Agreement of self-reported and proposed standard on oral health among children

Objective To analyze the consistency between self-reported oral health and proposed standard in evaluating children oral health status, and to test whether self-reported oral health can be used in children population. Methods The clinical examination data and questionnaire data were 2 158 children aged 12-year-old in Beijing, China. Child oral health status was measured by self-reported oral health and proposed standard from World Health Organization (WHO), and was classified into "good, general, poor” based on each method. Kappa test was used to evaluate the consistency of two measurements. Using multivariate nonordinal logistic regression to identify the influencing factors of self-reported oral health, and to explore the possible reasons for the consistency differences of two measurements. Results According to the WHO standard, 25.5%, 65.3% and 9.2% children oral health were rated as good, general and poor, respectively. The proportion was 50.6%, 37.7% and 11.8% respectively based on self-report method. Kappa value for two measurements was 0.04, indicating poor agreement between two methods. Results from regression model show that both the untreated caries ( OR = 2.47, P <0.01) and toothache ( OR = 3.54, P <0.01) were associated with self-reported oral health, while not observed in periodontal health ( OR = 1.34, P = 0.18) and oral hygiene status ( OR = 0.95, P = 0.75). Conclusion Self-reported oral health results can reflect caries status to some extents among children, but it failed to reflect other aspects, such as periodontal health status and oral hygiene. Self-reported oral health among children should be considered based on the requirements of assessment content and accuracy in the future work. 【摘要】 目的 分析口腔健康自我评价和世界卫生组织推荐标准对儿童口腔健康状况评估结果的一致性, 为口腔健康自 我评价在儿童群体中的使用提供依据。 方法  对北京市2 158名12岁儿童临床口腔检查和问卷调查的数据进行分析。 使用口腔健康自我评价和WHO推荐标准对儿童口腔健康状况进行评估, 评估结果均分为“好、中、差”3个等级。运用 Kappa分析进行一致性评价;运用多因素Logistic回归分析了解儿童口腔健康自我评价的影响因素。 结果 根据WHO的 推荐标准, 儿童口腔健康好、中、差的比例分别为25.5%, 65.3%, 9.2%;儿童口腔健康自评结果为好、中、差的比例分别为 50.6%, 37.7%, 11.8%。两种方法对儿童口腔健康结果评价的 Kappa 值为0.04,一致性较差。回归分析结果显示, 开放性龋 洞 ( OR = 2.47, P <0.01)和牙疼 ( OR = 3.54, P <0.01)均是儿童口腔健康自评的影响因素；而牙周健康 ( OR = 1.34, P = 0.18)和 口腔清洁状况 ( OR = 0.95, P =0.75)对自评结果的影响无统计学意义。 结论 儿童口腔健康自我评价结果能在一定程度上 反映群体龋病状况差异, 但难以反映儿童牙周和口腔清洁方面的健康状况。应根据工作内容和评估的精准度要求, 考虑口 腔健康自我评价工具在儿童群体的使用。