社會心理因素及抽菸與牙周健康相關性之探討 ─以社區民眾為例

The association of psychosocial factors and smoking with periodontal health in a community population

邱鈴真(Ling-Jan Chiou)

指導教授 ： 蔡吉政

高雄醫學大學/口腔醫學院/牙醫學研究所/博士(2009年)

摘要

研究目的：許多研究均指出社會心理因素和牙周病的相關，但是其相關可能會被抽菸習慣所影響。本研究的目的即是以社區民眾為研究對象，探討社會心理因素與抽菸習慣對牙周健康狀況的影響。
研究方法：本研究共有1764個在臺灣非機構(住家和牙科診所等)的社區樣本，以結構式問卷進行資料收集，所有的參與者均被訪問有關社會心理因素(CHQ-12 score：中國人健康量表)、抽菸習慣和其他相關因素，並檢查牙周狀況，包括社區牙周指數( CPI： community periodontal index) and 牙周附連喪失量( LOA：loss of attachment)。
研究結果：本研究發現社會心理因素與抽菸習慣和LOA呈現顯著相關，但與CPI無顯著相關，CHQ-12為6分(含)以上者比CHQ-12為0-2分者的LOA 2-4的odds ratio (OR)為1.69 ( 95%CI=1.01-2.77, p=0.0318 for linear trend)，而抽菸者比非抽菸者的LOA 2-4的OR為2.21 (95%CI=1.45-3.37)。本研究更發現抽菸者比非抽菸者的CHQ-12 score和LOA 2-4的相關性更強，抽菸者的OR為2.49 (95%CI=0.91-6.49)，而非抽菸者則為1.43 ( 95%CI= 0.76-2.58)。在CPI的部份，本研究發現結婚者(OR = 3.38, 95% CI = 1.26-10.81)和離婚/鰥寡者(OR = 3.83, 95% CI = 1.21-13.83)比單身者傾向有較差的牙周健康(CPI3-4)。

研究結論： 抽菸者的心理健康狀況與牙周病的相關性比非抽菸者更強，特別是累積性的牙周附連喪失。本研究認為心理健康狀況和抽菸習慣對牙周健康可能有協同作用。

關鍵字

牙周狀況 ； 社會心理因素 ； 抽菸

並列摘要

Background and Objective: The association between psychosocial factors and periodontal disease has been widely reported and might be modified by smoking status. This study aimed to investigate the association of periodontal status with psychosocial factors and smoking in a community population.

Materials and methods: A structured questionnaire was administered to a total of 1764 civilian non-institutional (homes or dental clinics) Taiwanese individuals to collect their psychosocial factors (using the 12-item Chinese Health Questionnaire [CHQ-12]), smoking habits and other related factors. The periodontal status was examined using community periodontal index (CPI) and loss of attachment (LOA).

Results: The psychological factors and smoking were significantly associated with LOA (odds ratio [OR] =1.69, 95%CI=1.01-2.77, comparing CHQ-12 score≥ 6 with score =0-2 and p=0.0318 for linear trend; OR=2.21, 95%CI=1.45-3.37, comparing smokers with non-smokers) but not with CPI. The association was found to be stronger among smokers than non-smokers. Those of CHQ-12 score ≥6 had a higher odds ratio (OR) of LOA in smokers (OR=2.49, 95% CI = 0.91-6.49) than non-smokers (OR=1.43, 95%CI = 0.76-2.58). For periodontal health measured by CPI, married and divorced/widowed subjects tended to have poor periodontal health (OR = 3.38, 95% CI = 1.26-10.81 and OR = 3.83, 95% CI = 1.21-13.83, respectively) than singles among non-smokers but not among smokers.

Conclusions: Poor mental health had stronger association with periodontal disease among smokers than non-smokers, especially in accumulative attachment loss. Our findings suggested that the mental health and smoking might have a synergistic effect on the risk of periodontal diseases.

並列關鍵字

Periodontal disease ； Psychosocial factor ； Smoking

參考文獻

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