台灣桃園縣身心障礙者的口腔健康狀況與醫療需求

研究背景: 至2003年底止台灣身心障礙者的人口數已達861,030人佔全國總人口數之 3.76%，桃園縣境內就有51,121人，佔縣內總人口數之2.86%，在全民健保下其口腔醫療照護的情形，是否與一般國民得到一樣的照護，有心了解特做本研究。研究目的: 本研究的目的是探討桃園縣身心障礙者的口腔狀況與醫療需求，以做為將來提供防治計劃基礎資料的依據。研究方法: 以立意取樣桃園縣境內所有21所身心障礙者教養院中的14所內大部分住民與一所啟智學校的大部分學生總計811人，其中男性446人，女性345人；18歲以下266人，19-44歲446人，45歲以上99人。以口腔檢查判定齲齒、缺牙、填補、與牙周狀況，牙菌斑、牙結石、牙齦炎、咬合狀況與膺復狀況，並評估其醫療需求。同時做問卷調查日常生活與口腔衛生習慣等以了解其對口腔健康的影響。研究結果: 研究統計結果顯示桃園縣身心障礙者的齲齒盛行率為86.96%，齲齒經驗指數 (DMFT Score)為9.00± 7.61顆，有33.21%的人有牙齦炎，72.34%的人有牙菌斑堆積，13.07%的人有牙結石的堆積；上顎有 32.59%的人有膺復需求，下顎有36.17的人有膺復需求，54.20%的人有矯正需求。研究結論: 桃園縣身心障礙者與正常人比較，DMFT指數沒有什麼差異，齲齒盛行率，牙菌斑罹患率與牙齦炎的罹患率的偏高，齲齒填補率偏低，顯示口腔衛生不佳與口腔醫療的不足，身心障礙者的弱勢並缺乏政府財力充足的支持，特別為身心障礙者提供的駐診或巡迴口腔衛教育與醫療的不足等是可能造成的因素。

關鍵字

醫療需求；身心障礙者；口腔健康狀況

並列摘要

Keywords: disability, oral status, treatment needs. Objective The aim of this study was to assess the oral heath status and treatment needs of the persons with disabilities in Taoyuan County, Taiwan. Method Dental caries, plaque, calculus and gingivitis index, etc., were scored by author's dental examination. The study population comprised of 811 people with disabilities from 14 of the 20 private institutes and 1 public school for disabilities in Taoyuan County, Taiwan. Among this population, there were 466 males and 345 females in 3 different age groups: (1) 1-18yrs(266), (2) 19-44yrs(446), and (3) above 45 yrs(99). The study described DMFT scores and gingival conditions. The prosthodontic, orthodontic status and treatment needs were also evaluated. The chi-square test was used in the statistic analysis of the data. Result The prevalence of caries was 86.96% and the mean DMFT score was 9.00(SD 7.61). The prevalence of gingivitis was 33.21%. The prosthodontic need was 32.59% in the upper jaw and 36.17% in the lower jaw. The orthodontic need was 54.20%. Conclusion The DMFT score appeared a little different between the persons with and without disabilities. But the high percentages of prevalence in caries and gingivitis, and low F/DMFT (25%) show the poor oral hygiene and few dental services in the disabled population. The lack of properly trained caregivers and dental personnel, combined with the high prosthodontic need, limited personal financial resources and public budget are possible explanations for their conditions.