle risk group and high risk group of children oral health Health knowledge rate were 72.22%, 72.08%, 56.62% and 47.44%, there are differences between the groups (P0.05); the correct brushing rate were 75.35%, 75.13%, 47.96% and 36.13%, there are differences between the groups (P0.05). The low risk group A oral health education, low risk group B, oral health knowledge in risk groups of children and the high risk group mastery rates were 88.40%, 89.20%, 87.66% and 87.78%, the difference was not statistically significant (P0.05); the correct brushing rate were 81.67%, 82.41%, 81.74% and 83.02%, the difference was not statistically significant (P0.05.5), this paper analyzed the cost and risk assessment of oral examination, oral health education. Topical fluoride, the average cost of the fissure and ART were 5.26 yuan, 1.44 yuan, 32.71 yuan, 35.63 yuan and 46.40 yuan. Low risk and low risk group A, B group, middle risk group and high risk group of children the average cost was 6.70 yuan / person, 76.18 yuan / person, 57.30 yuan / person, 115.40 yuan / person. Conclusion: 1. The caries risk assessment in high caries risk is mainly concentrated on the children to the third grade and that of children of migrant workers, these children should be the focus of prevention and treatment of.2, the application of dental caries risk assessment and management in primary school dental public health project, a reasonable allocation of oral cavity medical resources, the high risk of caries children focus on prevention, so as to control the occurrence and development of dental caries in children, worthy of promotion in dental public health projects.

【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R788.1

【相似文献】