[논문]지역사회 치면열구전색사업의 치아우식예방효과: 3년간 후향적 코호트 연구

전매숙; 김창숙; 이경수; 남인숙

doi:10.5393/jamch.2020.45.2.079

초록
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연구목적: 이 연구는 지역사회 치면열구전색 사업의 치아우식 예방효과를 평가하고자 시행되었다. 연구방법: 연구 대상자는 2005년부터 2008년까지 김천시에 소재한 34개 초등학교에 재학 중인 9,001명 중 2005년 최초 구강검사 당시 상·하악 제1대구치에 치아우식이 없는 치아와 학생 4,768명을 최종 대상자로 선정하였다. 2005년도에 치면열구전색을 실시한 1,478명에 대해 3년간 추적조사가 이루어졌고, 2006년에 치면열구전색을 실시한 999명에 대해 2년간 추적조사를 하였으며, 2007년에 치면열구전색을 실시한 458명에 대해 1년간 추적조사 후 기술통계 및 교차분석을 시행하였다. 연구결과: 치면열구전색 실시군의 DMFT rate는 1년 추적 후 1.4%에서 3년 추적 후 4.1%, DMFT index는 1년 추적 후 0.18개에서 3년 추적 후 0.70개로 추적기간이 길어질수록 높게 나타났다. 1일 평균 칫솔질 횟수는 DMFT rate와 DMFT index에 영향을 미쳤다. 즉 치면열구전색을 실시한 대상자라도 1일 평균 칫솔질 횟수가 적으면 DMFT rate와 DMFT index는 높게 나타났다. 결론: 치면열구전색을 실시한 대상자에서도 올바른 칫솔질에 대한 구강보건교육이 선행되어야 한다.

주제어

표/그림 (5)

그림 Figure 1. Subjects of fissure sealants
표 Table 1. Total number of sealed teeth by number of teeth Unit: N
표 Table 2. DMFT rate of follow up period by dental sealant Unit: N (%)
표 Table 3. DMFT rate and DMFT index by dental sealant and follow up period
표 Table 4. DMFT rate and DMFT index by daily tooth brushing frequency and dental sealant

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문제 정의

In Korea, the pit and fissure sealant has been implemented since 2005 as part of the national dental health project [5]. The purpose of this study is to prevent dental caries and preserve healthy permanent teeth by applying a fissure to the teeth before preschool children or elementary school students. The subjects were the first and second grade elementary students of the children who were recognized by the head of the health department and the principal of the school, and they were selected with the low income congested area after completing the consent form from the children’s parents.
Follow up studies are effective to establish the development pattern of dental caries after dental sealant. The purpose of this study was to understand the actual condition through comparative evaluation on the effect of dental caries according to the follow up period after the dental sealant.
This purpose of this study was to evaluate the effect of the program on sealant dental caries, percentage of permanent teeth affected with dental caries or missing or filled (DMFT rate) in accordance with number of brushing and number of dental caries or missing or filled permanent teeth(DMFT index), and it is to explore the epidemiological factors.

제안 방법

The aim of the present study was to evaluate the effects of fissure sealants on the occlusal fissures of permanent first molar for three years in schoolchildren by comparing the dental caries incidence rates, DMFT rate and DMFT index by time of each tooth between two groups, with fissure sealant and without fissure sealant. In 2005-2008, 4,768 students from 34 elementary schools located in Gimcheon city analyzed the results:
The analysis of individual and dental unit was compared with the DMFT index, which is an index of oral health. The dental caries rate was analyzed according to whether the dental sealant was applied or not, and the DMFT index was analyzed according to the number of toothbrushes and the presence of dental sealant. The relative risk was calculated according to the presence or absence of the dental sealant.
Oral examinations were performed under the natural lighting conditions under the guidelines of Oral Examination Guidelines [9] for Epidemiologic Investigations of WHO, using a tooth, a probe, and a penlight. The subject was examined near the window where the examinee was sitting in front of or behind the chair to have the enough natural light.
In the subsequent studies, it is necessary to examine the dental caries in detail, because it is mostly performed on the dental sealant. This study is a dental unit survey, but it is also necessary to study the tooth surface.

대상 데이터

tooth) of maxillary and mandibular permanent teeth among the 9,001 students who attended 34 elementary schools in Gimcheon City from 2005 to 2008. After selecting only the teeth and students who have no dental caries, 4,768 students of the final study were reconstructed by individual units for 1-3 years. Of the 4,768 subjects, 1,478 who underwent a dental sealant in 2005 were followed up for 3 years.
The purpose of this study was to investigate the relationship between the teeth and the teeth of the first molar (6^thtooth) of maxillary and mandibular permanent teeth among the 9,001 students who attended 34 elementary schools in Gimcheon City from 2005 to 2008. After selecting only the teeth and students who have no dental caries, 4,768 students of the final study were reconstructed by individual units for 1-3 years.
The subjects were the first and second grade elementary students of the children who were recognized by the head of the health department and the principal of the school, and they were selected with the low income congested area after completing the consent form from the children’s parents.

성능/효과

1. As for the DMFT rate depending on whether placing the fissure sealants, the teeth with the fissure sealants showed 1.4% in 1 year follow-up, 2.7% in 2 year follow-up and 4.1% in 3 year follow-up. When it comes to the teeth without the fissure sealants, it was 34.
2. DMFT index depending on whether placing the fissure sealants were 0.18 in 1 year follow-up, 0.42 in 2 year follow-up and 0.70 in 3 year follow-up in the group with fissure sealant and 1.36 in 1 year follow-up, 1.89 in 2 year follow-up, 2.25 in 3 year follow-up, which showed lower dental caries rates in the group with fissure sealants.
The DMFT rate was significantly lower in the group of ‘practitioner’ group than in ‘non-practitioner’ group in comparison with the group of subjects who were divided according to the number of brushing, DMFT rate and DMFT index after three years of follow up were more than 2 times different within the ‘practitioner’ group. The DMFT rate was also about twice that of the follow up period, and the DMFT rate after third year follow up was more than 10% according to the number of times of brushing, and the DMFT index showed a difference of more than 50%. ‘Chang’ supports the findings of this study by correlating the incidence of dental caries and frequency of brushing in children [16].
The DMFT rate was significantly lower in the group of ‘practitioner’ group than in ‘non-practitioner’ group in comparison with the group of subjects who were divided according to the number of brushing, DMFT rate and DMFT index after three years of follow up were more than 2 times different within the ‘practitioner’ group.
The result of analysis of the DMFT rate according to the follow up period of 3 years after dental sealant were 5.2%, 8.2%, and 5.8% on 16th tooth, 5.1%, 8.6%, and 6.1% on 26th tooth, 9.2%, 14.7%, and 12.0% on 36th tooth, and 8.4%, 12.3%, and 9.3% on 46th tooth after 1st, 2nd, and 3rd years respectively.
1% in 3 year follow-up. When it comes to the teeth without the fissure sealants, it was 34.0% in 1 year follow-up, 47.4% in 2 year follow-up and 56.5% in 3 year follow-up, which showed that DMFT rate of the teeth with the fissure sealants was very low.

참고문헌 (18)

Kim JB, Choi YJ, Baek DI, Shin SC, Jang GW Preventive dentistry. Seoul, Komoonsa, 2004, pp.185
Llodra JC, Bravo M, Delgado-Rodriguez M, Baca P, Galvez R. Factors influencing the effectiveness of sealants-a meta-analysis. Community Dent Oral Epidemiol 1993;21(5):261-268

상세보기
Ahovuo-Saloranta A, Hiiri A, Nordblad A, Makela M, Worthington HV. Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev 2008;(4):CD001830
Mejare I, Lingstrom P, Petersson LG, Holm AK, Twetman S, Kallestal C, et al. Caries-preventive effect of fissure sealants: a systematic review. Acta Odontol Scand 2003;61(6):321-330

상세보기
Ministry of Health and Welfare. 2005 Oral health project guide. Sejong: Ministry of Health and Welfare; 2005: 6-14, 105-109
Ministry of Health and Welfare. 2008 Basic plan of oral health project. Sejong: Ministry of Health and Welfare; 2007: 4, 38-39
Bravo M, Montero J, Bravo JJ, Baca P, Llodra JC. Sealant and fluoride varnish in caries: a randomized trial. J Dent Res 2005;84(12):1138-1143

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Werner CW, Pereira AC, Eklund SA. Cost-effectiveness study of a school-based sealant program. ASDC J Dent Child 2000;67(2):93-97

상세보기
World Health Organization. Oral health survey method. Seoul, Komoonsa, 2000, pp. 27-65
World Health Organization. Oral health survey-basic methods. Geneva, WHO, 2013
Lee HJ, Han DH. Exploring the determinants of secular decreases in dental caries among Korean children. Community Dent Oral Epidemiol 2015;43(4):357-365

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Kim HN, Han DH, Jun EJ, Kim SY, Jeong SH, Kim JB. The decline in dental caries among Korean children aged 8 and 12 years from 2000 to 2012 focusing SiC Index and DMFT. BMC Oral Health 2016;16:38

상세보기
Ministry of Health and Welfare. 2010 National oral health survey. Seoul: Ministry of Health and Welfare; 2010
World Health Organization. WHO Oral Health Country/Area Profile Programme [Internet]. 2018; World Health Organization. [cited 2018 April 18]. Available from: http://www.who.int/oral_health/databases/malmo/en/
Na EJ, Lim JH, Park WR, Cho JW. The effect of 2 years pit and fissure sealant program on Laos children. Int J Clin Prev Dent 2015;11(4):225-232
Chang YS, Park EJ, Kim HJ. Cor-relation co-efficient between the toothbrushing frequency or caries activity and the dental caries of periodontal state. Int J Clin Prev Dent 2013;9(4):225-230
Miyazaki H, Morimoto M. Changes in caries prevalence in Japan. Eur J Oral Sci 1996;104(4(Pt2)):452-458

상세보기
Joyson M, Deepa G, Rangeeth BN. Prevalence of dental caries, socio-economic status and treatment needs among 5 to 15 year old school going children of chidambaram. JCDR 2011;5(1):146-150

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연합인증

지역사회 치면열구전색사업의 치아우식예방효과: 3년간 후향적 코호트 연구
The Effects of Community-based Sealant Program for Preventing Dental Caries in the Permanent Teeth: 3 year Retrospective Cohort Study 원문보기

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지역사회 치면열구전색사업의 치아우식예방효과: 3년간 후향적 코호트 연구 The Effects of Community-based Sealant Program for Preventing Dental Caries in the Permanent Teeth: 3 year Retrospective Cohort Study 원문보기

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지역사회 치면열구전색사업의 치아우식예방효과: 3년간 후향적 코호트 연구
The Effects of Community-based Sealant Program for Preventing Dental Caries in the Permanent Teeth: 3 year Retrospective Cohort Study 원문보기

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