南京市玄武区3～5岁儿童龋病的影响因素分析及对生长发育和营养素摄入的影响

摘要 目的：对南京市玄武区3～5岁儿童患龋病进行流行病学调查,并分析患龋病的影响因素,及其对生长发育和营养素摄入的影响。方法：2020年3月~2022年2月期间,采用多阶段分层等容量随机抽样方法,随机抽取南京市玄武区6所幼儿园,共抽取792名3～5岁儿童,实际完成调查788人,响应率99.49%。记录南京市玄武区3～5岁儿童龋病发生情况,根据有无龋病发生分为龋病组（n=361）和无龋病组（n=427）。应用单因素和多因素Logistic回归性分析南京市玄武区3～5岁儿童龋病发生的影响因素。并观察龋病发生对儿童生长发育和营养素摄入的影响。结果：788例3～5岁儿童中,检查出存在龋病361人,发病率为45.81%。单因素分析显示,南京市玄武区3～5岁儿童龋病发生与年龄、喂养方式、糖摄入频次、睡前食用甜点、刷牙次数、开始刷牙年龄、家长口腔健康知识水平有关（P<0.05）。多因素Logistic回归性分析结果显示：年龄为5岁、喂养方式为全母乳、糖摄入频次为≥2次/d、睡前食用甜点是南京市玄武区3～5岁儿童龋病发生的危险因素（P<0.05）,而家长口腔健康知识水平较高是南京市玄武区3～5岁儿童龋病发生的保护因素（P<0.05）。无龋病组的身高、体重、胸围、肺活量均大于龋病组（P<0.05）。龋病组的能量、蛋白质、脂肪、钙、铁、锌、维生素C、叶酸低于无龋病组（P<0.05）。结论：南京市玄武区3～5岁儿童龋病的发病率较高,龋病对生长发育和营养素摄入均有一定的影响,而年龄、喂养方式、糖摄入频次、睡前食用甜点、家长口腔健康知识水平均是龋病发生的影响因素。     

伊宁地区维吾尔族和汉族3～5岁儿童重度龋危险因素的横断面调查

目的调查伊宁地区3~5岁维吾尔族和汉族儿童重度龋的流行情况及危险因素,为当地儿童龋病的防治提供科学依据。方法根据《第三次全国口腔健康流行病学调查方案》,采用多阶段、分层、整群抽样的方法,随机抽取伊宁地区城乡16所幼儿园的3~5岁维、汉两族儿童808名,对其进行口腔检查,并向家长发放问卷,对儿童的喂养方式、饮食习惯等方面进行调查,数据采用Logistic回归分析方法分析。结果伊宁地区儿童龋病的患病率为81.93%,龋均为4.45,重度婴幼儿龋的患病率为38.86%。多因素Logistic回归分析结果显示:年龄更大[OR=2.235,P0.001]、刷牙后/睡前进食情况频率更高[OR=1.742,P=0.011]、吃饼干、蛋糕更频繁[OR=1.698,P0.001]、孩子看电视时间更长[OR=1.365,P=0.021]是重度婴幼儿龋的危险因素;刷牙次数更多[OR=0.590,P=0.001]、帮助孩子刷牙[OR=0.724,P=0.003]是重度婴幼儿龋的保护因素。结论伊宁地区3~5岁维、汉两族儿童重度龋的患病率较高,应引起父母、幼儿园幼师、医务工作者的关注,开展婴幼儿龋的早期防治工作,以期降低当地儿童龋病的患病率,提高口腔健康水平。     

喀什市3～5岁维吾尔族、汉族儿童患龋情况及风险性评估

目的调查喀什市维吾尔族、汉族3~5岁儿童患龋情况及患龋风险因素的相关资料,建立儿童个体龋风险评估(caries risk assessment,CRA)模型,为当地儿童龋病风险性评估和制定综合防控计划提供样本及参考数据。方法采用分层、整群抽样的方式随机抽取喀什市3所幼儿园397名3~5岁健康儿童作为研究对象,进行口腔检查和龋风险评估。分别应用卡方检验、方差分析及Logistic回归分析方法对龋风险评估相关因素进行统计分析。结果 (1)喀什市3~5岁汉族与维吾尔族儿童分布在CAR低度组、中度组和高度组三组比较差异均有统计学意义(χ~2=8.055,P=0.018)。(2)汉族与维吾尔族儿童的龋在不同CAR分度组的差异均具有统计学意义(F1=47.46,P=0.000;F2=74.5,P=0.000)。(3)汉族和维吾尔族在龋风险评估各组之间的患龋率差异有统计学意义(χ~2_1=98.21,P=0.000;χ~2_2=154.89,P=0.000)。(4)多因素Logistic回归分析风险评估相关因素结果显示:年龄更大[OR=1.769,P=0.001]、母亲患有龋齿[OR=2.274,P=0.004]、经常用奶瓶和牛奶或果汁[OR=0.705,P=0.000]、经常吃零食[OR=4.825,P=0.000]是婴幼儿龋的危险因素;刷牙[OR=0.319,P=0.019]、辅助儿童刷牙[OR=0.305,P=0.002]是婴幼儿龋的保护因素。结论喀什市3~5岁儿童患龋情况严重,龋风险评估高的儿童占大多数,应加强口腔健康教育,开展多种防龋措施。     

儿童口腔微生物与乳牙早期龋研究进展

乳牙早期龋（Eady Childhood Caries,Ecc）是指发生在6岁以下儿童口腔中的龋病,是WHO在全世界范围内开展有关龋病预防的首要工作。据统计我国Ecc患病率可高达60％～80％,并有随着年龄的增长而增加的趋势,严重危害着我国少年儿童的生长发育。此外Ecc可以作为恒牙龋危险的预测指标：相对乳牙无龋病的儿童,乳牙患龋病的儿童有更高的恒牙患龋病的危险。     

河池市学龄前儿童猛性龋危险因素的调查分析

目的 调查学龄前儿童猛性龋的危险因素,并对诸多因素进行分析,为预防和控制猛性龋的发展提供干预措施.方法 采用Logistic分析方法,对800例2～5岁学龄前儿童进行调查和统计学分析.结果 各年龄组患病率间存在显著性差异(P＜0.05),母乳喂养时间、每天喂养次数、甜食习惯、奶瓶中加甜食、每天吃零食次数、较晚建立刷牙习惯及母亲文化教育程度为学龄前儿童猛性龋患病率的危险因素.结论 学龄前儿童猛性龋的发生、发展与诸多因素有关,及早识别猛性龋的危险因素,对预防和控制学龄前儿童猛性龋的发展有重要的临床意义.     

广西顶蛳山遗址人骨的龋齿病理观察

顶蛳山遗址位于广西壮族自治区南宁市邕宁区,保存了丰富的新石器时代文化遗存以及大量的古人类骨骼遗存。本文主要从龋齿研究入手,对顶蛳山二、三期文化(8-7 ka BP)中大于15岁的169个体的2737枚恒齿进行了观察。分别统计了龋齿等级和个体和牙齿患龋率以评估人群患龋情况,进而分析顶蛳山遗址人群的口腔健康状况,并探讨了食物构成、饮食行为与社会经济等。统计结果表明,顶蛳山遗址人群的个体和牙齿患龋率都较高。患龋率在两性、葬式、年龄段间都存在差异,女性患龋程度要高于男性;不同葬式之间差异也显著,随着年龄的增长患龋的比例和程度也随之加深。通过与其他8组新石器时代国内遗址人群的个体和牙齿患龋率的对比,我们看到包含顶蛳山在内的三组华南渔猎采集遗址的个体和牙齿患龋率都要高于其他遗址,农业遗址的人群要低于华南遗址的患龋率,而混合经济遗址的患龋率最低。龋齿的出现与人类饮食中的碳水化合物关系密切。据此,我们推测顶蛳山及其他两组华南遗址的高患龋与碳水化合物的摄入关系密切,但这与一般所认为的农业的出现没有联系。三组遗址都是以渔猎采集主导的社会经济形态,并且这时期农业并未传播至华南地区。因此我们的分析表明高患龋率与农业并没有必然联系,而华南地区当时人群所食用的碳水化合物可能源于当地的块茎类和含蔗糖类植物。     

3—12岁儿童膳食补充剂摄入现状及影响因素分析

目的：通过横断面调查,描述中国3—12岁儿童膳食补充剂的摄入现状,并讨论其相关因素。方法：采用多阶段随机整群抽样抽取中国7城市2农村3—12岁儿童1 806名,通过问卷调查获得其一般情况,通过膳食补充剂频率调查获得其摄入情况。 结果：家庭人均月经济收入高（P=0.001）、喂养人认为孩子体重偏低（P=0.024）、认为孩子营养状况不好（P=0.023）、每周外出就餐多（P<0.001）、父亲文化程度高（P＜0.001）、母亲文化程度高（P＜0.001）的儿童更容易使用补充剂。 结论：补充剂使用与儿童年龄、父母文化程度、家庭经济状况,生活习惯和喂养人对儿童健康的认知有关。应加强健康教育,建立对儿童健康和对营养素补充剂的正确认识。     

不同去龋技术在乳牙龋病治疗中的应用疗效分析

目的:比较传统机械切割法、非创伤性充填法(atraumatic restorative treatment,ART)和Carisolv化学法在临床乳牙龋病治疗中的应用效果差异。方法:选取2011年1月-2012年6月来我科就诊的5-8岁儿牙患者96名,患牙180颗,随机分为3个不同的治疗组:传统机械去龋组、ART组和Carisolv化学去龋组进行相应牙体充填治疗,通过去龋效果、去龋时间、术中疼痛发生率和术后长期疗效等方面比较不同去龋技术之间的差异。结果:常规机械去龋组和Carisolv组的去龋效果明显优于ART组(P0.05),二者之间无明显差异(P0.05);3种去龋方法的去龋操作时间无明显差异(P0.05);Carisolv组和ART组去龋治疗中患儿术中疼痛发生例数明显低于常规机械去龋组(P0.05),二者之间无明显差异(P0.05);治疗1年后的复诊发现,常规机械去龋组和Carisolv组中患牙继发龋发生率明显低于ART组(P0.05),二者之间无明显差异(P0.05);三种方法治疗后患牙充填物折断/脱落发生率无明显差异(P0.05)。结论:Carisolv化学去龋法能有效减轻术中疼痛和术后复发率,值得在临床乳牙治疗中推广应用;ART的去龋效果和远期疗效可能限制其广泛应用。     

红肉摄入量对中老年人铁蛋白水平的影响分析

目的：探讨中老年人红肉的膳食摄入情况,分析红肉摄入量与血清铁蛋白水平的相关性,并研究红肉摄入与中老年人患铁过载的风险的关系。方法：以参加体检的年龄在40~85岁的515名中老年人为研究对象,以血清铁蛋白作为铁营养状况指标,采用半定量食物频率法进行膳食调查,将居民的红肉摄入量和铁蛋白含量作相关性分析,并对居民红肉的摄入频率与铁过载之间的风险进行多因素Logistic回归分析。结果：在研究的中老年人群中,红肉摄入量与血清铁蛋白呈正相关。按四分位红肉摄入量为≤20.0g/d、20.0~42.9g/d、42.9~85.7g/d、＞85.7g/d分组,各组中老年人血清铁蛋白中位数分别为60.9、67.1、80.4、100.4μg/L。调整性别、年龄、BMI、吸烟、饮酒等多种混杂因素后,红肉每周摄入≥7次的中老年人群发生铁过载的风险显著高于每周摄入红肉≤4次的人群,OR为3.36 （95% CI：1.18,9.55,P<0.05）。结论：在中老年人群中,过量摄入红肉可增加机体发生铁过载的风险,个体膳食模式可能是高铁储量的重要调节因素。     

牛河梁红山文化人群龋齿的统计与分析

本文通过对牛河梁遗址出土的31例红山文化时期人类牙齿龋病的统计与分析, 获知: 1)牛河梁遗址男女两性的患龋率、龋齿率没有明显的性别差异; 2)他们的患龋率和龋齿率有随年龄增长逐步增高的趋势; 3)上颌的龋齿罹患率高于下颌; 4)龋齿的发生主要集中在臼齿,且以咬合面部位为主; 5)他们的患龋率和龋齿率均较低。牛河梁红山文化人群相对偏低的龋齿率可能暗示出他们的经济生活方式还处在以采集狩猎为主体的模式中, 农耕经济可能处于较低层次的状态。     

Experimental Activities in Primary School to Learn about Microbes in an Oral Health Education Context

Experimental science activities in primary school enable important cross-curricular learning. In this study, experimental activities on microbiology were carried out by 16 pupils in a Portuguese grade-4 classroom (9–10?years old) and were focused on two problem-questions related to microbiology and health: (1) do your teeth carry microbes? (2) why should you brush your teeth after meals? To solve problem-question (1), children’s samples of dental plaque were prepared and observed under the microscope. For question (2), culture medium plates were inoculated with children’s dental plaque either before or after tooth brushing and the colonies were counted. Results showed that pupils easily recognised the presence of microorganisms in the mouth and verified the effectiveness of the process of teeth-brushing. Pupils understood that microorganisms were potentially responsible for the onset of dental caries. These practical activities on microbiology in primary school were very effective in ensuring young children easily understand the causes of dental caries and how they can be prevented. Pupils became aware that the act of brushing their teeth is not only a socially correct behaviour or a simple rule to meet, but also a matter of preventing illness and promoting health.     

The efficacy of three formulations of Lippia sidoides Cham. essential oil in the reduction of salivary Streptococcus mutans in children with caries: A randomized,double-blind,controlled study

Essential oils of many plants have been previously tested in the treatment of oral diseases and other infections. This study was a randomized, double-blind, in parallel with an active control study, which aimed to evaluate the efficacy of three formulations of the Lippia sidoides Cham. essential oil (LSO) in the reduction of salivary Streptococcus mutans in children with caries. 81 volunteers, aged 6–12 years, both genders, with caries, were recruited to participate in this study, and randomly assigned to either one of five different groups. Each group received topical treatment with either 1.4% LSO toothpaste, 1.4% LSO gel, 0.8% LSO mouthwash, 1% chlorhexidine gel, or 0.12% chlorhexidine mouthwash. A 5-ml volume of each gel was placed inside disposable trays, and applied for 1 min, every 24 h, for 5 consecutive days. The mouthwash groups used 5-ml volume of a mouthwash inside disposable syringes. In the toothpaste group, children brushed their teeth for 1 min, once a day for 5 days. Saliva was collected before and after treatment. MS colonies were counted, isolated and confirmed through biochemical tests. Differences in MS levels measured in different days within the same treatment group was only verified with LSO toothpaste, chlorhexidine gel and chlorhexidine mouthwash. Comparison between groups of LSO mouthwash, toothpaste and gel showed that the toothpaste group expressed significantly lower MS levels than the mouthwash and gel groups at day-30. Chlorhexidine significantly reduced MS levels after 5 days of treatment, but these levels returned to baseline in other periods of the study. LSO toothpaste reduced MS levels after 5 days of treatment, and MS levels remained low and did not return to baseline during subsequent analysis. Hence, LSO toothpaste demonstrated the most long-lasting MS reduction in saliva, whereas other LSO formulations did not effectively reduce MS levels in children with dental caries.     

Clinical and behavioural risk indicators for root caries in older people

Objective: To investigate the clinical and behavioural factors indicating root caries risk among older people. Desing: Cross sectional clinical and interview data from the National Diet and Nutrition Survey (aged 65 years and over) in Great Britain. Logistic regression models of the prevalence of root caries and linear regression models of the extent of root caries were constructed to quantify the role of a range of clinical and behavioural risk indicators, including sugars intake. Setting: A national sample of older British adults, free‐living and institutionalised. Participants: 462 dentate adults aged 65 years or over. Results: Nine or more intakes of sugars per day more than doubled the odds of root caries being present (OR 2.2–2.4). Other clinical and behavioural factors affecting root caries included wearing a partial denture in the presence of heavy plaque deposits (OR 2.1–2.6) and infrequent tooth brushing (OR 2.8 – 4.1). Linear regression models showed that, amongst those that had root caries, sucking sweets in the presence of a dry mouth, poor hygiene, partial dentures and living in an institution contributed to the extent of root caries, as measured by the RCI(d). Conclusions: Of the factors open to possible clinical or behavioural intervention, frequent sugars intake, poor hygiene and partial dentures were all associated with large increases in risk.     

Stomatological studies of the slavic cemetery at the Spandau Burgwall, Berlin.]

The dentition of a medieval population from the former Spandau Burgwall in Berlin was investigated with regard to caries and other abnormities of the teeth, the palate and the jaws. The caries frequency amounts to 7.9%, while 63.6% of the individuals had a caries dentition. The diminuation of the caries frequency from the juveniles to the 40--60 years old individuals depends on the high rate of loss of tooth during life. Probably, all teeth which have been lost during life can be evaluated as decayed teeth. X-ray pictures have shown that three sets of teeth have hypercementotic alterations at the roots, eight permanent dentitions have cysts and apical parodontitis. Supernumerary cuspids at the toothcrowns are to be seen as a tuberculum paramolare and a tuberculum intermedium. A second upper molar has a reduced crown with only two cuspids and shows the tendency of reduction to a bicuspid. Toothrotation and other deviations of teeth from their position in the row are frequent in this material. Four deciduous dentitions of children were investigated, too. Three carious teeth were found among 45 available teeth, two deciduous molars and one first upper molar show a Carabelli's tubercle, the other first molar has a fovea carabelli.     

Dismembering bodies for display: a bioarchaeological study of trophy heads from the Wari site of Conchopata, Peru

This study integrates isotopic, palaeopathological, and historical evidence to investigate infant and young child feeding practices in a Roman period (1st to 3rd centuries AD) skeletal sample from the Isola Sacra necropolis (Rome, Italy). Stable isotope analysis of bone collagen from 37 rib samples indicates that transitional feeding began by the end of the first year and weaning occurred by 2-2.5 years of age. Both delta(15)N and delta(13)C data clearly show the trophic level effect associated with breastfeeding. Childhood diet is investigated using dental pathology data in the deciduous dentitions of 78 individuals aged between 1 and 12 years. The presence of calculus, caries, and tooth wear in young children suggests that individuals were provided complementary foods and other items that impacted their dental health at an early age. The isotopic and dental data are generally consistent with the historical evidence from the Roman period with respect to the general timetable of weaning and the character of complementary foods. This is the first study to integrate isotopic and deciduous dental pathology data to explore infant and young child feeding practices in the Roman world.     

Salutogenic factors that may enhance lifelong oral health in an elderly Japanese population

Objectives: The objective of this study was to assess which factors affected the maintenance of more than 20 teeth in Japanese patients aged 80 years and older, using a life‐course perspective. Subjects and methods: The oral examination was carried out by dentists. The questionnaire asked about family background, background during various stages of growing up, tooth brushing, snacking, job history, health examination, war experience, number of children, oral health condition and dietary preferences. Some of the questions asked about conditions when they were a primary school student, 20 years old, 40 years old and 60 years old. Multivariable logistic‐regression analysis was used to adjust for sex at significant life stages. Results: The group with mothers who did not prefer sweet food had an approximately four times greater chance of having ≥20 teeth compared with the group with mothers who preferred sweet food. Those participants who did not prefer sweet food themselves were approximately three to five times more likely to be in the ≥20 tooth group compared with those who preferred sweet food at all stages of their life course. Non‐smokers and those who quit smoking were three times more likely to be in the ≥20 tooth group than those who smoked throughout the years from 20 to 60 years of age. Conclusions: Factors associated with the maintenance of a sufficient number of functioning teeth were: not having a mother with a preference for sweet food, not having a preference for sweet food themselves and not smoking over a long period.     

Formation of anterior maxillary teeth in 0-3-year-old children with cleft lip and palate and prenatal risk factors for delayed development

Formation of deciduous and permanent maxillary incisors and canines was studied in 361 children with cleft lip and palate. Altogether, 704 occlusal X rays of the children aged from 2 weeks to 41 months were assessed using a 13-stage scale. The early timing of tooth development was in both dentitions close to that reported for healthy children. However, developmental asymmetry was noted between contralateral teeth on the cleft and noncleft sides. In the unilateral cleft lip and palate group, every tenth cleft-side deciduous central incisor, deciduous canine, and permanent central incisor was delayed compared to the corresponding contralateral tooth. The formation timing was also compared within 11 prenatal and hereditary variables. Risk factors for delayed development were low placental weight, short gestation, mother's use of drugs during pregnancy, first in birth order, cleft with multiple additional malformations, and relatives having malformations other than oral clefts. However, the associations between a risk factor and tooth development were weak.     

Dental caries in disabled children

The aim of the study was to evaluate oral health conditions and dental caries status in disabled and healthy children. Two groups of randomly selected children 3-17 years old were examined. The first group comprised 80 children with disabilities (cerebral palsy, mental retardation, Down syndrome, autism and hearing-speaking disorders) and the second (control) group included 80 healthy children. Examined children were selected from several institutions which take care of disabled persons, kindergardens and four elementary schools. Clinical examination was performed by using a mirror and a probe and revealed the presence of dental caries, missing (extracted) and filled teeth. All clinically detected cavitations were registered as dental caries. The degree of oral hygiene was evaluated according to the OHI-S index values, which was determined by marking the plaque with 1% eozine solution. The values of OHI-S index ranged from 3.8-4.53 in disabled children and 2.73-2.84 in healthy children. In disabled children, the average dft values were 3.42 in deciduous teeth and 5.24 in mixed dentition. In healthy children, the average dft values were 1.43 in deciduous teeth and 5.1 in mixed dentition. The average DMFT index in disabled children was 1.41 for mixed and 6.39 for permanent dentitions. In healthy children, the average DMFT values were 1.23 in mixed and 4.76 in permanent dentitions. In general, the results revealed significantly poor level of oral hygiene and quite high level of caries prevalence in both disabled and healthy children, accentuating the need to reorganize preventive care measurements and improve dental care, particularly in disabled children in Croatia.     

Number of teeth in relation to oral health behaviour in dentate elderly patients in Lithuania

Aim: To describe oral self‐care practices and the use of dental services among dentate elderly patients attending public dental service in Kédainiai, Lithuania, and relate these parameters to the number of remaining teeth. Design: Cross‐sectional questionnaire study. Setting: Two public dental offices in Kédainiai, Lithuania. Participants: Dentate patients aged 60+. Methods: A self‐administered questionnaire covering oral hygiene practices, use of sugar, utilisation of dental services, and number of teeth. Age, gender, and education served as background factors. Results: In all, 174 dentate elderly people responded, their mean age being 69.2 years (CI 95% 68.2–70.2) and mean number of teeth reported 16.2 (CI 95% 15.4–17.1). Of these respondents, 30% reported that they brushed their teeth twice daily and 57% that they always used fluoridated tooth paste. Having 21+ teeth was strongly associated (p < 0.001) with these habits, with brushing in the evening, and with enrolment in higher education, but not with gender. After controlling for various self‐care and background factors, frequent tooth brushing remained as the only significant factor in the logistic regression model (OR 2.0, CI 95% 1.2–3.3, p = 0.01) to explain subjects’ retention of 21+ teeth. Conclusions: Elderly Lithuanians’ oral self‐care is far from meeting recommendations. To preserve their natural teeth, dentate elderly people should improve their oral self‐care practices, in particular as regards tooth brushing. To reach that goal, all efforts by the community and dental profession are welcomed.     

Amounts of Sr and Ca Eluted from Deciduous Enamel to Artificial Saliva Related to Dental Caries

This study was performed to elucidate the relationship between dental caries and the levels of Sr and Ca eluted from enamel, and to examine whether these elements are useful as factors to assess caries risk. The available 103 (Sr) and 108 (Ca) samples were obtained among 111 collected deciduous teeth. The healthy regions of enamel were decalcified in artificial saliva at pH 6.2 and 5.5. The eluted levels of these elements from enamel were determined using atomic absorption spectrophotometry. Sr and Ca levels were not affected by the sex nor tooth type. Sr levels of the caries-experienced tooth (CE) group were 2.6-fold (pH 6.2) and 2.2-fold (pH 5.5) higher than those of the sound tooth (ST) group, respectively. Furthermore, the Sr levels were significantly higher in the teeth with treated than in those with untreated caries. Only at pH 6.2 was a significant difference found in Ca levels between the ST and CE groups. In the ST group, at pH 5.5, both the Sr and Ca levels significantly increased when the children had six or more carious teeth. The Sr and Ca elution levels were significantly inhibited in the teeth receiving fluoride application every 3 or 4 months compared to those that were not. These findings indicate that Sr can be an indicator of the acid resistance of teeth, and a useful factor to assess future caries risk.