An investigation of risk factors in deciduous teeth caries and planning for dental health strategy

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This study was conducted to compare regional characteristic and identify the factors of deciduous caries and to make a regional diagnosis of deciduous teeth caries using PRECEDE model as a framework of deciduous teeth caries. Then, based on those researches, planning for health strategy was performed. As a result, although caries prevalence (dmft) was 1.33 in urban areas, those were 2.27 and 2.59 respectively in the tow local areas despite the difference were decreasing. It still showed almost twice dmft. However, analyzing the ratio of accumulated dmft, in all three areas only 10% of all children had 50% or more of the whole dmft, and an inequality of dmft among children is an important future problem. Each factor in PRECEDE model differ from dental health service and health education offered in each area While "period of feeding", "use of feeding bottle" and "tooth brushing habit", which have been indicated that they had a strong influence on deciduous teeth caries incidence so far, appropriate behavior to those factors was shown in all the areas. As a result of analysis using logistic regression analysis in which dependent variable was dmft and explanatory variable was health behavior factor in PRECEDE model, "frequency of ingestion of isotonic drink" was a strong risk factor being the odds ratio 2.406. Although "between-meal snack" and "isotonic drink" were caries incidence factors in the area in Kanagawa, in two areas with higher dmft, "the finish polish" in Hiraizumi and "rugular checkups" in Oshamanbe was a significant risk factor respectively. Understanding to fluoride application as one of "Predisposing factors" was not sufficient in this survey as well. Therefore, fluoride application in public health is suggested as population strategy considering that the difference of dmft is increasing among children. Moreover, the structure of caries factors by areas differ and it was shown by this study that PRECEDE model is also useful as a tool of local diagnosis.