1歳半から3歳までの日本人小児におけるう蝕と乳児期の摂食および口腔保健関連行動との関連性について

Caries and Its Association with Infant Feeding and Oral Health-related Behavior in 18-month and 3-year-old Japanese Children.

抄録

本研究の主な目的は，生後 18 ヵ月から 3 歳までの日本人小児におけるう蝕の有病率と，乳児期の摂食および口腔衛生関連行動との関連を明らかにすることであった．合計387名の乳児を対象に、生後18ヵ月（一部19ヵ月）で最初の検診を行い、その後、3年後（一部3年1ヵ月）に再度検診を行った。第一の目的は、生後18ヵ月の小児におけるう蝕の有病率に影響を与える要因を明らかにすることであった。副次的な目的は、1歳半の時点でう蝕のない子どもを追跡調査し、背景因子と3歳までのう蝕の増加との間に潜在的な相関関係を求めることであった。調整後の多変量ロジスティック回帰モデルでは、母乳育児を継続している子どもは、そうでない子どもに比べて、生後18ヵ月時点でう蝕がある可能性が約7倍高かった。生後12か月頃に口腔内の検査や相談を受けた乳児は、そうでない乳児に比べて、生後18か月の時点でむし歯になる可能性が低かった。多変量ロジスティック回帰分析の結果、生後12カ月に歯科検診を受けなかった乳児は、3歳時点でのむし歯の発生率が有意に高かった。今回の結果から，長期にわたる母乳育児は，生後18ヵ月の時点での幼児期う蝕の危険因子であり，生後12ヵ月から定期的な口腔ケアプログラムを実施している乳児は，生後18ヵ月および3年の時点で幼児期う蝕を発症する可能性が低いことが示唆された．

The primary aim of this study was to determine the prevalence of dental caries and its association with infant feeding and oral health-related behavior in Japanese children between the ages of 18 months and 3 years. A total of 387 infants were initially examined at the age of 18 months (or 19 months in some cases) and then again at 3 years (or at 3 years 1 month in some cases). The primary objective was to identify factors contributing to the prevalence of caries in children aged 18 months. The secondary objective was to follow up children with no caries at the age of 18 months to seek potential correlations between background factors and the increment of caries by the age of 3 years. In an adjusted multivariate logistic regression model, children who continued breastfeeding were approximately 7 times more likely to have dental caries at 18 months of age than those who did not. Infants brought in for an oral examination and consultation at around 12 months of age were less likely to develop dental caries at 18 months of age than those who were not. Multivariate logistic regression analysis revealed that infants who did not receive a dental check-up at 12 months of age showed a significantly higher incidence of dental caries at 3 years of age. The present results suggest that prolonged breastfeeding is a risk factor for early childhood caries at 18 months of age, and that infants in whom a regular oral care program is implemented from the age of 12 months are less likely to develop early childhood caries at 18 months or 3 years.