社區長者口腔衛教實作模式的成效探討-以臺北市北投區為例

Effect of Oral Hygiene Practices for the Elderly in the community of the Beitou District in Taipei City

吳俊良(Chun-Liang Wu)

指導教授 ： 陳雅美

國立臺灣大學/公共衛生學院/健康政策與管理研究所/碩士(2019年)

https://doi.org/10.6342/NTU201904019

摘要

研究目的
本研究之研究目的為探討臺北市北投區社區長者口腔衛教實作模式的成效，採單組前後測設計。
研究方法
有效樣本共計33人，男性7 人（21.2%），女性26 人（78.8%），平均年齡為 74.61 歲，教育程度在高中以上計17人（51.5%）為最多。介入期間計10週，團體口腔衛生教育隔週上1次，每次2小時，計4次。前後測由牙醫師、助手及護理人員協助長者接受口腔狀況檢查及填寫口腔知識問卷。
經口腔衛教實作模式介入後，結果為口腔知識得分增加1.54（增加率26.7%），有顯著增加（P=0.002）。每天刷牙次數平均值增加0.27（增加率11.0%），但未達顯著（P=0.22）。牙菌斑指數(範圍為0-3)平均值增加0.09（增加率5.8%），未達顯著（P=0.33）。牙齦指數(範圍為0-3)平均值減少0.01（減少率0.97%），未達顯著（P=0.88）。
討論與結論
結論為經口腔衛教實作介入後，後測口腔知識得分有顯著增加，顯示口腔衛教實作模式對於長者口腔知識的增進有顯著成效。每天刷牙次數平均值有增加但未達顯著，顯示對於原本刷牙次數較多的長者，口腔衛教實作模式可能會遇到天花板效應。對於刷牙的潔牙效果，若使用貝氏刷牙法建議使用的軟毛平整型小刷頭牙刷，可能會因為長者不容易短時間內學會並習慣使用正確的貝氏刷牙法，造成去除牙菌斑及減少牙齦發炎的效果不如預期。

關鍵字

口腔衛教實作 ； 口腔衛生教育 ； 長者 ； 社區 ； 刷牙 ； 牙菌斑指數 ； 牙齦指數

並列摘要

Study Purpose
The purpose of this study is to investigate the effect of oral hygiene practices for the elderly in the community of the Beitou District in Taipei City. This study is a one-group pretest-posttest design study.
Method
The intervention included 10 weeks of oral hygiene practices and 4 oral hygiene courses using a hygiene practice model. Before and after the intervention, dentists, dntal assistants and nurses collected a survey of oral situation and questionnaire on oral health knowledge was administered.
Results
Thirty-three elder people aged 65 years old and over completed the intervention and pre-post tests. Among these older adults, 21.2% were male (n=7), and 78.8% were female (n=26). The average age is 74.61 years of age.
After the 10-week oral hygiene practices intervention, the results showed that the oral knowledge score significantly increased by 1.54 points (increased rate of 26.7%, P=0.002). The average number of brushings per day increased by 0.27 (11.0% increase, P = 0.22). The plaque index (range 0-3) increased by 0.09 (5.8% increase, P=0.33) . The mean value of the gingival index (range 0-3) was reduced by 0.01 (reduction rate 0.97%, P = 0.88).
Discussion and Conclusion
After the intervention of oral health education, the score of post-test oral knowledge has increased significantly, indicating that the oral hygiene practices has a significant effect on the improvement of oral knowledge. The average number of brushing times per day has increased but not significant, indicating that for the elderly who have more brushing times, the oral health practice mode may encounter a ceiling effect. For the cleaning effect of brushing teeth, if soft-brushed small brush head toothbrush is used as recommended by Bass brushing method, the brushing method is very different from Taiwanese older adults’ knowledge about teeth cleaning. Thus, it may be difficult for the Taiwanese elderly to learn and use the correct Bass brushing method and require a longer time to learn and change behaviors. This is also the potential reason resulting the removal of plaque and the effect of reducing inflammation of the gums is not as good as expected in the current study.

並列關鍵字

oral hygiene practice ； oral health education ； elderly ； community ； toothbruthing ； plaque index ； gingival index

參考文獻

一、英文文獻：

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Amirfaridi, F., & Bågesund, J. Plaque removal efficacy of a high bristle count toothbrush compared to a conventional toothbrush.

Attin, T., & Hornecker, E. (2005). Tooth brushing and oral health: how frequently and when should tooth brushing be performed? Oral health & preventive dentistry, 3(3).

Berdon, J. K., Hornbrook, R. H., & Hayduk, S. E. (1974). An evaluation of six manual toothbrushes by comparing their effectiveness in plaque removal. Journal of periodontology, 45(7), 496-499.