Dental status of New Caledonian children: is there a need for a new oral health promotion programme?

Background: Before implementing a new oral health promotion program in the French overseas territory of Nouvelle Calédonie, the health authorities needed recent data about dental status of the New Caledonian child population. Objectives: This study aimed to describe the dental status of 6, 9 and 12-yr-old New Caledonian children and to investigate the environmental and behavioural risk factors related to oral health. Methods: A randomly selected sample of 2734 children (744 6-yr-olds, 789 9-yr-olds, and 1201 12-yr-olds) was examined clinically by seven calibrated investigators and participants responded to a questionnaire. The main variables were objective criteria about dental status and subjective criteria about experience of dental care, dental fear, self-perception of oral health, cultural or ethnic identity and environmental and behavioural risk factors. Results: Overall, most of the children had infectious oral diseases: more than 50% had gingivitis, and 60% of 6- and 9 yr-olds had at least one deciduous or permanent tooth with untreated caries. The mean 12-yr-old number of decayed missing and filled teeth (DMFT) was 2.09±2.82. The number of carious lesions was related to the unfavourable lifestyle, deprived social status and no preventive dental care. Kanak, Polynesians and Caledonians (respectively 27%, 18% and 45% of the study sample) were more affected by caries than metropolitan French and Asian children. Children with many untreated carious lesions had negative perceptions of their oral health; they complained of chewing difficulty and had higher scores for dental anxiety. Conclusion: This study highlights the need for new strategies aimed at improving oral health and at reducing inequalities in New Caledonia. An oral health promotion program would need to be developed in connection with other health programmes using the common risk factor approach within the context of the local environment.

研究背景：在法属海外领地新喀里多尼亚（Nouvelle Calédonie）推行全新口腔健康促进项目之前，当地卫生主管部门亟需获取新喀里多尼亚儿童群体的口腔健康现状最新数据。研究目标：本研究旨在描述新喀里多尼亚6岁、9岁及12岁儿童的口腔健康现状，并探究与口腔健康相关的环境与行为风险因素。研究方法：本研究通过随机抽样选取2734名儿童作为研究对象（其中6岁组744人、9岁组789人、12岁组1201人），由7名经过校准的临床检查医师开展口腔临床检查，同时要求受试者填写调查问卷。核心观测变量包括口腔健康现状相关的客观指标，以及牙科诊疗经历、牙科恐惧、口腔健康自我认知、文化或族群认同、环境与行为风险因素相关的主观指标。研究结果：整体而言，多数儿童存在感染性口腔疾病：超过50%的儿童罹患牙龈炎，60%的6岁与9岁儿童至少存在1颗乳牙或恒牙患有未治疗龋病。12岁儿童的龋失补牙数（DMFT）均值为2.09±2.82。龋损数量与不良生活方式、社会经济地位低下以及未接受预防性牙科诊疗存在显著相关性。卡纳克人、波利尼西亚人与喀里多尼亚人（分别占研究样本的27%、18%与45%）的龋病患病比例高于法国本土儿童与亚裔儿童。存在大量未治疗龋损的儿童对自身口腔健康的认知偏消极，他们主诉咀嚼困难，且牙科焦虑评分更高。研究结论：本研究凸显了新喀里多尼亚亟需制定全新策略以改善口腔健康状况并缩小健康不平等。口腔健康促进项目需结合当地环境背景，采用共同风险因子路径，与其他健康项目协同开展。