*中心館藏網址:http://tulips.ntu.edu.tw/record=b2180872*cht

[ 摘要 ]
學齡前兒童正是乳牙發育及脫落時期，也是恆牙正值發育時期，唯因未作好口腔衛生，在尚未掉落前幾乎多已齲齒。根據研究顯示台灣地區五歲小孩齲齒指數男童達6.5，女童達8.4。據部分相關研究顯示山地鄉部份小學學童齲齒盛行率有高達百分之一百，而治療率低至零者。學齡前兒童齲齒未經治療不僅會影響恆齒的發育及兒童健康，更影響孩童的心理。除了山地鄉醫療資源較不足，可能影響齲齒的治療外，究竟影響山地鄉托兒所幼稚園兒童齲齒因素及其口腔狀況為何，實有待探討。
因此本研究主要是以台灣省屏東縣八個山地鄉幼稚園、托兒所三至六歲兒童為範圍，進行口腔檢查及以結構式問卷訪視孩童的家長或生活照顧者，探討兒童齲齒狀況及其影響因素，以期提供政府擬定及執行口腔保健計劃之參考。
本研究計取得屏東縣山地鄉三至六學齡前兒童口腔檢查卡共584份，其中有邏輯錯誤及年齡性別不詳的份數為56份，共計528份完整資料進入分析，其中男童277位，女童251位，其年齡別3-4歲組有178人佔33.7%，4-5歲組有215人佔40.7%，5-6歲組有135人佔25.6%。
另依據各鄉人口結構隨機抽樣170份，具有口腔檢查卡及問卷調查者，進行齲齒與相關因素分析探討。
口腔檢查結果(n=528)，齲齒盛行率每百人為78.96，乳齒齲蝕顆數(deft)平均為5.33顆，乳齒齲蝕面數(defs) 平均為9.90面；齲齒內容: 齲蝕齒數(dt)5.01顆，缺牙數0.02顆，填補齒數0.30顆；齲齒型態分佈以溝隙型態(fissure pattern)佔多數。
影響學齡前兒童牙齒健康因素與孩童的年齡﹑母親及主要照顧者教育程度(本研究65.7%主要照顧者來自母親)﹑主要照顧者自覺幼童牙齒好不好、吃含糖食物等有統計學上意義。在同時期研究結果比較中，發現屏東縣平地鄉學齡前兒童及屏東縣山地鄉學齡前兒童齲齒盛行率相差14.47%，齲齒顆數(deft)3.36比5.33，齲齒面數(defs)5.66比9.90，顯見八個山地鄉齲齒狀況嚴重除照顧者態度、行為影響外，其無牙醫師照護也是重要因素。

[ 英文摘要 ]The preschool children’s milk teeth are in the period of developing or dropping,in the mean while, permanent teeth are growingDue to lack of doing good oral hygiene, the milk teeth are almost decayed beforethey fall. The formal study shows that caries indexes among 5 years old children in Taiwan area are 6.5(boys) and 8.4(girls). Refer to some related studies, it appears that the prevalence rate of caries in some of the mountain area elementary school studentsreaches to 100%, but the treatment rate is low to 0%! If preschool children with caries hadn’t been well cared, they would be deeply affected not only in their permanent teeth’s development and health, but also mental condition. Besides the poor medical resources, what else factors can affect the caries and oral status of preschool children in mountain area? It’s worthy for us to study.
This study is mainly based on 3 to 6 years old children, cases are selected from 8nursery schools and kindergartens in mountain areas of Pingtung county, Taiwan province.
There are two statistic methods: oral examine cards and structured questionnaires. The goal of this study is to understand the status and causes of dental caries in mountain area preschool children and wish to provide suggesstions for health government.
A total of 584 children’s oral examine cards were collected, 528valid to analyse, 277 boys and 251 girls, 178 aged 3-year to 4-year (33.7%), 215 aged 4-year to 5-year (40.7%), 135 aged 5-year to 6-year( 25.6%), and the complete rate was 90.41%. In other way, a total of 170 were selected by clustered sampling for the study of oral status and affected factors, with the structed questionnaires answered by their parents or conservators.
The results revealed that the dental caries prevalence rate was 78.96% ,the mean deft of all children was 5.33, and the defs was 9.90. The fissure pattern was the most common seen.
We concluded that besides children’s ages, the educational levels and attitudes towards oral health , and sweet intakes show statistical correlation. Among these factors, sweet intakes are the major one . In Pingtung, we compare the preschool children with the preschool children in mountain areas, the prevalence rate of dental caries former is lower 14.47% than latter, the deft is 3.36 to 5.33, and the defs is 5.66 to 9.90.
It appears that the dental caries status of preschool children in mountain areas of Pingtung county is serious. Obviously, except the attitudes and behaviors of their parents or conservators, no dental manpower is also the important factor.