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

对1.5岁儿童社区龋病预防系统进行了评估。在该项目中，所有受试者都可以免费接受为期两年的定期预防管理。目的：评价两年后的防龋效果和成本效益，分析影响患龋率的相关因素。方法：该系统的参与者是3,686名儿童中的2,379名，他们在1999年接受了1.5岁的健康检查。他们在牙科诊所接受了定期的预防性治疗。两年后，对1.5岁儿童进行患龋率评估，并对影响患龋率的因素进行问卷调查。结果：参与者组3.5岁时DMF发生率为25.5%，非参与者组为42.4%。预防性管理时间对DMF发生率有显著影响，<6个月组39.8%，6~12个月组30.0%，12~18个月组29.3%，18个月以上组20.3%。与3.5岁患龋率相关的有统计学意义的因素有“祖父母白天照看”、“夜间哺乳”、“夜间奶瓶喂养”、“软饮料”、“饭前2小时内吃零食”、“哥哥姐姐有龋齿”和“以前从未看过牙医”。社区龋齿预防系统的总费用约为36160000英镑。干预年与对照年比较，在长崎市3300名3.5岁的调查对象中，每增加1名无龋者成本为158,091人，减少1次征兵成本为19,947人。参与者组与非参与者组相比，人均成本为10,847，才能使DMF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.