低出生体重早产儿乳牙患龋现状调查及影响因素分析

Investigation of the prevalence and risk factors of dental caries in deciduous teeth among preterm infants with low birth weight

摘要

目的 调查低出生体重早产儿乳牙患龋现状并分析乳牙患龋的影响因素.方法 选取成都市双流区妇幼保健院2018年3月至2021年3月收治的426例低出生体重早产儿为研究对象.所有受试者均随访3年,记录随访期间患儿乳牙患龋现状.依据患儿乳牙患龋情况将其分为患龋组和未患龋组,比较两组患儿临床资料;采用多因素Logistic回归分析低出生体重早产儿乳牙患龋的影响因素.结果 随访3年期间,共脱落19例,余407例低出生体重早产儿乳牙患龋的发生率为31.20%(127/407),其中龋齿共431颗,龋均(2.09±0.62)颗,充填率为8.82%(38/431),乳牙患龋以上颌乳中切牙为好发部位.患龋组缺铁性贫血史、家庭月收入＜5000元、照顾者不了解口腔健康知识、开始刷牙年龄＞2岁、每天刷牙频次＜2次、经常摄入甜食/甜饮、经常含奶瓶睡觉、未定期牙齿检查占比高于未患龋组(χ²介于6.214~16.308之间,P＜0.05);多因素Logistic回归分析结果显示,缺铁性贫血史(OR＝1.939,95％CI:1.206~3.115)、照顾者不了解口腔健康知识(OR＝1.763,95％CI:1.130~2.751)、开始刷牙年龄＞2岁(OR＝2.680,95％CI:1.515~4.742)、每天刷牙频次＜2次(OR＝2.472,95％CI:1.414~4.321)、经常摄入甜食/甜饮(OR＝2.184,95％CI:1.309~3.642)、经常含奶瓶睡觉(OR＝2.264,95％CI:1.352~3.790)均为低出生体重早产儿乳牙患龋的危险因素(P＜0.05),定期牙齿检查(OR＝0.723,95％CI:0.556~0.940)为其保护因素(P＜0.05).结论 低出生体重早产儿乳牙患龋率较高,缺铁性贫血史、照顾者口腔健康知识、开始刷牙年龄、每天刷牙频次、摄入甜食/甜饮、含奶瓶睡觉、定期牙齿检查均为低出生体重早产儿乳牙患龋的影响因素.

Abstract

Objective To investigate the prevalence of dental caries in deciduous teeth among preterm infants with low birth weight (LBW) and to identify associated risk factors. Methods A total of 426 preterm LBW infants admitted to Shuangliu District Maternal and Child Health Hospital in Chengdu from March 2018 to March 2021 were enrolled. All participants were followed up for 3 years to record the status of dental caries in deciduous teeth. Based on the presence or absence of caries, infants were divided into a caries group and a non-caries group. Clinical data were compared between the two groups, and multivariate logistic regression was used to identify risk factors associated with dental caries in this population. Results During the 3-year follow-up, 19 participants were lost, leaving 407 infants for analysis. The prevalence of dental caries in deciduous teeth was 31.20% (127/407), with a total of 431 decayed teeth, an average of 2.09±0.62 decayed teeth per affected child, and a filling rate of 8.82% (38/431). The maxillary primary central incisors were the most commonly affected teeth. The caries group had significantly higher proportions of children with a history of iron-deficiency anemia, monthly family income ＜￥5000, caregivers lacking oral health knowledge, initiation of tooth brushing after 2 years of age, brushing less than twice daily, frequent consumption of sweets/sweetened beverages, frequent bottle feeding during sleep, and no regular dental check-ups (χ ²＝6.214-16.308, all P＜0.05). Multivariate logistic regression analysis showed that a history of iron-deficiency anemia (OR＝1.939, 95%CI: 1.206-3.115), caregiver's lack of oral health knowledge (OR＝1.763, 95%CI: 1.130-2.751), tooth brushing initiated after 2 years of age (OR＝2.680, 95%CI: 1.515-4.742), brushing less than twice daily (OR＝2.472, 95%CI: 1.414-4.321), frequent intake of sweets/sweetened beverages (OR＝2.184, 95%CI: 1.309-3.642), and frequent bottle feeding during sleep (OR＝2.264, 95%CI: 1.352-3.790) were independent risk factors for dental caries in deciduous teeth among preterm LBW infants (P＜0.05). Regular dental check-ups were identified as a protective factor (OR＝0.723, 95%CI: 0.556-0.940, P＜0.05). Conclusion The prevalence of dental caries in deciduous teeth among preterm LBW infants is relatively high. Key influencing factors include a history of iron-deficiency anemia, caregiver's oral health knowledge, age at initiation of brushing, daily brushing frequency, consumption of sweets/sweetened beverages, bottle feeding during sleep, and whether regular dental check-ups are performed.

关键词

乳牙 / 龋病 / 低出生体重 / 早产儿 / 影响因素

Key words

deciduous teeth / dental caries / low birth weight / preterm infant / risk factor

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基金资助

2022年成都市医学科研课题立项项目(2022343)