Mariél de Aquino Goulart, Andrea Sherriff, David I Conway, Alex D McMahon
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引用次数: 0
Abstract
Background: Child dental caries is highly prevalent worldwide, with significant treatment costs, but its broader societal impact remains underexplored. This cross-sectional study examined associations between child oral health and school absences in Scotland.
Methods: Four population-wide data sets were linked at the individual level, where the outcome was part-day school absence during first primary school year across six academic years (2008/2009-2010/2011, 2012/2013, 2014/2015 and 2016/2017). Oral health was assessed using three metrics: caries experience, urgent need of dental treatment (UNDT) and dental extractions under general anaesthetic (DGA). Gamma-distributed general linear models (identity link) estimated adjusted mean differences, including interaction terms for socioeconomic deprivation (Scottish Index of Multiple Deprivation (SIMD) deciles). Models adjusted for sex, age, academic year and SIMD.
Results: Records from 263 597 children (mean age: 5.5 years) showed 33% had caries experience (median 16 part-day absences), 9% had UNDT (median 19) and 2% had DGA (median 20). Children without caries experience had a median of 11 part-day absences. Adjusted models showed mean differences of 5.0 (95% CI 4.9 to 5.2) more absences for children with caries experience versus none; 6.2 (95% CI 5.9 to 6.5) more absences for UNDT versus no UNDT; and 6.5 (95% CI 5.8 to 7.1) more for DGA versus no DGA. Interaction analysis showed a deprivation gradient: children in the 10% most deprived areas had nearly twice the burden of absences related to poor oral health compared with the 10% least deprived.
Conclusion: Poor oral health was associated with higher absenteeism, with socioeconomic inequalities exacerbating the impact.
背景:儿童龋齿在世界范围内非常普遍,治疗费用很高,但其更广泛的社会影响尚未得到充分探讨。这项横断面研究调查了苏格兰儿童口腔健康和缺课之间的关系。方法:在个人层面上,将四个人口范围的数据集联系起来,结果是六个学年(2008/2009-2010/2011、2012/2013、2014/2015和2016/2017)的小学一年级兼职缺勤情况。使用三个指标评估口腔健康:龋齿经历、迫切需要牙科治疗(UNDT)和全身麻醉下拔牙(DGA)。伽马分布一般线性模型(身份链接)估计调整后的平均差异,包括社会经济剥夺的相互作用项(苏格兰多重剥夺指数(SIMD)十分位数)。模型根据性别、年龄、学年和SIMD进行了调整。结果:263 597名儿童(平均年龄:5.5岁)的记录显示,33%有过龋齿经历(中位数缺勤16天),9%有过UNDT(中位数19天),2%有DGA(中位数20天)。没有龋齿经历的儿童旷课的中位数为11天。调整后的模型显示,有龋齿经历的儿童与没有龋齿经历的儿童的缺勤率平均差异为5.0 (95% CI 4.9至5.2);与没有unt相比,unt缺勤多6.2 (95% CI 5.9 - 6.5);DGA组比无DGA组多6.5 (95% CI 5.8 - 7.1)。相互作用分析显示了剥夺梯度:10%最贫困地区的儿童因口腔健康状况不佳而缺勤的负担几乎是10%最贫困地区的儿童的两倍。结论:口腔健康状况不佳与较高的缺勤率有关,社会经济不平等加剧了这种影响。
期刊介绍:
The Journal of Epidemiology and Community Health is a leading international journal devoted to publication of original research and reviews covering applied, methodological and theoretical issues with emphasis on studies using multidisciplinary or integrative approaches. The journal aims to improve epidemiological knowledge and ultimately health worldwide.