Dental caries status and its influencing factors among residents in plateau regions: a comparative cross-sectional study of Rikaze and Chongqing

Duan Weifeng; Xue Linyu; Liu Hui; Cong Yaqi; Tan Ruoxue; Wei Hanqing; Dawa Zhuzha; Zhou Xia

doi:10.16016/j.2097-0927.202606020

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Dental caries status and its influencing factors among residents in plateau regions: a comparative cross-sectional study of Rikaze and Chongqing

Think Tank for Public Health | 更新时间：2026-10-19

- Dental caries status and its influencing factors among residents in plateau regions: a comparative cross-sectional study of Rikaze and Chongqing
- Journal of Army Medical University Vol. 48, Issue 19, Pages: 2780-2789(2026)
- 作者机构：
  
  1.中国人民解放军陆军第九五三医院门诊部，西藏日喀则
  2.陆军军医大学（第三军医大学）大坪医院口腔科，重庆
  3.西藏军区总医院口腔科，西藏拉萨
- 作者简介：
  
  Zhou Xia， E-mail： dentistzx@tmmu.edu.cn
- 基金信息：
  
  the Science and Technology Projects of Rikaza City(RKZ2025ZR-002);the Natural Science Foundation of Xizang Autonomous Region(XZ202501ZR0050);the General Project of Natural Science Foundation of Chongqing(CSTB2024NSCQ-MSX0043)
- DOI：10.16016/j.2097-0927.202606020
  CLC： R195.4;R339.54;R781.1
- Received：05 June 2026，
  
  Revised：2026-08-08，
  
  Accepted：20 August 2026，
  
  Published：15 October 2026
- 稿件说明：
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段伟峰，薛琳瑜，刘辉，等.高原地区居民龋病现况调查及其影响因素分析：一项日喀则与重庆的对比横断面研究［J］.陆军军医大学学报，2026，48（19）：2780-2789.DOI：10.16016/j.2097-0927.202606020.

Duan W F，Xue L Y，Liu H，et al.Dental caries status and its influencing factors among residents in plateau regions： a comparative cross-sectional study of Rikaze and Chongqing［J］.J Army Med Univ，2026，48（19）：2780-2789.DOI：10.16016/j.2097-0927.202606020.
段伟峰，薛琳瑜，刘辉，等.高原地区居民龋病现况调查及其影响因素分析：一项日喀则与重庆的对比横断面研究［J］.陆军军医大学学报，2026，48（19）：2780-2789.DOI：10.16016/j.2097-0927.202606020. DOI：

Duan W F，Xue L Y，Liu H，et al.Dental caries status and its influencing factors among residents in plateau regions： a comparative cross-sectional study of Rikaze and Chongqing［J］.J Army Med Univ，2026，48（19）：2780-2789.DOI：10.16016/j.2097-0927.202606020. DOI：

摘要

目的

高原地区特殊环境（低氧、低温、干燥、强紫外线）可能影响口腔微生态及居民口腔健康，但目前针对高原与平原地区居民龋病流行情况及口腔健康知信行的系统性比较研究仍较缺乏。本研究旨在调查西藏日喀则市市区居民龋病患病状况及口腔健康知信行水平，并与平原地区（重庆市）居民进行对比，分析龋病与知信行水平（knowledge-attitude-practice， KAP）的关联性，以期为高原地区口腔疾病防控策略的制定提供科学依据。

方法

采用横断面研究设计方案，以分层整群抽样方法抽取西藏日喀则市市区（高原组，1 196例）和重庆市（平原组，1 297例）3岁以上常住居民。由经世界卫生组织口腔健康调查规范培训并通过标准一致性检验的调查员（Kappa=0.82）进行口腔检查，记录患龋率、龋均及因龋缺牙修复方式，同时采用自制KAP问卷收集居民的口腔健康认知、态度和行为数据统计分析KAP得分与龋病的关联。

结果

高原组患龋率为93.0%~99.5%（随年龄增长而升高），龋均（decayed，missing and filled teeth，DMFT）随年龄增长从（6.9±3.9）升至（14.5±6.8），均显著高于第四次全国口腔健康流行病学调查报告同年龄组水平。高原组因龋缺牙后实际修复率仅6.4%，远低于平原地区及全国平均水平，且未普及种植修复。高原组居民在口腔健康认知（正确刷牙方法知晓率48.7%

84.7%）、态度（“口腔疾病应得到重视”认同率4.8%

90.7%）及行为（每天刷牙≥2次比例24.8%

76.9%）各维度得分均显著低于平原组（均

0.05）。多因素Logistic回归显示，校正年龄、性别、民族、文化程度等因素后，认知得分（

=0.10，95%

：0.07~0.13）、态度得分（

=0.21，95%

：0.18~0.26）、行为得分（

=0.13，95%

：0.10~0.17）每增加1分，龋病发生风险分别降低90%、79%和87%（均

0.05）。多因素线性回归显示，海拔高度、年龄、民族及文化程度均是KAP得分的独立影响因素（均

0.05）。

结论

高原地区居民面临龋病高发（患龋率87.7%~99.5%）与极低修复率（6.4%）的双重困境，口腔健康KAP水平全面落后于平原地区，且KAP水平是龋病的独立保护因素。高原自然环境、低认知水平、薄弱态度与不规范行为共同构成龋病高发的复合危险因素。对策　建议立足国家《儿童青少年“五健”促进行动计划（2026—2030年）》，在藏区落实儿童口腔保健指导率80%以上及每年10 000颗窝沟封闭目标，将口腔健康知识纳入中小学课程和社区卫生宣教；扩大藏区“一口好牙”关爱机制，覆盖全年龄段人群，定期开展口腔检查及卫生保健宣教；利用三级医院援藏帮扶机制，培养本地口腔卫生人才，提升藏区口腔基层服务能力；加快龋病预防产品研发，降低高原地区龋病发生率。

Abstract

Objective

The unique environment of plateau regions (low oxygen

low temperatures

dryness

and intense ultraviolet radiation) may affect the oral microbiome and oral health of residents. However

there remains a lack of systematic comparative studies on the prevalence of dental caries and oral health knowledge

attitude

and practice (KAP) between residents in the plateau and plain regions. This study aims to investigate the prevalence of dental caries and the levels of oral health KAP among residents in the urban area of Rikaze

Xizang

to compare these findings with residents in a plain area (Chongqing)

and to analyze the association between dental caries and KAP levels

providing a scientific basis for the formulation of oral disease prevention and control strategies in plateau regions.

Methods

A cross-sectional study design was adopted. Permanent residents aged 3 years and above were selected from the urban area of Rikaze

Xizang (high-altitude group

=1 196) and from Chongqing (plain group

=1 297) by stratified cluster sampling. Oral examinations were conducted by investigators trained in accordance with the World Health Organization’s oral health survey guidelines who had passed a standardization test (Kappa=0.82). The investigators recorded the prevalence of dental caries

mean number of decayed

missing

and filled teeth (DMFT)

and types of restorations for caries-related tooth loss. Additionally

a self-designed KAP questionnaire was used to collect data on residents' oral health knowledge

attitudes

and behaviors. Statistical analysis was performed to examine the association between KAP scores and dental caries.

Results

The caries prevalence in the plateau group ranged from 93.0% to 99.5% (increasing with age)

and the mean DMFT number increased from 6.9±3.9 to 14.5±6.8 with age

both significantly higher than those of the same age groups reported in the Fourth National Oral Health Epidemiological Survey. The actual restoration rate for teeth lost due to caries in the plateau group was only 6.4%

far lower than the average rat

e in plain areas and the national average

and no implant restoration was detected. Residents in the plateau group scored significantly lower than those in the plain group across all oral health KAP dimensions: knowledge (awareness of correct brushing techniques: 48.7%

84.7%)

attitude (agreement that “oral diseases should be taken seriously”: 4.8%

90.7%)

and behavior (proportion brushing teeth ≥2 times daily: 24.8%

76.9%) (all

0.05). Multivariate logistic regression analysis showed that after adjusting for age

gender

ethnicity

and education level

and other factors

every 1-point increase in the knowledge score (

=0.10

95%

: 0.07 to 0.13)

attitude score (

=0.21

95%

: 0.18 to 0.26)

and practice score (

=0.13

95%

: 0.10 to 0.17) was associated with a 90%

79%

and 87% reduction in caries risk

respectively (all

0.05). Multivariate linear regression analysis indicated that altitude

age

ethnicity

and education level were all independent influencing factors for KAP scores (all

0.05).

Conclusion

Residents in plateau regions face the dual dilemma of high caries prevalence (93.0% to 99.5%) and an extremely low restoration rate (2.1%). Their oral health KAP levels lag significantly behind those in plain area residents in all dimensions

and KAP levels serve as an independent protective factor against dental caries. The natural environment of the plateau

low levels of knowledge

negative attitudes

and non-compliant behaviors jointly constitute the composite risk factors for the high incidence of dental caries. Countermeasures It is recommended to build upon the national "Five Health" Promotion Action Plan for Children and Adolescents (2026 to 2030)

implementing in Xizang a target of over 80% coverage of oral health care guidance for children and 10 000 pit-and-fissure sealants per year

and incorporating oral health knowledge into school curricula and community health education; to expand the “Healthy Teeth” care mechanism in Xizang to cover all age groups

providing regular dental examinations and oral health education; utilize the assistance mechanism provided by tertiary hospitals supporting Xizang to train local dental professionals and improve primary oral health care capacity in Xizang areas; and to accelerate the development of caries prevention products to reduce the incidence of dental caries in plateau regions.

关键词

Keywords

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