台灣15-18歲青少年牙周狀況與相關因素之探討

背景：越來越多數據顯示牙周感染發炎是造成許多全身性疾病的危險因子。然而，近年來國內關於口腔狀況調查研究在全國性報告較少，大多局限於區域性或針對齲齒之調查，若合併牙周狀況且針對15-18歲青少年來做進一步探討則更是缺乏。研究目的：本研究主要的目的是在探討15-18歲青少年的社會人口學變項、口腔保健行為與牙周健康狀況之相關性。研究方法：以設籍且居住在台灣,具有中華民國國籍年齡滿15-18歲的青少年為調查對象，包括台灣21縣市(不含金門縣與連江縣)、台北市、高雄市，共23縣市。採分層抽樣調查法(Stratified survey sampling)，共抽樣2,944人，逐一進行口腔健康狀況檢查並配合問卷取得社會人口學特質、飲食習慣及潔牙狀況調查，最後實際樣本計2475人，問卷及口腔檢查所收集之資料以Microsoft Access軟體設計資料庫，經過譯碼、編碼後，將資料建入資料庫內。以JMP 5.12之電腦統計軟體進行統計分析。結果：在牙菌斑指數方面，沒有牙菌斑有10.57%，最嚴重的則為中度牙菌斑，佔42.65%。本研究顯示潔牙方式、年齡愈大者，牙菌斑的罹患也隨之上升；牙齦狀況而言，25.94%沒有牙齦炎，其中以牙結石最嚴重有37.54%。結果發現年齡愈大、喜歡吃甜食的偏好、潔牙方式及刷牙次數愈少罹患牙齦炎機率也隨之增加；牙結石指數方面，沒有牙結石之比率佔62.79%，且年齡愈大、潔牙方式及刷牙次數愈少罹患牙結石情況有愈來愈嚴重的趨勢；社區牙周指數而言，健康佔26.37%，牙周囊袋≧4mm有11.34%，且年齡愈大、潔牙方式及刷牙次數愈少患有牙周症狀機率愈增加。本研究發現影響口腔健康狀況的相關因素包括年齡、年齡及潔牙習慣等重要變項。結論：研究結果顯示在社會人口學中，性別及年齡均與牙菌斑指數、牙齦炎指數、牙結石指數及社區牙周指數之間在統計學上達顯著性;女生在牙周健康狀況較男生佳;年齡愈大，牙周健康狀況愈差。在飲食習慣上可見甜食的攝取對口腔健康狀況有相當程度的影響，然而刷牙是維持口腔衛生最有有效之方法，因此藉由潔牙的頻率及時機均可作適度改善。美國公共衛生服務部在「健康國民2010年」(Health of the people 2010)中強調，預防口腔疾病，增進口腔健康，對於實現健康國民及增進生活品質有相當大的重要性。因此，要達到這個目標，唯有在日常生活中養成良好的口腔衛生習慣，才能擁有健康的口腔環境。

關鍵字

牙周病；口腔健康；社區牙周指數

並列摘要

Background: More and more data has shown that periodontitis is a risk factor for many systemic diseases. However, in recent years, have been few nation wide reports about studies of the oral health status in Taiwan. Most studies have been regional and toward the research of dental caries. There is also insufficient research on the combination of periodontal status toward teenagers aged 15 to 18 years old. Objectives: The purpose of this study was to investigate the relationship between socio-demographic variables, oral health behavior and the periodontal status of teenagers aged 15 to 18 years old. Method:The subjects were teenagers aged 15 to 18 years old who reside in Taiwan. The study included Taipei City and Kaohsiung City with a total of 23 counties and cities in Taiwan (Kinmen and Lienchiang Counties were excluded). Using stratified survey sampling, a total of 2,944 samples. We were collected conductied an oral health status examination with questionnaires to obtain the socio-demographic characteristics, eating habits, and teeth brushing status. Finally, a total of 2,475 samples were obtained. Data collected from questionnaires and oral health examination were coded with Microsoft Access and analyzed by the software package JMP version 5.12. Results: In dental plaque index, 10.57% had “no dental plaque“ ,42.65% had “mild dental plaque“ and 42.65% had severe dental plaque .This study showed that the dental plaque index increased with the method of cleaning teeth and age. For gingival status, 25.94% had “no gingivitis“ and 37.54% had “dental calculus“ which was the most severe. The prevalence of gingival inflammation increased with age, habit of eating sweets, method of cleaning teeth and frequency of toothbrushing. In dental calculus index, the percent of “no dental calculus“ was 62.79% ,and it increased with age, habit of eating sweets, method of cleaning teeth and frequency of toothbrushing. By periodontal index,26.37% of the subjects had healthy periodontal tissue, 11.34% of the subjects had periodontal pockets ≧4mm, it increased with age, habit of eating sweets, method of cleaning teeth and frequency of toothbrushing. The findings showed that the related variables that influence oral health status included age and habit of cleaning teeth. Conclusion: The findings showed that in socio-demographics, there was a statistically significant difference between sex and age with dental plaque index, gingival status, dental calculus index, and community periodontal index. The female periodontal status was better than males, and with increasing age, the periodontal status got worse. In eating habits, eating sweets has a strong influence on the oral health status. However, brushing teeth is the most effective way to maintain oral health. Therefore, by the frequency and timing of cleaning teeth, it can be improved. Health of the people 2010, the United States Department of Health and Human Services emphasizes that preventing oral disease and increasing oral health are very important to realize people’s health and increase quality of life. Therefore, in order to reach this goal, having good oral health habits in daily life is the only way to have a good oral condition.