早期咨询改善先天性心脏病患儿的口腔健康行为：随机对照试验。

IF 2.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Caries Research Pub Date : 2023-01-01 Epub Date: 2023-07-13 DOI:10.1159/000531817

Essi Karikoski, Taisto Sarkola, My Blomqvist

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引用次数: 0

摘要

保持先天性心脏病（CHD）患儿的最佳口腔健康行为对于控制龋齿发展和感染性心内膜炎的风险非常重要。本研究旨在评估早期和重复口腔健康促进干预（OHPI）对先天性心脏病患儿的影响。随机对照试验包括 2017 年 4 月 1 日至 2020 年 10 月 31 日在芬兰出生的 91 名儿童中的 72 名，这些儿童(a) 患有可能被纳入心内膜炎预防标准的严重先天性心脏病，或(b) 任何先天性心脏病经手术修复后合并染色体综合征。87名健康儿童在出生时被纳入平行被动对照（C）组。患有先天性心脏病的儿童按 1:1 随机分配到干预组（CHD-I）和对照组（CHD-C）。OHPI 包括通过动机访谈进行的咨询、送上门的牙膏和牙刷以及书面信息，分别在 CHD-I 组的基线、6、12 和 18 个月大时提供。24 个月时的主要结果指标是儿童的口腔健康行为（刷牙、糖摄入量和牙科护理接触）。次要结果指标是父母对口腔健康行为重要性的认识，以及口腔健康行为对儿童行为的预测作用。24 个月时，CHD-I 患儿中有 20/27 人（74%）每天刷牙两次，CHD-C 患儿中有 13/30 人（43%）每天刷牙两次（CHD-I vs. CHD-C p = 0.03），健康对比患儿中有 37/50 人（74%）每天刷牙两次（CHD-C vs. C p = 0.01）。在 CHD-I 儿童中，12/27（44%）使用电动牙刷；在 CHD-C 儿童中，5/30（17%）使用电动牙刷（CHD-I vs. CHD-C p = 0.04）；在健康对比儿童中，7/50（14%）使用电动牙刷（CHD-C vs. C p = 0.76）。在 CHD-I 儿童中，刷牙和使用电动牙刷的情况在 12 个月至 24 个月期间有所改善。CHD-C儿童更常摄入糖饮料（CHD-C vs. C p = 0.02），但与CHD-I儿童相当。父母每天刷牙两次预示着儿童每天刷牙两次。在牙科保健接触方面没有统计上的群体差异。患有先天性心脏病的儿童有口腔卫生行为不良的风险。通过早期和反复的口腔健康促进家长咨询，可以改善这种情况。

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Early Counseling to Improve Oral Health Behavior in Children with Major Congenital Heart Defects: A Randomized Controlled Trial.

Maintaining optimal oral health behavior in children with a congenital heart defect (CHD) is important in managing the risk for caries development and infective endocarditis. The aim of this study was to evaluate the impact of an early and repeat oral health promotion intervention (OHPI) among children with major CHD. Randomized controlled trial including 72 out of 91 children born in Finland April 1, 2017-October 31, 2020 with (a) major CHD potentially included in the criteria of endocarditis prophylaxis or (b) any CHD with surgical repair combined with a chromosomal syndrome. A parallel passive control (C) group of 87 healthy children were recruited at birth. CHD children were randomized 1:1 to intervention (CHD-I) and control (CHD-C) groups. The OHPI included counseling by motivational interviewing, home delivered toothpaste and toothbrushes, and written information, and was provided at baseline, 6, 12, and 18 months of age to CHD-I group. The primary outcome measure at 24 months was child's oral health behavior (toothbrushing, sugar intake, and dental care contact). The secondary outcome measures were parents' awareness of the importance of oral health behavior, and oral health behavior as a predictor for child behavior. At 24 months, toothbrushing was performed twice a day in 20/27 (74%) among CHD-I, in 13/30 (43%) among CHD-C (CHD-I vs. CHD-C p = 0.03), and in 37/50 (74%) among healthy comparisons (CHD-C vs. C p = 0.01). Electric toothbrush use was 12/27 (44%) in CHD-I, 5/30 (17%) in CHD-C (CHD-I vs. CHD-C p = 0.04), and 7/50 (14%) in healthy comparison (CHD-C vs. C p = 0.76) children. Among CHD-I, toothbrushing and use of electric toothbrush improved between 12 months and 24 months. Sugar drink intake was more common among CHD-C (CHD-C vs. C p = 0.02), but comparable to CHD-I children. Parental toothbrushing predicted child toothbrushing twice a day. There were no statistical group differences in dental care contact. Children with CHD are at risk for poor oral health behavior. This could be improved with early and repeat oral health promotion parental counseling.

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来源期刊

Caries Research 医学-牙科与口腔外科

CiteScore

6.30

自引率

7.10%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Caries Research'' publishes epidemiological, clinical and laboratory studies in dental caries, erosion and related dental diseases. Some studies build on the considerable advances already made in caries prevention, e.g. through fluoride application. Some aim to improve understanding of the increasingly important problem of dental erosion and the associated tooth wear process. Others monitor the changing pattern of caries in different populations, explore improved methods of diagnosis or evaluate methods of prevention or treatment. The broad coverage of current research has given the journal an international reputation as an indispensable source for both basic scientists and clinicians engaged in understanding, investigating and preventing dental disease.