Effects of Community Caries Preventive System for 1.5-year-old Children

对社区1.5岁儿童龋齿预防系统进行评价。在本项目中，所有受试者均可免费接受为期两年的定期预防性管理。目的：评价两年后的龋防治效果及成本效益，分析影响龋发病率的相关因素。方法：该系统的参与者是1999年接受1.5岁健康检查的3686名儿童中的2379名。他们在牙科诊所定期接受预防性治疗。两年后，我们在儿童1.5岁时使用问卷调查的13个项目评估龋齿患病率并分析龋齿患病率相关因素。结果：3.5岁时，参与者组dmf率为25.5%，非参与者组dmf率为42.4%。预防性管理的持续时间显著影响dmf率；6个月以下组为39.8%，6-12个月组为30.0%，12-18个月组为29.3%，18个月及以上组为20.3%。与3.5岁儿童龋齿患病率相关的统计显著因素为“白天由祖父母照顾”、“夜间母乳喂养”、“夜间奶瓶喂养”、“软饮料”、“晚餐前2小时内吃零食”、“哥哥/姐姐有蛀牙”和“以前从未看过牙医”。社区预防龋齿系统的总费用约为36,16万美元。干预年与对照年比较，长崎市3300名3.5岁受试者中，每增加1名无携带者的成本为158091美元，每减少1名草稿的成本为19947美元。与未参加组相比，参加组人均花费为10847美元，dmft率下降16.9%，dmft指数下降0.88。

A community caries preventive system for 1.5-year-old children was evaluated. In this project, all the subjects could receive periodic preventive managements for two years free of charge. Objectives : The aim of study was to evaluate the caries preventive effects and its cost-benefit after two years, and to analyze the factors related to caries prevalence. Methods : The participants to this, system were 2,379 of 3,686 children who received a 1.5-year-old health checkup in 1999. They received periodic preventive managements at the dental offices. Two years later we evaluated caries prevalence and analyzed the factors related to caries prevalence using 13 items of the questionnaire at the age of 1.5 years. Results : dmf-rate at the age of 3.5 years was 25.5% for participant group, 42.4% for non-participant group, respectively. The duration of preventive managements influenced dmf-rate significantly ; 39.8% for the less than 6 months group, 30.0% for the 6-12 months group, 29.3% for the 12-18 months group and 20.3% for 18 months and more group. Statistically significant factors related to caries prevalence at the age of 3.5 years were "grandparents as a daytime caregiver", "breast feeding during the night", "bottle feeding during the night", soft drink", "snacks within 2 hours before dinner", "older brother/sister has cavities" and "never visited dentist for oral health checkup before". The total cost of the community caries preventive system was approximately \36,160,000. Compared the intervention year with the control year, it costs \158,091 in order to increase one subject who is caries free among 3,300 subjects aged 3.5 years in Nagasaki city, and it costs \19,947 in order to decrease 1 draft. Compared the participant group with the non-participant group, it costs \10,847 per person in order to get the decrease of 16.9% in dmf-rate and of 0.88 in dmft-index.