Oral Health Among Children and Youth With Special Health Care Needs
Oral Health Among Children and Youth With Special Health Care Needs
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DOI：
10.1542/peds.2020-025700
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发表时间：
2021-08-01
期刊：
影响因子：
8
通讯作者：
Kinsman, Sara B.
中科院分区：
文献类型：
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作者：
Lebrun-Harris, Lydie A.;Canto, Maria Teresa;Kinsman, Sara B.
目的：我们试图估计有特殊卫生保健需求的儿童和青少年（CYSHCN）中口腔健康问题的患病率和预防性口腔健康（POH）服务的接受情况，并调查与儿童和家庭水平特征的关系。方法：我们使用2016-2018年全国儿童健康调查的汇总数据。分析样本仅限于1至17岁的儿童，包括23 099名CYSHCN和75 612名无特殊卫生保健需求的儿童（非CYSHCN）。父母和照顾者报告的口腔健康问题包括牙齿状况一般或较差、蛀牙和蛀牙、牙痛和牙龈出血。公共卫生服务包括预防性牙科检查、清洁、刷牙和口腔保健指导、氟化物和密封剂。进行了双变量和多变量logistic回归分析。结果在过去一年中，接受预防性牙科就诊的CYSHCN患者比例高于非CYSHCN患者（84% vs 78%, P < 0.0001）。所审查的具体预防服务也发现了类似的模式。然而，与非CYSHCN相比，CYSHCN的口腔健康问题发生率更高。例如，16%的CYSHCN和11%的非CYSHCN报告了蛀牙和蛀牙（P < 0.0001）。在调整分析中，有几个因素与CYSHCN中接受POH服务的患病率下降显著相关，包括年龄较小或较大、家庭教育程度较低、非英语、缺乏健康保险、缺乏医疗家庭和牙齿状况较差。结论：与非CYSHCN人群相比，CYSHCN人群使用POH服务的比例较高，但口腔健康状况较差。确保青少年卫生保健服务的适当使用对减少口腔健康问题至关重要。
OBJECTIVES We sought to estimate the prevalence of oral health problems and receipt of preventive oral health (POH) services among children and youth with special health care needs (CYSHCN) and investigate associations with child- and family-level characteristics. METHODS We used pooled data from the 2016-2018 National Survey of Children's Health. The analytic sample was limited to children 1 to 17 years old, including 23 099 CYSHCN and 75 612 children without special health care needs (non-CYSHCN). Parent- and caregiver-reported measures of oral health problems were fair or poor teeth condition, decayed teeth and cavities, toothaches, and bleeding gums. POH services were preventive dental visits, cleanings, tooth brushing and oral health care instructions, fluoride, and sealants. Bivariate and multivariable logistic regression analyses were conducted. RESULTS A higher proportion of CYSHCN than non-CYSHCN received a preventive dental visit in the past year (84% vs 78%, P < .0001). Similar patterns were found for the specific preventive services examined. However, CYSHCN had higher rates of oral health problems compared with non-CYSHCN. For example, decayed teeth and cavities were reported in 16% of CYSHCN versus 11% in non-CYSHCN (P < .0001). In adjusted analyses, several factors were significantly associated with decreased prevalence of receipt of POH services among CYSHCN, including younger or older age, lower household education, non-English language, lack of health insurance, lack of a medical home, and worse condition of teeth. CONCLUSIONS CYSHCN have higher rates of POH service use yet worse oral health status than non-CYSHCN. Ensuring appropriate use of POH services among CYSHCN is critical to the reduction of oral health problems.