矯正機關男性收容人安非他命使用者與非使用者之口腔健康狀況探討

背景:甲基安非他命的濫用問題已成為全球之非法藥物成長最快速之一。在矯正體系中之成年收容人，有極高比例是因為非法藥物濫用而入監服刑。而許多文獻中常提及因吸食甲基安非他命而造成高盛行率之牙科疾病罹患率。爰此，希望藉由研究能更瞭解收容人吸食安非他命之口腔健康相關問題及照護需求。研究目的:為瞭解南部某間矯正機構入監服刑一年內之男性收容人安非他命使用者與非使用者口腔健康相關因素之調查。研究方法:採橫斷式研究設計，針對南部某間矯正機構入監一年內之男性25~55歲收容人，於2013年2月至3月間，以立意取樣方式進行結構式問卷調查及口腔健康檢查來瞭解研究對象之口腔健康狀況。抽樣有效樣本數為296人，有效回收率為97.69%。統計方法有描述性統計、t 檢定、卡方檢定、變異數分析及邏輯斯迴歸分析。結果:本研究利用邏輯斯迴歸分析，結果發現，「吸食安非他命」為影響齲齒指數、牙根齲齒、殘根、社區牙周指數的重要變項，與四個依變項皆達統計上顯著性差異。影響口腔健康狀況因素中，年齡、職業、每日刷牙次數、定期看牙醫、喝含糖飲料、吸食安非他命、嚼食檳榔、吸菸、喝酒等九個自變項被認為是對齲齒指數、社區牙周指數、牙根齲齒與殘根等依變項有重大影響之危險因子。在控制這些變項後發現，每日刷牙次數、定期看牙醫、吸食安非他命、嚼食檳榔、吸菸等五個自變項皆與依變項在統計上有顯著性差異。。結論:研究發現曾吸食安非他命者牙齒疾病盛行率高於未吸食者，相對牙科治療需求也比未吸食者高。惟改善收容人的口腔健康才能改善整體的健康。建議未來能建立有組織的口腔保健知識和飲食諮詢計畫，重視口腔健康教育，加強宣導藥物使用及高糖飲食對口腔健康的危害，而入監服刑亦是介入衛教及口腔健康促進的良好時機。

關鍵字

甲基安非他命；矯正機構；口腔健康；齲齒指數

並列摘要

Background: The problem of methamphetamine abuse is one of the world’s most rapidly increasing illegal drug cases. A high proportion of adult inmates in correction systems are imprisoned due to illegal drug abuse. Many studies also emphasize the relationship between the high rate of dental diseases and the use of methamphetamine. Given that, the researcher aims to conduct a study to better understand the oral health issues and required care among inmates who once took methamphetamine. Objective: To investigate the oral health-related factors between male inmates who once took methamphetamine and those who did not (with both groups having been imprisoned for no more than one year) in a correction facility in Southern Taiwan. method: Cross-sectional research was conducted during February and March 2013 with the subjects being inmates aged 25-55 who had been imprisoned for no more than one year in a correction facility in Southern Taiwan. Purposive sampling was adopted for a structured questionnaire survey and oral check-up was employed to understand the oral health condition of the subjects surveyed. A total of 296 valid samples were acquired, reaching a valid response rate of 97.69%. Statistical methods included: descriptive statistics, t-test, chi-squared test, analysis of variance and logistic regression analysis. Result: This study adopted logistic regression analysis; it showed that “taking methamphetamines” is a major variable that influences caries index, root caries index, residual root, and community periodontal index, and statistically reaches a significant difference with these four dependent variables. Among the factors that affect oral health, the nine independent variables: age, occupation, frequency of teeth brushing in a single day, regular dental check-up, drinking sugared beverages, taking methamphetamines, chewing betel nuts, smoking, drinking were regarded as having influenced the dependent variables of caries index, community periodontal index, root caries index and residual root. It was found that after the variables were controlled, the five independent variables of frequency of teeth brushing in a single day, regular dental check-up, taking methamphetamines, chewing betel nuts and smoking statistically reached a significant difference with the dependent variables. Conclusion: The research results showed that the dental disease prevalence of those having taken methamphetamines is higher than for those who did not; therefore, the former demands more dental treatment than the latter does. Only by improving inmates’ oral health can their overall health condition be enhanced.It is suggested that an organized oral health knowledge and dietary consultation plan can be set up in the future to include more oral health education programs and raise the awareness of the hazards of illegal drugs and beverages high in sugar, in regard to oral health. Imprisonment is also a time for oral health education promotion in order to improve inmates’ oral health.