東台灣機構身心障礙者口腔健康狀態之探討

中文摘要背景：口腔乃健康之重要關口，身心障礙者礙於行動之不便，口腔健康亦受影響。此外，東台灣地區為醫療資源較貧乏之地區，倘能針對地方醫療資源狀況瞭解身心障礙者的口腔健康狀況，則對其口腔健康之促進是指日可待的。研究目的：簡述分為兩大部分：1.探討身心障礙者之口腔健康狀況，包括DT.MT.FT.與DMFT指數、齲齒盛行率、填補率、牙科醫療需求與牙周狀況等。2.探討身心障礙者之口腔健康狀況與飲食及生活習慣、口腔清潔習慣、看牙醫的經驗等之相關性。研究方法：研究對象取自台灣身心障礙者之口腔健康狀況調查計畫中，領有身心障礙手冊者、居住於東台灣地區機構內之身心障礙者，共有605人。其中，18歲以下有277人，19－44歲有234人，45歲以上者有94人。研究內容為主要是透過專業的牙醫師來對身心障礙者對口腔健康狀況檢查，與利用標準化問卷的調查方式對身心障礙之主要照護者來進行口腔健康狀況與飲食、潔牙生活習慣問卷調查。抽樣方法為分層集束抽樣調查法(PPS)；以等比隨機抽樣機率、機構為抽樣單位，來進行抽樣。以MS Acess來設計資料庫，SAS與JMP來做統計分析。結果：研究分析結果顯示，東台灣機構內身心障礙者平均DMFT指數為男性8.08，女性8.40，且明顯以45歲以上17.17為最高，19－44歲9.34次之(P<0.0001)；平均齲齒盛行率為男性91.89%，女性93.85%，以45歲以上98.94%為最高，19－44歲93.59%次之(P<0.0001)；平均齲齒數為4.30；以45歲以上5.94最高，19－44歲5.08次之；平均缺牙數為男性2.86，女性2.67，以45歲以上10.60為最高，19－44歲2.42次之(P<0.0001)；平均填補率男性為23.66%，女性為37.03%，以18歲以下35.67為最高，19－44歲28.43%次之(P<0.0001)。結論：歸納言之，身心障礙者之口腔健康狀況普遍不佳，除了礙於行動之不便外，飲食之生活習慣亦為其關鍵，而就醫的方便性與就醫之配合度亦影響口腔狀況。此外，少醫療補綴、潔牙行為不足亦是身心障礙者共同的口腔健康問題。關鍵詞：身心障礙、口腔健康狀況、齲齒經驗指數

關鍵字

口腔健康狀況；身心障礙；齲齒經驗指數

並列摘要

Abstract Background: The oral cavity is a significant gateway to health. Impeded by physical inconvenience, a disabled persons oral health is affected . The eastern areas of Taiwan have poor medical resources. It is necessary to focus on the local medical resources for the purpose of understanding the oral healthy condition of the disabled people and thus further improve their oral health. Purpose: The purpose of this study was to investigate the oral health condition of the disabled. The items in the oral examination included DT, MT, FTand DMFT index, prevalence of caries, filling rate, dental treatment needs and periodontal status. The items in related factors include the oral health status, dietary and living habits, oral cleaning habits and the experience of dental visits. Methods: The samples of the people with disabled were extracted from the study “Oral Health Status and Related Factors of Disabled People in Taiwan”. A total of 605 disabled people participated in this study. The samples were divided into three age groups: under 18, 19-44 and over 45 years old, with a sample sizes of 277, 234, and 94 respectively. Professional dentists carried out the oral examinations for the disabled people. The dietary habits, oral health habits and status of daily activities were collected in a standardized questionnaire. Stratified cluster sampling design and Probability Proportional to Size (PPS) were used; the sample units were chosen on the basis of equable random ratio and institution. Database was designed through MS Access and the data were analyzed by using SAS and JMP Results: In this study, the disabled people in the institution of eastern Taiwan area had an average male DMFT index of 8.08, female DMFT index of 8.40. The group aged over 45 had a significantly higher DMFT index (17.17) than other age groups (P<0.0001). The second index was 9.34 in the group aged 19-44. The average caries prevalence was 91.88% for male, 93.85% for female and the group aged over 45 had the highest rate at 98.94%, with the second at 93.59% in the group aged 19-44. (P<0.0001). The average amount of caries teeth was 4.30 and the group aged over 45 was highest at 4.44, with the second at 5.08 in the group aged 19-44. The average amount of missing teeth were 2.86 for male, 2.67 for female and the group over 45 was the highest at 10.60, with the second at 2.42(P<0.0001) in the group aged19-44. The average filling rate was 23.66% for males, 37.03% for females and the groups under 18 had the highest rate at 35.67%, with the second at 28.43%(P<0.0001) in the group aged 19-44. There were 38.84% of individuals who had calculus. Conclusion: The disabled people generally have bad oral health because of physical impediment as well as the dietary and living habits. The convenience of medical service and the degree of the patient’s coordination also influenced the oral situation. In addition, the common problems of disabled people were lack of prosthesis and of teeth cleaning.