青少年口腔狀況對生長發育之影響

The impact of adolescents oral status on growth and development.

張雅惠(Ya-Hui Chang)

指導教授 ： 何佩珊

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2010年)

https://doi.org/10.6832/KMU.2010.00124

摘要

中文摘要
研究背景：
在人類生長發育的過程中，存在兩個生長快速的「高峰期」--嬰兒期和青春期。在這兩個時期，我們的軀體會明顯變長增高。眾所周知，國中青少年正值青春期的生長高峰期，而口腔狀況對於咀嚼食物、營養吸收的關係又極為密切。因此，青少年的口腔狀況與其生長發育之間的關係確實值得我們去研究，同時我們也調查青少年自覺口腔問題對日常生活造成困擾的程度。
研究目的：
在調整其他影響生長發育的重要因素後，探討口腔健康狀況對身體生長發育及口腔健康相關生活品質之相關及影響。
研究方法：
本研究屬追踨研究（Follow-up Study），研究樣本是屏東縣立兩所國中八、九年級的學生，調查日期為98年10月間。一共取得有效樣本1075人，其中男生529人女生546人。研究工具為結構式問卷，問卷內容涵蓋：基本家庭社會人口學資料、個人飲食習慣、飲食內容、口腔保健知識與態度、睡眠狀況、身體活動強度、自覺口腔狀況對日常生活的影響。學生口腔狀況摘錄新生入學時的口腔檢查紀錄，生長發育情形採用該校保健中心每學年測量的身高與體重資料。將口腔檢查結果及問卷調查資料進行編碼（Coding）後，利用SPSS 14.0版的統計軟體進行統計分析。
研究結果：
本研究發現：在國中新生入學時男生體位（BMI）過輕或超重，其DMFT指數顯著高於體位正常者；而女生體位（BMI）超重者，其DMFT指數顯著高於體位過輕、正常或過重者。迴歸分析指出，影響身高發展的因素男生為：父母親的身高、晚上就寢時間及DMFT指數；女生則是：父母親的身高及DMFT指數，均有統統計上顯著性差異。而影響男生體位（BMI）發展的因素有：父母親的BMI值及晚上就寢時間；女生部份則是：父母親的BMI值及DMFT指數。自覺口腔問題上，不分男女及年級皆自覺蛀牙與敏感性牙齒為最普遍注意到的口腔問題，且女生多於男生。男、女生又分別以牙痛、蛀牙與九種日常生活表現受影響有顯著相關性。目前口腔狀況對於日常生活影響以「刷牙/牙齒清潔」最多（30.64％），其次是「吃東西」（29.35％）。「刷牙/牙齒清潔」與「吃東西」受影響的頻率最多皆為「每月1~2次」。迴歸分析中發現，九年級學生自覺口腔健康相關生活品質比八年級學生好，在統計上有逹顯著性差異。
結論：
口腔狀況對於青少年的生長發育確實有一定程度的影響，齲齒情況愈嚴重，青少年身高增長的表現就會愈差。在自覺口腔問題與影響日常生活表現關係中發現，牙痛與蛀牙影響日常生活表現相關性最多。因此，我們應該要加強口腔保健的宣導，促使青少年每半年至少做一次口腔檢查。及早治療蛀牙、牙痛等口疾，以減少此等口腔問題對他們身高增長與日常生活的影響，進而提升生活品質。

關鍵字：青少年、齲齒、生長發育、日常生活影響

關鍵字

青少年 ； 齲齒 ； 生長發育 ； 日常生活影響

並列摘要

Abstract
Background:
In the process of human growth and development, there are two fast-growing "peaks" -- infancy and adolescence. During these two periods, our body length increases significantly. As we all know, junior high students are in the growth peak, and the oral condition has a very close relationship on chewing food and nutrient intake. Therefore, the relationship between oral status of adolescents and their growth and development is worthy of study. We have investigated the annoyances caused by perceived oral problems on the daily lives of adolescents at this time.

Objectives:
After adjusting for other important factors of growth and development, we investigated the impact of oral health status on physical growth and development and oral health related quality of life.

Methods:
This was a follow-up study, the samples were eighth and ninth-grade students from two junior high schools in Pingtung County and the survey was carried out in October 2009. A total of 1,075 valid samples, including 529 boys and 546 girls, were collected. A structured questionnaire was used as the research tool. The adolescents were asked the following questions: basic family demographics, personal eating habits, diet content, oral health behavior, sleep status, physical activity intensity and perceived impact of oral condition on daily life. The oral status of the students was recorded according to the records of oral examination when they were admitted to junior high school. The condition of growth and development was based on the height and weight data, which are measured by the school health center every year. The oral examination results and the questionnaire data were encoded, and then analyzed by using SPSS 14.0 version statistical software.

Results:
Our study found: First year boys’ BMI (Body Mass Index) is classified as too light or obese, their DMFT index is significantly higher than those of normal weight; first year girls’ whose BMI is classified as obese, their DMFT index is significantly higher than those of under weight, normal or overweight. Regression analysis indicated that the male students’ height is influenced by the following factors: parental height, bedtime and the DMFT index; female students’ is parental height and the DMFT index. Both genders are statistically significantly difference. Boys’ BMI is affected by the following factors: parental BMI and bedtime; girls’ is parental BMI and the DMFT index. In the perceived oral problem, the most common are conscious of tooth decay and tooth sensitivity, irrespective of gender and grade, and girls more than boys. No matter boys or girls, their nine daily-life performances are significantly impacted by toothache and tooth decay. The daily lives, "brushing / teeth cleaning", is the most (30.64%) affected by the current oral status, followed by "eating" (29.35%). "Brushing / teeth cleaning" and "eating" are the most frequently affected, both up to "1 ~ 2 times every month."

Conclusion:
Oral status of adolescents does have a certain impact on their growth and development, the more severe dental caries, the performance of adolescents’ height growth will be worse. In the relation between the perceived oral problem and the impact of daily-life performance, we found that toothache and tooth decay are statistically significantly correlated with their daily lives. Therefore, we should strengthen oral health promotion, and make young people have oral examination at least once every six months. Early treatment of tooth decay, toothache or other oral diseases are indicated to reduce the impact of these oral problems on their growth and daily lives, thus enhancing the quality of life.

Key words: adolescents, caries, growth, impact of daily lives.

並列關鍵字

adolescents ； caries ； growth ； impact of daily lives

參考文獻

參考文獻

1. 王素真、蔡吉政、黃純德、陳月珍、洪玉珠。國小學童口腔健康之相關因素探討。中華牙醫學雜誌 2003；22：29-42。

2. 王素真、洪玉珠。影響學童口腔健康相關因素之探討。華醫學報 2004；21：41-55。

3. 王乃亭。台灣12-18歲國高中生的口腔狀況調查與醫療需求的探討﹝碩士論文﹞。高雄：高雄醫學大學口腔衛生科學研究所；2006。

4. 呂宜珍、金繼春。國小高年級學童口腔衛生行為及其相關因素。公共衛生 1999；26：115-127。