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Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data
BACKGROUND: Early childhood is a critical stage for the prevention of dental caries. The prevalence of caries in preschool children is still high in Taiwan, where National Health Insurance covers 99% of the population. The effort to improve the oral health of preschool children should be based on co...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239081/ https://www.ncbi.nlm.nih.gov/pubmed/37268948 http://dx.doi.org/10.1186/s12903-023-03077-w |
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author | Lin, Ying-Chun Huang, Shun-Te Yen, Cheng-Wei Huang, Yung-Kai Shieh, Tzong-Ming Chi, Wei-Hsueh Yao, Wu-Lin Ho, Pei-Shan |
author_facet | Lin, Ying-Chun Huang, Shun-Te Yen, Cheng-Wei Huang, Yung-Kai Shieh, Tzong-Ming Chi, Wei-Hsueh Yao, Wu-Lin Ho, Pei-Shan |
author_sort | Lin, Ying-Chun |
collection | PubMed |
description | BACKGROUND: Early childhood is a critical stage for the prevention of dental caries. The prevalence of caries in preschool children is still high in Taiwan, where National Health Insurance covers 99% of the population. The effort to improve the oral health of preschool children should be based on conceptual model that encompasses more than individual-level factors. This study input nationwide survey data in a conceptual model to evaluate the effects of comprehensive factors related to the high prevalence of caries in preschool children. METHODS: This observation study examined factors related to the oral health of preschool children by employing a comprehensive multilevel model to analyse nationally representative data from the Taiwan Oral Health Survey of Preschool Children (TOHPC) 2017–2018. Individual-level, family-level and community-level contextual effects were evaluated through multilevel analysis in this study. The proportional change in variance (PCV) was used to compare the multilevel model with the null model and individual-level, family-level, and community-level context effects. RESULTS: The estimated deft index for preschool children was 1.34 (1.22–1.47) at age 3, 2.20 (2.08–2.32) at age 4, and 3.05 (2.93–3.18) at age 5. The overall prevalence of caries in preschool children in Taiwan was 34.27% (30.76%, 37.78%) at age 3, 51.67% (48.99%, 54.35%) at age 4, and 62.05% (59.66%, 64.44%) at age 5. The model that included the individual-, family-, and community-context levels exhibited the highest reduction of variance (PCV = 53.98%). The PCV was further reduced to 35.61% when only the level of accessibility to dental services for individuals, families, and the community was considered. For the model in which no community-context cofactors were considered and the model considering only the individual level, the PCVs were 20.37% and 5.52%, respectively. CONCLUSIONS: Our findings indicate the key components that affect oral health in preschool children and can serve as a reference for policy makers. The most notable finding of this study is that to improve the oral health of preschool children, community-level factors should be targeted. To rely solely on dentists for leading oral health education programs for children is impractical and inefficient. Training more professional oral health educators to provide additional community-based oral health promotion campaigns is critical. We suggest training more professional oral health educators to provide more community-based oral health promotion campaigns. |
format | Online Article Text |
id | pubmed-10239081 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102390812023-06-04 Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data Lin, Ying-Chun Huang, Shun-Te Yen, Cheng-Wei Huang, Yung-Kai Shieh, Tzong-Ming Chi, Wei-Hsueh Yao, Wu-Lin Ho, Pei-Shan BMC Oral Health Research BACKGROUND: Early childhood is a critical stage for the prevention of dental caries. The prevalence of caries in preschool children is still high in Taiwan, where National Health Insurance covers 99% of the population. The effort to improve the oral health of preschool children should be based on conceptual model that encompasses more than individual-level factors. This study input nationwide survey data in a conceptual model to evaluate the effects of comprehensive factors related to the high prevalence of caries in preschool children. METHODS: This observation study examined factors related to the oral health of preschool children by employing a comprehensive multilevel model to analyse nationally representative data from the Taiwan Oral Health Survey of Preschool Children (TOHPC) 2017–2018. Individual-level, family-level and community-level contextual effects were evaluated through multilevel analysis in this study. The proportional change in variance (PCV) was used to compare the multilevel model with the null model and individual-level, family-level, and community-level context effects. RESULTS: The estimated deft index for preschool children was 1.34 (1.22–1.47) at age 3, 2.20 (2.08–2.32) at age 4, and 3.05 (2.93–3.18) at age 5. The overall prevalence of caries in preschool children in Taiwan was 34.27% (30.76%, 37.78%) at age 3, 51.67% (48.99%, 54.35%) at age 4, and 62.05% (59.66%, 64.44%) at age 5. The model that included the individual-, family-, and community-context levels exhibited the highest reduction of variance (PCV = 53.98%). The PCV was further reduced to 35.61% when only the level of accessibility to dental services for individuals, families, and the community was considered. For the model in which no community-context cofactors were considered and the model considering only the individual level, the PCVs were 20.37% and 5.52%, respectively. CONCLUSIONS: Our findings indicate the key components that affect oral health in preschool children and can serve as a reference for policy makers. The most notable finding of this study is that to improve the oral health of preschool children, community-level factors should be targeted. To rely solely on dentists for leading oral health education programs for children is impractical and inefficient. Training more professional oral health educators to provide additional community-based oral health promotion campaigns is critical. We suggest training more professional oral health educators to provide more community-based oral health promotion campaigns. BioMed Central 2023-06-02 /pmc/articles/PMC10239081/ /pubmed/37268948 http://dx.doi.org/10.1186/s12903-023-03077-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lin, Ying-Chun Huang, Shun-Te Yen, Cheng-Wei Huang, Yung-Kai Shieh, Tzong-Ming Chi, Wei-Hsueh Yao, Wu-Lin Ho, Pei-Shan Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data |
title | Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data |
title_full | Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data |
title_fullStr | Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data |
title_full_unstemmed | Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data |
title_short | Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data |
title_sort | comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239081/ https://www.ncbi.nlm.nih.gov/pubmed/37268948 http://dx.doi.org/10.1186/s12903-023-03077-w |
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