| 摘要: | 背景: 過去研究顯示造成齲齒的原因包含很多方面如孩童本身,家庭環境,生活習慣等 等,而根據 Andersen 提出醫療利用行為的原因也分成傾向因素,能力因素和需 要因素、個人健康行為等方面。齲齒風險因子被確定的有許多,但其因子與實際 的醫療利用之關係以及其年齡分層的文獻較少,大部份的文獻顯示就醫與年齡有 很大的關係,但很少有論文做分層的研究。本研究的目的是想了解以齲齒因子分 析孩童之齲齒就醫治療行為影響為何。
目標: 透過台灣全民健保資料庫連結 2005 年國民健康訪問調查 12 歲以下孩童以年齡分 層先做影響牙科就醫行為的因子分析,再針對 3-6 歲孩童可能生成齲齒的危險因 素及齲齒就醫的因子分析其與孩童齲齒醫療利用的關係。 方法: 本研究篩選 2005 年國民健康訪問調查之 3-6 歲孩童的特定因子,包含性別,婚 姻狀況,父母社經地位,飲食習慣,潔牙習慣,城鄉差異以羅吉斯迴歸分析來分 析其在 2004, 2005, 2006, 2007 年做齲齒治療與否的情形。並將四年來齲齒治療嚴 重程度加總取 LOG,以線性模型分析各因子影響齲齒治療嚴重度的情形。 結果:
影響 3-6 歲孩童因患齲齒進行牙科治療的因子包含傾向因素,能力因素,個人健
viii
康行為還有造成?齲齒的飲食習慣。研究結果顯示在傾向因素中年齡越高者,父
母婚姻狀況為已婚者也較會去就診。在能力因素方面,父親學歷及家庭收入越高
者越會去就診治療。在個人健康行為中,刷牙次數較高者較會去就診治療。飲食
習慣部份,還有使用奶瓶者,每天吃餅乾糖果者,每天吃甜食越多者較會因齲齒
就診。在 3-6 歲混齡族群中連續四年的齲齒治療嚴重度,唯有低收入者有明顯較
少齲齒治療;刷牙次數較高者治療嚴重程度較高
結論:
關鍵字: 兒童,牙科門診利用,齲齒因子
經過年齡分層結果發現其實 3-6 歲是齲齒形成和治療很重要的時期,此因兒童就
醫隨年齡提高而會提高就醫意願,故年齡分層的研究是重要的。孩童主要就診原
因皆是因為齲齒,而因齲齒做牙科醫療利用的原因除了年齡,父母婚姻,都市化
程度,父親學歷,家庭收入,及刷牙外,飲食習慣也是常被忽略卻相當重要具影
響力的因素。
Background: Previous research has shown that caries risk factors have many aspects, such as children themselves, family income and education level, diet habit and tooth-brushing habit. According to Andersen Model medical service utilization included predisposing factors, enabling factors, need factors and personal health practice. However, what makes a child having caries and makes them having caries treatment is not well understood. Objective: We selected children at the age of 3-6 from 2005 National Health Interview Survey in Taiwan. The factors including sex, age, parents marriage status, living area, parents’ education level, family income, tooth brushing habit, and diet habit were chosen from the survey and connected to caries treatment data of National health insurance program. Evaluate the relationship between these factors and the utilization of caries treatment. Methods: Use logit regression to analysis which factor influence the utilization of caries treatment in Taiwan. Factors related to severity of caries treatment were analyzed in general linear Model. Results: Age is the most important factor influencing the caries formation and dental treatment of caries. Elder children have more caries treatment probability. Higher Family Income and father’s education level increased the chance of caries treatment. Diet habit of nursing bottle and sweets intake increase the probability of caries treatment. The severity of caries treatment is related to low income family, urban-rural difference, and sweet intakes. Conclusion: There are different factors influencing dental caries formation and dental utilization of caries in different age of children. Diet habit is always one of the factors that cannot be beglected.
Keywords: Children, Dental Utilization, Caries risk factors |
