ČIMBENICI ORALNOGA ZDRAVLJA ŠKOLSKE DJECE NA URBANOM I RURALNOM PODRUČJU

disertacija

• Naslov (engleski): SCHOOL CHILDREN ORAL HEALTH FACTORS IN URBAN AND RURAL AREAS
• Autor: Stjepanka Lešić
• Mentor: Walter Dukić (mentor)
• Član povjerenstva: Katica Prskalo (predsjednik povjerenstva)
• Član povjerenstva: Bernard Janković (član povjerenstva)
• Član povjerenstva: Zrinka Tarle (član povjerenstva)
• Član povjerenstva: Domagoj Glavina (član povjerenstva)
• Član povjerenstva: Dubravka Negovetić Vranić (član povjerenstva)
• Ustanova koja je dodijelila akademski / stručni stupanj: Sveučilište u Zagrebu; Stomatološki fakultet; (Zavod za dječju i preventivnu stomatologiju); Zagreb
• Datum i država obrane: 2019-01-29, Hrvatska
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Dentalna medicina; Dječja i preventivna dentalna medicina
• Univerzalna decimalna klasifikacija (UDC): 616.31 - Stomatologija

Sažetak

Cilj istraživanja: Utvrditi prevalenciju karijesa i povezanost zatečenog stanja s poznatim čimbenicima rizika za nastanak karijesa na uzorku školske djece iz ruralnog i urbanog područja Hrvatske, te analizirati razlike u rasprostranjenosti karijesa i povezanost oralnog zdravlja sa socioekonomskim statusom (SES) kao i prehrambenim (PN) i oralno-higijenskim (OHI) navikama ispitanika. Ispitanici i metode: Istraživanje je obuhvatilo 1874 osnovnoškolske djece ruralnog i urbanog područja Republike Hrvatske: Štitara i Babine Grede (ruralno) te Županje, Zagreba i Dubrovnika (urbano). U standardiziranim uvjetima prema kriterijima Svjetske zdravstvene organizacije (WHO), vizualno-taktilnom metodom pregledani su zubi osnovnoškolske djece te zabilježeni njihovi oralni statusi. Ispitanici su ispunili i upitnike o svojim OHI, PN i SES-u. U ovom istraživanju izračunati su dmft/DMFT, dmfs/DMFS i SiC indeksi te je provedena analiza ispunjenih upitnika. Rezultati: Prevalencija karijesa trajnih zubi iznosila je 50,0 % sveukupno pregledane djece, od čega je 70,2 % (ruralno) i 46,0 % (urbano). Medijan DMFT-a sveukupno pregledane djece iznosio je 2; 4 (ruralno), 2 (urbano) (p<0,001). Po regijama, medijan DMFT-a za Slavoniju iznosio je 3, za Zagreb 1 te za Dubrovnik 1 (p<0,001). Među 12-godišnjom djecom srednja vrijednost DMFT-a iznosila je 3,4; a medijan DMFT-a ruralno bio je 4 te urbano 3. Postoji statistički značajna razlika između mlađe (6 ‒ 10 godina) i starije djece (11 ‒ 16 godina), čiji su DMFT i DMFS indeksi značajno veći (p<0,001). Sveukupni medijan SiC indeksa bio je 4; ruralno 4, urbano 4. Sveukupni medijan dmft-a iznosio je 1, dok je najveći medijan dmft-a izmjeren kod 6-godišnje djece (9 ruralno i 7 urbano). Analizom upitnika utvrđena je pozitivna statistički visoko značajna povezanost između SES-a i učestalosti pranja zubi te stupnja OH-a, kod mlađe i starije djece te kod roditelja mlađe djece. Jednostavnom linearnom regresijskom analizom utvrđeno je postojanje slabe, negativne i statistički značajne povezanosti između SES-a i oralnog zdravlja mlađe i starije djece. Zaključak: Rezultati istraživanja pokazali su veliku prevalenciju karijesa od 50 % među djecom osnovnih škola u istraživanim dijelovima Hrvatske. Nameće se potreba za epidemiološkim istraživanjem koje će obuhvatiti sva područja Hrvatske uz pomoć kojega bi se mogli postaviti ciljevi potrebnih preventivnih programa i kurativne skrbi.

Sažetak (engleski)

Aim: The aim of this study was to establish the caries prevalence and the connection between the recorded resultsand the known risk factors for caries development, on the sample of schoolchildren from rural and urban areas of Croatia. The purpose was also to analyse the differences in caries prevalence in different regions of Croatia and the connection of oral health to socioeconomic status (SES) and to dietary and hygiene habits.
Subjects and methods: The study included 1874 elementary schoolchildren in rural and urban areas of Croatia: Štitar and Babina Greda (rural population) as well as Županja, Zagreb and Dubrovnik (urban population). Children’s teeth were examined under standardized conditions using visual-tactile method and their oral health status was recorded, according to the World Health Organization (WHO) criteria. The dmft/DMFT, dmfs/DMFS and SiC indexes were calculated and the analysis of the filled questionnaires was done.
Results: Caries prevalence of all schoolchildren was 50,0%, of which 70,2% was from rural and 46% from urban areas. Median DMFT of all schoolchildren was 2, in rural area it was 4 and in urban area it was 2 (p<0,001). Considering regions, median DMFT for Slavonia was 3, and for both Zagreb and Dubrovnik it was 1 (p<0,001). The mean DMFT for all 12-year-olds was 3,4 whilst median DMFT was 4 in rural and 3 in urban areas. There was a statistically significant difference between younger (6–10 years of age) and older (11–16 years of age) schoolchildren, where DMFT and DMFS indexes of latter were significantly higher (p<0,001). Median SiC index of all schoolchildren was 4; in rural areas was 4 and in urban areas was 4. Median dmft of all schoolchildren was 1 and the highest median dmft score was found in 6-year-olds (it was 9 in rural and 7 in urban areas). The questionnaire analysis showed positive and statistically highly significant interconnection between SES and the frequency of tooth brushing as well as between SES and oral hygiene level. That interconnection was found in younger and older schoolchildren groups, as well as in younger schoolchildren's parents. The simple linear regression analysis showed a weak and negative, statistically significant
interconnection between SES and oral health status of younger (6-10 years of age) and older (11-16 years of age) schoolchildren.
Conclusion: The study results showed high caries prevalence of 50% among schoolchildren in primary schools in investigated parts of Croatia. Schoolchildren in investigated rural and urban areas of Croatia fall into moderate to high DMFT group, according to WHO classification of DMFT. Those results indicate the need for a comprehensive epidemiological research involving all areas of Croatia which could help in setting goals for necessary preventive programmes and curative care. Only SES, of all investigated caries risk factors, showed the influence on the oral health of the examinees, the higher the SES, the higher was the oral health. In conclusion, there is a need for good preventive strategy, a systematic education of the parents, children, dental medicine doctors and entire population on the importance of oral health and caries prevention as well as on the necessity of preventive programmes implementation.

• Ključne riječi: karijes; epidemiologija; urbano; ruralno; DMFT; DMFS; SiC; karijes indeksi; socioekonomski status; prehrambene navike; oralna higijena
• Ključne riječi (engleski): caries; epidemiology; urban; rural; DMFT; DMFS; SiC; caries indexes; socioeconomic status; dietary habits; oral hygiene
• Jezik: hrvatski
• URN:NBN: urn:nbn:hr:127:929195
• Studijski program: Naziv: Dentalna medicina; Vrsta studija: sveučilišni; Stupanj studija: poslijediplomski doktorski; Akademski / stručni naziv: doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina (dr.sc.)
• Vrsta resursa: Tekst
• Način izrade datoteke: Izvorno digitalna
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2020-01-14 12:28:53