Multilevel analysis of factors influencing dental caries in 12-year-old children in two regions of Qinghai province, China

Objective To investigate the oral health status of 12-year-old children in Xining and Haidong, Qinghai province, China as well as the influencing factors at individual and school levels, and to provide a basis for developing and improving oral intervention policies for children in Qinghai province.

Methods Using the data from the fourth oral epidemiological survey in Qinghai Province in 2016, a multilevel logistic regression model was used to analyze oral health status and related influencing factors among 813 children aged 12 years.

Results The prevalence rate of dental caries among 12-year-old children in the two regions of Qinghai Province was 29.90%. The prevalence rate of dental caries was significantly higher in girls than in boys (33.33% vs. 26.37%, χ²=4.71, P=0.030). Rural children had a slightly higher prevalence rate of dental caries than urban children, which was not significant (30.49% vs. 28.97%, χ²=0.21, P=0.644). The oral health status of children was aggregated at the school level (σ_μ²=0.002, P<0.001). The multilevel logistic regression analysis showed that female was a risk factor for dental caries in children (odds ratio OR=1.48, 95% confidence interval CI: 1.08-2.02); a high school diploma or higher of the mother was a protective factor against dental caries in children (OR=0.62, 95%CI: 0.39-0.93); poor or moderate self-rated oral health was a risk factor for dental caries (OR_poor= 1.94, 95%CI: 1.21-3.16; OR_moderate=1.46, 95%CI: 1.01-2.14); believing that "regular oral examinations are necessary" is incorrect or having no idea was a risk factor for dental caries in children (OR=1.21, 95%CI: 1.12-1.54).

Conclusion In Xining and Haidong of Qinghai province, dental caries is still a serious problem among 12-year-olds, and effective comprehensive oral intervention measures should be implemented, which are particularly important for girls. Schools should act as an effective platform to provide targeted oral health courses, regular oral examinations, and oral health education for parents, to help children establish a correct concept of oral health and develop good oral health behaviors to reduce the incidence of dental caries.