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研究生:潘倩慧
研究生(外文):Pan, Chien-Hui
論文名稱:台南市幼稚園.托兒所幼童齲齒狀況及其影響因素之探討
論文名稱(外文):A Study of Caries and Its Affecting Factors of Kindergarten Children in Tainan City
指導教授:謝天渝, 洪玉珠
指導教授(外文):Tian-Yu Shieh, Yuh-Ju Horng
學位類別:碩士
校院名稱:高雄醫學院
系所名稱:口腔衛生科學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:1998
畢業學年度:86
語文別:中文
論文頁數:139
中文關鍵詞:齲齒分層兩階段集束抽樣法
外文關鍵詞:CariesStratified two stage cluster sampling
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齲齒是兒童期最嚴重的慢性疾病,根據世界衛生組織的預測,若不採取
任何預防措施,則至西元2000年,台灣兒童的齲齒狀況,將達到非常嚴重的
程度.乳牙發生齲蝕將嚴重影響恆牙的發育.萌出與排列,且根據許多研究
顯示:幼年期的許多經驗與學習,終身不易改變,若能在幼年期即養成良好
的口腔衛生習慣,則許多口腔問題得以早期被預防,故追本溯源,齲齒之防
治應由學齡前幼童開始. 本研究之目的,希望瞭解台南市幼稚園.拖兒
所幼童的齲齒狀況,並探討其與幼童之背景因素.哺育經驗.甜食使用情形.
潔牙習慣.使用氟化物與否及看牙醫情形的相關性,最後期望能掌握家庭及
學校教育對幼童齲齒狀況的影響,使有關當局重視學齡前幼童齲齒之預防
與口腔衛生教育. 調查方法採分層兩階段集束抽樣法,並利用抽取率與
單位大小成比例之抽樣設計,對台南市立案幼稚園.托兒所幼童,年齡2-6歲
進行抽樣.抽中之幼童所屬學校,全體皆為口腔檢查與問卷調查之對象,而
學校人員包括園長.導師.校護及行政人員亦接受問卷調查.共有幼童906人
接受調查,完成率90.6%,學校人員91人接受調查,完成率100.0%. 研究
結果:齲齒盛行率平均76.1%,def指數平均4.7+4.4顆,填補率15.7%,三歲到
五歲間是學齡前幼童齲齒增加的關鍵期,而填補率於此年齡間並無明顯變
化.齲齒型態的分佈,幼小兒童以無齲齒型.小窩裂溝型及唇舌面型佔多數,
隨年齡增加,唇舌面伴隨臼齒鄰接面型比例偏高.奶瓶性齲齒盛行率, 依國
際間不同診斷定義為15.8%-44.5%,五個年齡組幼童乳齒齲蝕機率,皆以下
顎第二乳臼齒最高,六足歲幼童恆牙第一大臼齒萌發率40.0%,齲齒盛行
率12.1%,填補率皆為零.幼童齲齒狀況(包括:齲齒盛行率及def指數)與幼
童喝奶完有無潔牙.甜食頻率.刷牙情形.看牙醫情形.局部塗氟情形及家長
教育程度有統計顯著差異.影響幼童是否罹患齲齒的因素包括:幼童年齡.
幼童看牙經驗及母親教育程度.影響幼童是否填補齲齒的因素包括:幼童年
齡.幼童就讀學校公私立別.學校人員口腔衛生知識.家長口腔衛生態度與
行為.
Dental caries is the most serious chronic disease in
childhood. According topredictions by WHO, without any
preventive measures, the dental caries stituation will be very
serious by the year 2000. Carious deciduous teeth will serious
affect the health, eruption and arrangement of the permanent
teeth. According to manyresearchers, there are many childhood
experiences which influences all our lives. If there are good
oral hygiene habits in childhood, many oral problems could
beprevented. Therefore, prevention of dental caries should begin
in preschool period. The aims of this research are the
following:(1)to understand the caries statusof preschool
children (2)to explore the relationship between background
factors,nursing experiences, intake of sweets, oral hygiene
habits, fluorides application,children''s dental visits and the
caries status (3)to urge the authorities to seriouslyconsider
improving the education of preschool children with regards to
caries prevention and proper oral hygiene. The sampling method
adopted stratified by areas and public or private schools within
the strata in a two stage cluster sampling with PPS design from
all day-care centers and kindergartens in Tainan city. There
were 906 children, aged 2-6 years, who accepted the oral
examinationsand questionnaires, and 91 school members, including
school leaders, teachers,nurses and administrators who also
accepted questionnaires. The completion rateof children was
90.6%, and that of school memberswas 100.0%. The results
revealed that the caries prevalence was 76.1%, the mean def
indexwas 4.7 and the filling rate was 15.7%. The critical period
of increase in carieswas between 3 and 5 years old, but the
filling rate between the ages did not obviously change. The
distribution of caries patterns was different among different
age groups. The caries-free pattern, pit and fissure caries
pattern and facial-ligual caries pattern were dominanat in the
younger age group. With increasing age, the facial-lingual plus
approximal molar caries pattern wasdominant. The prevalence of
nursing caries was between 15.8% -44.5%. The madibular second
deciduous molars were the most susceptible to caries in the
primary dentition. The eruption rate, caries prevalence and
filling rate of the permanent first molars in the 6 years old
children were 40.0%, 12.1% and0.0%. We concluded that there
were statistical significance between the nursingexperience,
frequency of sweets intake, oral cleaning habits, fluoride
application, dental visits of children, parent''s educational
levels and thecaries status (including caries prevalence and def
index). The caries prevalence was influenced by children''s age,
children''s dental visits andmother''s educational levels. The
treatment rate was influenced by childre''sage, attendance in
public or private schools, oral hygiene knowledge of
schoolmembers and oral hygiene attitudes and behaviors of
parents.
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