上海口腔医学

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (1): 101-106.doi: 10.19439/j.sjos.2026.01.017

• 论著 • 上一篇    下一篇

上海市静安区幼儿重度低龄儿童龋分级管理效果评价

陈琦雯1, 周琴1, 沈艳华1, 于雪迪1, 曾晓莉2,3, 虞瑾2,3, 江华峰4, 苗苗5, 施乐1   

  1. 1.上海市静安区牙病防治所,上海 200070;
    2.上海市口腔医院,上海 200000;
    3.上海市颅颌面发育与疾病重点实验室,上海 200000;
    4.上海市静安区石门二路街道社区卫生服务中心,上海 200041;
    5.上海市静安区共和新路街道社区卫生服务中心,上海 200070
  • 收稿日期:2024-12-10 修回日期:2025-01-09 出版日期:2026-03-12 发布日期:2026-03-12
  • 通讯作者: 施乐,E-mail：13003162720@163.com

Evaluation on the effect of grading management of severe early childhood caries in infants in Shanghai Jing 'an District

Chen Qiwen1, Zhou Qin1, Shen Yanhua1, Yu Xuedi1, Zeng Xiaoli2,3, Yu Jin2,3, Jiang Huafeng4, Miao Miao5, Shi Le1   

  1. 1. Shanghai Jing'an Dental Clinic. Shanghai 200070;
    2. Shanghai Stomatological Hospital and School of Stomatology, Fudan University. Shanghai 200000;
    3. Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University. Shanghai 200000;
    4. Shanghai Jing'an District Shimen Second Road Community Health Care Center. Shanghai 200041;
    5. Shanghai Jing'an District Gonghexin Road Community Health Care Center. Shanghai 200070, China
  • Received:2024-12-10 Revised:2025-01-09 Online:2026-03-12 Published:2026-03-12

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摘要： 目的 通过专科联动模式对上海市静安区12~18月龄幼儿重度低龄儿童龋进行龋病分级管理,并进行效果评价。方法 采用随机整群抽样方法,在2021年9月—2022年3月从上海市静安区内两家社区卫生服务中心,各抽取200名12~18月龄幼儿,分别作为对照组和试验组,进行龋病风险评估。对照组幼儿进行常规口腔保健,试验组幼儿采用专科联动下的龋病分级管理,干预18个月后进行再次评估。结果 干预18个月后,失访31名幼儿,最终对照组181名,试验组188名。总患龋率为22.8%,其中对照组为29.8%,试验组为16.0%,两组差异有统计学意义（P=0.002)。试验组幼儿龋风险等级降低比例显著高于对照组（P=0.012）。对照组幼儿的龋病相关影响因素包括每天3次以上进食含糖食品或饮料（P<0.001）、12个月内接受过专业涂氟（P<0.001）和定期口腔检查（P=0.023）;试验组幼儿的龋病相关影响因素包括每天3次以上进食含糖食品或饮料（P=0.005）、看护者每天为幼儿使用牙线（P=0.022）和看护者每天为幼儿刷牙（P=0.007）。结论 采用专科联动下的龋病分级管理模式对12~18月龄幼儿进行管理,能有效降低幼儿重度低龄儿童龋的患龋率和患龋风险。

Abstract: PURPOSE: Through specialty collaboration model, an evaluation was conducted based on graded management of severe early childhood caries in infants who are aged 12-18 months in Jing'an District, Shanghai. METHODS: Using the random cluster sampling method, totally 200 children aged 12 to 18 months were selected from each of the two community health care centers in Shanghai Jing'an District during September 2021 to March 2022, allocated as the control group and the experimental group, and caries risk assessment was conducted. Children in the control group received routine oral health care at the child health department, while children in the experimental group adopted dental caries grading management based on collaboration of specialty. A re-evaluation was conducted after 18 months of intervention. RESULTS: After 18 months of intervention, totally 31 of the 400 infants were lost to follow-up, the total caries prevalence rate was 22.8%. The caries prevalence rate in the control group was 29.8%, while that in the experimental group was 16.0%, with significant difference between the two groups (P=0.002). The reduction rate of caries risk grade in the experimental group was significantly higher than that in the control group(P=0.012). The caries related factors in the control group included eating sugar-containing food or beverage more than 3 times/day (P<0.001), receiving professional fluoridation within 12 months(P<0.001) and regular oral examination(P=0.023). The caries related factors in the experimental group included eating sugar-containing food or beverage more than 3 times/day（P=0.005）, the caregiver performing floss for the child every day (P=0.022) and brush for the child every day(P=0.007). CONCLUSIONS: It is capable to effectively reduce the caries prevalence rate and the risk of severe early childhood caries in infants aged 12-18 months by adopting dental caries grading management based on collaboration of specialty.