Factors Influencing Dental Caries in 3-year-old Children : Effect of Prenatal Oral Health Examination on Behavioral Change

The aim of this study was to analyze factors influencing dental caries in 3-year-old children. In
addition, we investigated the effect of prenatal oral health examination on oral health behavior related to dental caries by a retrospective cohort study.
The subjects enrolled in this study were 647 children and their mothers who received oral health examinations from 2015 to 2020 at both the 18-month and 3-year-old health check-ups, which were conducted by Naruto City, Tokushima Prefecture, Japan. The relationship between dental caries in 3-year-old children and items related to oral health behavior were analyzed by binomial logistic regression analysis using the results of the questionnaire for the 18-month-old or 3-year-old child health check-ups. Furthermore, 480 subjects who had not received a dental check-up during pregnancy were divided into two groups: a prenatal examination group, who received prenatal oral health examination conducted by the municipality, and a non-examination group. Then, differences in oral health behavior after childbirth were analyzed between the two groups.
The prevalence rate of dental caries in 3-year-old children was 14.5%. It showed that dental caries was significantly correlated with the frequency or regularity of eating between meals, regular dental check-ups, mothers’ knowledge of periodontal disease, and smoking habits of mothers or family members. In addition, the rate of mothers/children who acquired the behavior of regular dental check-ups after childbirth significantly increased, and the rate of regular dental check-ups of the mother at the 18-month-old child checkup was higher in the prenatal examination group when compared with the non-examination group.
These results indicate that factors related to dental caries in 3-year-old children were eating between meals, regular dental check-ups, knowledge of periodontal disease, and smoking habits. Furthermore, prenatal oral health examinations may promote mothers’ acquisition of good health behavior for themselves or their child, such as understanding the necessity of having regular dental check-ups after childbirth.

　本研究の目的は，3 歳児う蝕に影響を与える要因分析，および後ろ向きコホート研究によりう蝕関連の口腔保健行動に対する妊婦歯科健康診査の有効性を検証することである．
　研究対象者は，2015 年から 2020 年までに徳島県鳴門市が実施した 1 歳 6 か月児健康診査と 3 歳児健康診査の両方で歯科健康診査を受けた 647 人の子どもとその母親である．二項ロジスティック回帰分析により，3 歳児う蝕と 1 歳 6 か月児または 3 歳児健康診査時のアンケート結果からの口腔保健行動の項目との関連を分析した．さらに，妊娠中に定期的な歯科健診を受けていなかった対象者 480 名を，鳴門市が実施した妊婦歯科健康診査を受けた妊婦健診群と非健診群の 2 群に分け，出産後の口腔保健行動の相違を 2 群間で分析した．
　3 歳児のう蝕有病率は 14.5% であり，間食回数または規則性，母親の定期的な歯科健診，歯周病に関する知識，母親または家族の喫煙習慣と有意に関連していた．また，出産後に定期的な歯科健診を受ける母子の割合は増加し，1 歳 6か月時の母親の定期歯科健診受診率は，妊婦健診群では非健診群に比べて有意に高かった．
　これらの結果から 3 歳児う蝕に関連する要因として，間食，定期歯科健診，歯周病に関する知識，喫煙習慣が示された．さらに，妊婦歯科健康診査は，出産後の定期的な歯科健診受診など，母親が自分自身や子どものための良好な保健行動獲得に影響を与える可能性がある．

内容要旨・審査要旨・論文本文の公開
本論文は，著者Harumi Sakamotoの学位論文として提出され，学位審査・授与の対象となっている。