Periodontal Disease and Its Challenge in Taiwan

臺灣社群牙周病現況與面臨的挑戰

賴弘明(Hong-Min Lai)

《臺灣牙周病醫學會雜誌》 21卷3期 (2016/09) Pp. 246-262

https://doi.org/10.6121/TAP.2016.21.3.06

摘要

臺灣在2007~2008以國際常用之社群牙周與附連喪失指數(CPI and LA)調查18歲以上成年人之牙周病情況。發現99%有不等程度之牙周病，54%有牙周囊袋。而且牙周囊袋之罹患率隨年齡而增加，從18~24歲之22%，35~44歲之53%，到65~74歲已達73%。但只有29%之民眾認為自己有牙周病，不到10%的人有每天正確使用牙線；雖然絕大多數人每天刷牙。幾乎2,300萬人都需要潔牙教育，但牙醫師分身乏術，目前國內又沒有口腔衛生師之制度，衛教人力嚴重缺乏。另外，全民健保對囊袋之治療卻只能提供有需求者之3%。臺灣牙周病防治之供需失調，會隨人口老化而持續擴大，但目前未見政府、牙醫界與學界對這方面有具體之策略。

關鍵字

社群牙周指數與附連喪失 ； 牙周盛行率 ； 危險因子 ； 治療需要 ； 治療需求

並列摘要

The Taiwan National Periodontal Survey covering the years 2007 and 2008 showed that 99% of adults living in Taiwan had periodontal disease to some extent with 54% having periodontal pockets. The prevalence of pocketing increases with age, ranging from 22% in the 18 to 24 year age group, to 53% in 35 to 44 year-old age group and reaching 73% in the 65 to 74 year-old age group. Notwithstanding the high prevalence of periodontal diseases, only 29% of adults were found to be aware of periodontal disease, with less than 10% flossing daily, which contrasts with almost all adults brushing daily. Nearly all 23 million people living in Taiwan need oral hygiene instruction, but dentists are generally too busy to teach in this area and Taiwan has no dental hygienists. In addition, while Taiwan's National Health Insurance covers 45.4% of all periodontal treatment that are needed, only 3% of periodontal pockets are treated by the NHI system. The gap between demand and provision is very likely to become worse as the population ages rapidly. Notwithstanding the above, no solid strategy has been developed by the government, by dental professionals or by academic institutions to address these problems. Clinical implications: To achieve long-term success when carrying out periodontal treatment, clinicians need to put more effort into controlling the risk factors of periodontal disease such as plaque, smoking, etc. Since the burden of periodontal treatments is so heavy, but only small percentage of cases consist of severe periodontitis that may cause tooth loss, the goal of the community should focus on simple and effective treatment such as root planing that will keep teeth functional longer, rather than the use of sophisticated surgery in pursuit of perfection.

並列關鍵字

Community Periodontal Index and Loss of Attachment ； periodontal prevalence ； risk factors ； treatment needs ； treatment demands