ブラジル南部の農村部と都市部に住む学童の口腔健康状態。

Oral health status of schoolchildren living in rural and urban areas in southern Brazil.

• Ângela Dalla Nora
• Andressa Dalmolin
• Larissa D'Olanda Gindri
• Carlos Heitor Cunha Moreira
• Luana Severo Alves
• Júlio Eduardo do Amaral Zenkner

抄録

本研究では、ブラジル南部の学童のう蝕経験に対する居住地域（農村部と都市部）の影響を評価した。この横断的調査はブラジル南部のロサリオ・ド・スルで実施され、公立の市立学校に通う9-14歳の学童373名（農村部に122名、都市部に251名）を対象とした。データ収集には、質問紙と臨床検査が含まれています。永久歯列の臨床検査では、可視プラーク指数、歯肉出血指数、う蝕経験（非空洞化と空洞化、活動性病変と活動性病変）を調べた。フッ化物濃度を確認するために水のサンプルを採取した。農村部の学童と都市部の学童の間で，カイ二乗検定とマン・ホイットニー検定を用いて，異なる基準を用いてう蝕の有病率と程度をそれぞれ比較した．説明変数とう蝕活動の程度（活動性う蝕病変の数）との関連をポアソン回帰を用いて評価した。う蝕を虫歯レベル（WHO基準）で記録した場合、農村部と都市部で差は認められなかった（p ≥ 0.05）。逆に、活発な非虫歯病変を計算した場合、都市部の学童では、より高いう蝕の有病率と程度が認められた（p < 0.05）。調整したポアソン回帰モデルでは、都市部の学童は農村部の学童よりも57％多くの活動性病変を呈する可能性が高かった（RR = 1.57; 95％CI = 1.29-1.92）。農村部では水道のフッ化物濃度が十分ではなかったが、都市部では理想的な濃度が検出された。結論として、この横断的研究では、都市部の学童は農村部の学童に比べて齲蝕の経験が多く、この増加は活発な非キャビテーション病変と関連していることが明らかになった。

This study assessed the effect of area of residence (rural vs. urban) on dental caries experience among southern Brazilian schoolchildren. This cross-sectional survey was conducted in Rosário do Sul, southern Brazil, and included 373 9-14-year-old schoolchildren attending public municipal schools (122 living in the rural area, and 251, in the urban area). Data collection included a questionnaire and a clinical examination. Clinical examination of the permanent dentition involved visible plaque index, gingival bleeding index and dental caries experience (non-cavitated and cavitated, inactive and active lesions). Samples of water were collected to check the fluoride concentration. Caries prevalence and extent using different criteria were compared between rural and urban schoolchildren using the chi-square test and the Mann-Whitney test, respectively. The association between explanatory variables and the extent of caries activity (number of active caries lesions) was assessed using Poisson regression. When caries was recorded at the cavity level (WHO criterion), no difference was observed between rural and urban populations (p ≥ 0.05). Conversely, higher caries prevalence and extent were found among urban schoolchildren when active non-cavitated lesions were also computed (p < 0.05). In the adjusted Poisson regression model, urban schoolchildren were 57% more likely to present more active lesions than rural students (RR = 1.57; 95%CI = 1.29-1.92). Rural communities did not have sufficient fluoride in the water supply, whereas ideal concentrations were detected in the urban areas. In conclusion, this cross-sectional study found that urban schoolchildren showed greater caries experience than rural students, and that this increment was related to active non-cavitated lesions.