生活方式及心理社會因素與台灣成年人之慢性牙周炎的相關性研究--以醫院為基礎的配對式病例對照等研究

Lifestyle and Psychosocial Factors associated with Chronic Periodontitis in Taiwanese Adults： A Hospital-based and Pair-matched Case-Control Study, et al.

鄧秀珍(Hsiu-Chen Teng)

指導教授 ： 蔡吉政 ； 張永源

高雄醫學大學/口腔醫學院/牙醫學研究所/博士(2003年)

摘要

中文摘要
背景：慢性牙周炎是多重因子的疾病，無法由少數因子來完全解釋其所有的變異性。本系列研究以三個都是醫院為基礎的病例對照回溯性研究設計來執行，其中分別是非配對式、配對式和以35歲的年齡為分層的研究，其主要目的主要有兩項：
一、 同時分析生活型態及心理社會因子與慢性牙周炎之相關性。
二、 針對特定的危險因子，估計慢性牙周炎的可歸因百分率。
方法：本系列研究中：非配對式病例對照的研究設計，共計252位病例個案及309位對照個案；配對式病例對照回溯性的研究設計，共計250位病例個案及250位以年齡（相差三歲以內）及性別配對的對照個案；以年齡為分層的病例對照研究設計，共計129位年輕成人群及432位年長成人群。本研究同時收集以上所有病例組及對照組的口腔檢查及問卷資料，並應用多變項對數迴歸分析多重因子與慢性牙周炎之相關性。
結果：本系列研究結果發現：吸菸、刷牙頻率及身心健康與慢性牙周炎的發生最具顯著性相關。以配對式病例對照研究為例，以上三者與牙周病的發生不但有顯著性相關，而且都呈現顯著的劑量效應關係。如果刷牙頻率很低，相對於一天刷兩次以上者、身心狀況差相對於狀況佳者以及吸菸量達21包年以上相對於從不吸菸者，其慢性牙周炎發生機會分別是5.77、5.32及3.93倍。
結論：對於台灣成年人而言，有36.1%的慢性牙周炎病人，可歸因於刷牙頻率太低、身心健康狀況差以及抽菸量過高所致。因此，若欲建立一個積極有效的預防保建計畫以提升牙周健康狀況，則應先從這三點著手，也就是宣導刷牙的重要性、提升身心健康以及建議減低抽菸量。
關鍵詞：危險因子；可歸因危險；牙周炎；身心疾病

關鍵字

危險因子 ； 牙周炎 ； 可歸因危險 ； 身心疾病

並列摘要

Abstract
Background: The development of chronic periodontitis (CP) is a multifactorial process. It should be noted that the variation in severity of the CP could not be explained only by few risk factors. Three case-control retrospective studies were conducted among a population of Taiwan adults. The aims were: 1) to explore simultaneously the lifestyle and psychosocial factors of the CP, and 2) to estimate the proportion of total CP cases attributable to one or more risk factors considered.
Methods: Thee study designs were the case-control retrospective study, the matched case-control retrospective study and age-stratified case-control study, 252 cases of CP patients and 309 controls, 250 cases and 250 controls were matched by age (within 3 years) and gender, 129 young adults (18-34 years) and 432 older adults ( ³ 35 years), respectively. For both case and control groups, complete dental examinations were performed based on the clinical criteria for CP. Structured questionnaires were conducted to collect lifestyle and psychosocial factors. Multivariate logistic regression was applied to assess the association between risk factors and chronic periodontitis.
Results: This study showed that tooth-brushing frequency, mental illness and smoking were the most significantly risk factors of CP. For example, pair-matched case-control retrospective study showed that tooth-brushing frequency (OR: 5.77, if rarely; OR: 3.50, if once a day), mental illness (OR: 5.32, if CHQ-12 scores were ³ 6), and smoking (OR: 3.93, if pkyrs smoked was more than 21) are significantly and independently associated with chronic periodontitis. In addition, all these variables reflected a dose-response effect (P trend = <0.001, 0.004, and 0.005, respectively).
Conclusions: For Taiwanese adults, 36.10% of CP cases were presumably attributable to tooth-brushing frequency, mental illness and smoking. These three factors should be the first priority in establishing a preventive program in order to improve periodontal health status.
Key Words: Taiwan; risk factors; attributable risks; periodontitis; mental illness.

並列關鍵字

Taiwan ； risk factors ； attributable risks ； periodontitis ； mental illness

參考文獻

參考文獻

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