Preliminary Effect Assessment Of Internet In Caries Management Of Children And New-onset Caries Risk Prediction Of First Permanent Molars

ObjectivesBuilding the Internet+caries management platform.To assess the preliminary effect of the Internet+caries management platform in the caries risk-based management of children and to explore the related factors of new-onset caries in first permanent molar.MethodsBased on the Internet and mobile Internet application technology,an Internet+caries management platform was established through wechat public account,wechat mini program and WEB terminal.The platform includes doctor side and patient side,it has the functions of doctor-patient communication,data statistics,patient group management,follow-up management,caries education and caries related behavior recording.The study included 225 second-graders from a primary school at baseline.They were randomly divided into experimental group and control group by the class code.The caries risk assessment tool was used to grade the caries risk of children in two groups.The experimental group used Internet for caries management,while the control group used traditional classroom for caries management.The international Caries Detection and Assessment System II and the World Health Organization caries examination standard were used to record the caries lesions by tooth surface.The basic information and oral health knowledge,attitude and behavior were collected by electronic questionnaire.At baseline,there were 114 children in the experimental group and 111 in the control group,respectively.Outcome data were collected one year later for 113 children in the experimental group and 96 in the control group.The caries risk assessment items,caries risk level,oral health knowledge,oral health behavior(sugar intake behavior,oral hygiene behavior,medical treatment behavior)and caries prevalence were analyzed by Pearson χ2 test.The mean caries surface and plaque index were analyzed by non-parametric rank sum test.The new-onset caries related factors of first permanent molars were analyzed by Logistic and negative binomial regression.Results1.After one year,the cognitive level of oral health knowledge was significantly improved in both groups,and there was no statistical difference.The caries risk assessment items,such as "frequency of eating sugary snacks or beverages more than 3 times/day between three meals"(p=0.033)and "usage of fluoride toothpaste"(p=0.022)and the health behavior indicators,such as "frequency of eating sweets before bedtime"(p=0.032),"brushing duration"(p=0.002)and caries filling rate of deciduous teeth(p<0.001)and first permanent molars(p=0.003),there were statistical differences between the two groups,the improvement effect of experimental group was more obvious than that of control group.2.In Logistic regression analysis,the number of pit and fissure sealing surfaces(RR=0.773,95%CI:0.638-0.936,p=0.008)was related to new caries occurrence in first permanent molars.In negative binomial regression,baseline dmfs(RR=1.054,95%CI:1.028-1.080,p<0.001)and number of pit and fissure sealing surfaces(RR=0.659,95%CI:0.537-0.810,p<0.001)were correlated with the number of new-onset caries surfaces in first permanent molars.The risk ratio(RR)for the number of new-onset caries surfaces was 0.177(95%CI:0.068-0.458)for children with average monthly household income of 10000 yuan or more at baseline,lower than that for children with average monthly income of 5000-10000 yuan and less than 5000 yuan.3.Most of the children with new-onset caries(50.94%)and teeth surfaces with new-onset caries(67.12%)were in the children with dmfs≥23 at baseline.In the children with baseline dmfs≥23,the majority of children with new-onset caries(55.56%)and teeth surfaces with new-onset caries(63.27%)were concentrated in the population with baseline dmfs≥32.According to the dmfs of deciduous teeth ≤22,23-31,≥32 at baseline,the rate of new-onset caries(p=0.008)and the number of new-onset caries surfaces(p<0.001)in the three groups were statistically different.Conclusions1.The Internet+caries management platform improved the health related behaviors(oral hygiene practice,sugar consumption behavior,and medical treatment behavior)more advantageous than the traditional classroom caries management,and the difference was statistically significant.The Internet+caries management platform promotes the consistency of health knowledge and health behavior,and provides a reliable realization path for the occurrence and persistence of health related behaviors.2.Low income and high deciduous teeth caries are the risk factors of caries in first permanent molars,and pit and fissure closure is a strong protective factor.It was found that dmfs of deciduous teeth of 23 and 32 were the critical values of caries risk grade for children with high caries in this study.It is significant to predict new-onset caries of first permanent molars by previous caries experience of deciduous teeth.