Investigation On The Status Survey Of Dental Caries Of Young Children In The Community And Its Influencing Factors Of Prevention And Treatment Based On IMB Model

Objective:1.To investigate the overall prevalence and trend of childhood dental caries in Pudong New Aera of Shanghai from 2016 to 2018.To review implementation of dental caries prevention policies from 2016 to 2018.To identify demographic characteristics and influencing factors of children with dental cavities.2.To identify confounding factors associated with dental caries prevention in young children,as the basis for the development of subsequent improvement on health management plan for dental caries prevention in young children.Methods:From June 3,2019 to June 22,2019,we visited child care division of four Community Health Service Centers in Pudong New Aera of Shanghai and retrieved medical history of children who had clinic visits during February 2016 to November 2018,including demographic information,oral exam results,and dental caries prevention measures.From June to September 2019,we conducted a questionnaire survey among parents of young children enrolled in five kindergartens in the district of Shanghai Steel Community,Pudong New District,Shanghai,using the convenience sampling method.The survey included basic demographic characteristics on parents and children,information,motivation,behavioral skills,and behavior for dental caries prevention.Statistical analysis was performed using SPSS 24.0 and AMOS 24.0.Results:A total of 25,458 cases were retrieved,including 7,571 in 2016,9,102 in 2017,and 8,785 in 2018.The prevalence of dental caries was 60.7%,54.66%,and 48.95% in 2016,2017 and 2018 respectively.The number of dental caries in primary molar teeth was higher than in permanent teeth.The dental caries rates in children were significantly different among four communities(P<0.05),and the dental caries rate was significantly higher in primary school children than in kindergarten children(P<0.05).From 2016 to 2018,the dental caries rate differed significantly by age(P<0.05),the dental caries rate initially increased then decreased by age,with children 7-9 year old having the highest rate for dental caries.From 2016 to 2018,the fluoride application in children surveyed was 100%,and the use of pit and fissure sealant was 9.1%,8.5%,and 7.0% from 2016 to 2018 respectively.Multivariate Logistic regression analysis showed that age and number of pit and fissure sealant were the protecting factors of caries in children(P<0.05).Among 18 parents surveyed,the median information score was 8(7,9),the median personal motivation score was 20(19,20),the median social motivation score was 9(8,10),the median behavioral skills score was 25(24,25),and the median behavioral score was 7(5,8).Motivation was positively associated with behavioral skills(P <0.05),both information and behavioral skills were positively associated with dental caries prevention(P <0.05).Personal motivation had a direct influence factor of 0.796 on behavioral skills and an indirect influence factor of 0.150 on dental caries prevention;behavioral skills and information had a direct influence factor of 0.189 and 0.258 respectively on dental caries prevention.Conclusions:Since the beginning of 2015,Pudong New Aera of Shanghai implemented preventativefluoride-application program.The program has achieved desired results.The dental caries rate has been decreasing each year.In the next step,the focus of caries prevention should be at the early stage of children teeth eruption.Through strengthening oral health publicity of parents(guardians),the acceptability and development rate of effective measures for prevention and treatment of dental caries(such as pit and groove closure and dental caries filling)should be further improved,so as to prevent dental caries in the future.Our study suggest that in addition to oral hygiene information and education for parents of young children,mental support should be a key component of any community-based dental caries prevention program.