| Abstract: | 現今台灣地區智障兒童的口腔健康狀況不被了解。本流行病學研究之主要目的是探討6 到12 歲智障兒童的口腔健康情形與治療需求及其相關因素。本研究的對象包括：135 位就讀台中市七所小學啟智班的學生(第一組)、82 位6 到12 歲在啟智教養院的智障兒童(第二組)、488 位來自七所小學一般班的學生(對照組)。這些兒童接受：問卷調查(由父母填寫)與口腔檢查。本研究的結果發現：平均乳牙dmft (Decayed,missing and filled primary tooth) (在對照組,第一組, 第二組分別是2.7, 2.3, and 1.8)與平均恆牙DMFT (Decayed, missing, andfilled permanent tooth) (在對照組, 第一組,第二組分別是1.4, 1.5, 0.9)沒有顯著差異(p>0.05)。而蛀牙的盛行率在三組分別是78%, 49%, 83%，有顯著差異(p<0.05)。在個別牙齒的治療需求方面，第一組需要較多的單面填補，其他治療在三組沒有差別。問卷調查的結果顯示下列因素在三組有顯著差異：父母所認知的口腔健康問題、牙科治療需求、使用牙科治療的障礙；是否看過牙醫；是否用過全身或鎮靜麻醉；刷牙次數；是否曾經塗氟；是否用含氟牙膏；是否用含氟漱口水；是否用過氟錠、父母的教育程度等。以多變項邏輯斯回歸分析蛀牙與否，在控制了年齡、性別、定期看牙醫、刷牙次數、塗氟、用含氟牙膏、用含氟漱口水、用氟錠、父母的教育程度、及出生次序等因素後，第二組比對照組較少蛀牙(勝算比=0.2, 95% 信賴區間:0.1-0.4)。多變項回歸分析，同時控制上述重要因子後，第二組比對照組的dmft 低(p<0.05)，而DMFT 沒有顯著差異。總結而言，在啟智教養院的兒童比就讀小學啟智班的兒童及普通班的學童有較少的蛀牙。
The oral health and treatment need of mentally retarded children in Taiwan has rarely been studied and is unclear. The purposes of this epidemiological study are to examine dental health and treatment needs of children with mental retardation and normal controls, and to investigate the children's use of dental care, parents’ perception of treatment needs, and barriers to utilization of dental services. Study subjects included (1) group 1: 135 mentally retarded students in the special education programs from seven elementary schools, (2) group 2: 82 mentally retarded children in special institutions, and (3) group 3: 488 controls at regular program from seven elementary schools in Taichung city. These children received a questionnaire for parents to answer and an oral examination. The results of oral examination showed that both mean dmft (decayed, missing and filled primary tooth) (2.7, 2.3, and 1.8 for controls, group1, and group2, respectively) and mean DMFT (decayed, missing, and filled permanent tooth) (1.4, 1.5, and 0.9 for controls, group1, and group 2, respectively) were not significantly different among three groups of children. The caries prevalence was 83%, 78%, and 49%, respectively, for controls, group1, and group 2 (p<0.05). As for individual tooth's treatment need, only one-surface filling was significantly higher in group 1 children, the others were similar among three groups. In the questionnaire survey, variables significantly different among three groups were: parent's perception of child's dental problems and treatment needs, ever had a dental visit, ever had general anesthesia or sedation in dental treatment, difficulty in seeking dental care, frequency of tooth brushing per day, topical fluoride gel use, fluoride toothpaste use, fluoride mouth rinse, and fluoride tablet uses. In the logistic regression analysis for caries (yes vs. no), group 2 children were significantly less likely to have dental caries compared to controls (odds ratio=0.2, 95% confidence interval: 0.1-0.4), adjustment for age, sex, regular dental visit, frequency of tooth brushing per day, fluoride toothpaste use, fluoride tablets use, fluoride gel use, fluoride mouth rinse use, parents' educational levels, and birth order. The multiple linear regression analysis found that group 2 children had significantly lower dmft than controls after controlling for important factors. DMFT were not different among groups in the multivariable analysis. In conclusion, mentally retarded children in the special institutions had less dental caries than mentally retarded children in special program and control children in elementary schools. |
