南區機構內老年失智症者的口腔健康狀況調查

An Investigation of the Oral Health Status of the Elderly with Senile Dementia in Southern Institutes

蘇珮孜(Pei-Tzu Su)

指導教授 ： 黃純德

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2008年)

https://doi.org/10.6832/KMU.2008.00064

摘要

背景：
失智症(Dementia)已成為二十一世紀「流行病」。國外研究發現失智症患者口腔健康普遍不佳。但目前國內缺乏失智症者方面的口腔相關研究，為了針對老人失智者的口腔健康狀況做改善，必須先瞭解國內老年失智者的口腔健康狀況。
研究目的：
為瞭解失智老人口腔健康狀況，基本人口學、咀嚼/吞嚥狀況、最近半年內的飲食狀況、口腔衛生習慣，進而探討失智者基本口腔狀況、瞭解失智者口腔衛生習慣、看牙醫經驗的現況及受影響的因素。以及瞭解失智者口腔狀況的影響因素。
研究方法：
原先聯絡五家長期照護機構，基於設有失智專區可以集中失智人數，加上願意配合且能維持良好互動的場所，故選擇不同屬性及願意配合的機構，採取立意取樣針對高屏地區三家長期照護機構的住民，利用問卷及口檢進行資料收集，全部樣本共149人。先以Microsoft Access 軟體設計資料庫，再將所收到的口腔檢查表與問卷經過譯碼及編碼後鍵入資料庫內，以SAS8.0與JMP5.0統計套裝軟體進行統計分析。
結果：
研究分析結果顯示，老年失智症者平均DMFT index為24.41±8.04，平均齲齒率66.44％，平均齲齒數（D）3.91±5.32，平均缺牙數（M）20.44±9.88，平均填補率（F）0.05±0.38，平均缺牙率80.67±25.01。在DMFT中以85歲以上25.35±8.21為最高。影響DMFT index的重要原因是老年失智症者沒有定期行口腔檢查，呈現牙痛時才就醫，而產生更嚴重的口腔健康問題。
結論：
研究結果顯示隨著年齡的增加，失智症的盛行率愈高，主要以阿茲海默氏症居多，近一半的失智老人普遍有咀嚼吞嚥的問題及可能是因牙痛或口腔問題所引起拒絕吃東西的行為，吞嚥困難伴隨著口腔乾燥，加上無法自行行口腔清潔，造成口腔衛生不佳，為提昇長期照護機構的失智老人的口腔健康，需要照護者及牙科相關專業衛生人員共同來維護失智者良好的口腔衛生狀況。

關鍵字

失智症 ； 老年 ； 口腔健康

並列摘要

Background:
Dementia has become an epidemic disease in the 21st century. Research from other countries has show that the oral health condition of those suffering with dementia is usually poor. However, there are fewer studies about oral health of the elderly with senile dementia in Taiwan. By improving the current oral health condition of the elderly with senile dementia, we must get a better understanding of it.

Study objective:
The purpose of this study was to investigate the oral health condition of the elderly with senile dementia, basic demography, the state of chewing / swallowing, diet state in the most recent six months, and oral hygiene habits. Furthermore, to understand the basic oral state, the hygiene habits and the experience of dental visits and the influencing factors of it and the influencing factors of the oral status .

Method:
Five long-term care institutions were enrolled in this study. Because the reason that the dementia area can gather the dementia population, also the ones whom can be well-cooperated, therefore, choose different institutions that are willing to be cooperative. Information was collected by a questionnaire and oral health examination of three long-term care institutions in the greater Kaohsiung-Pintung area. This research applied questionnaires and oral examinations to collecting data. There were 149 samples in total. After finishing the preliminary investigation, a database was designed using Microsoft Access software. Then, the questionnaire and oral health examination were coded before analyzing them by using the software package SAS8.0 and JMP 5.0.

Result:
According to the research analysis, the average DMFT index of the elderly with senile dementia was 24.41±8.04, the average caries prevalence was 66.44％, the average number of caries teeth (D) was 3.91±5.32, the average number of missing teeth (M) was 20.44±9.88, the average number of filled teeth (F) was 0.05±0.38, the average number of missing rate was 80.67±25.01. In DMFT, the average of the group aged over 85 years old was the highest, was 25.35±8.21. The most important factor influencing the was DMFT index was that the elderly with senile dementia patients don’t have an oral health examination regularly. They go to the doctor when they have a toothache. This causes more serious oral health problems.

Conclusion:
The results of this study show that dementia occurs more with the increase of age. Mainly, because of Alzheimer’s Disease, approximately half of the elderly with senile dementia have the problems with swallowing and chewing food because of toothache or an oral health condition that makes them refuse to eat. Difficulty in swallowing because of oral dryness and unable to do oral cleaning by themselves brings about worse oral hygiene. In order to promote oral health for the elderly with senile dementia in the long-term care institutions, the care givers and dental professionals cooperation is necessary to help of the elderly with senile dementia to maintain good oral hygiene.

並列關鍵字

Dementia ； senile ； elderly ； oral health

參考文獻

參考文獻

中文部分

1.台灣失智協會。失智症亞太地區盛行報告。取自

http://www.tada2002.org.tw/~tada/。2006年10月14日取得。

2.行政院主計處。2005年65歲以上老年人人口總數。取自