刘相武 黄东瑛 王 忠 张力群 王 雪
老年恒牙冠龋相关影响因素分析
刘相武 黄东瑛 王 忠 张力群 王 雪
目的 对老年恒牙冠龋的相关影响因素进行研究,进一步为老年口腔预防保健工作提供依据。方法 抽取我省360例作为研究对象,男、女各为180例,采取CPI探针对全口恒牙牙冠龋病情况进行检查,进一步结合调查问卷及龋病进行相关性分析。结果 城市老年人患龋比率为31.67%,农村老年人患龋比率为43.33%;农村老年人患龋率高于城市老年人患龋率,两组数据差异有统计学意义(P<0.05)。女性老年人患龋比率为40.83%,男性老年人患龋比率为34.17%;女性老年人患龋率高于男性老年人患龋率,两组数据差异有统计学意义(P<0.05)。将360例受检人口纳入Logistic回归分析,调查的内容包括性别、生活区域、吸烟史及是否饮茶等。通过分析可知,与患龋呈正相关性的因素包括生活在农村、女性、一年前存在牙痛史;与患龋呈负相关性的因素包括无吸烟史、收入>1万元、具备饮茶史及刷牙史等。结论 对于老年恒牙冠龋病,在明确相关影响因素的基础上,需采取有效的防治措施,特别是在农村,需要大力改善口腔卫生条件,以此使老年人口腔保健得到有效强化,进一步提高老年人的生活质量。
老年恒牙;冠龋;相关影响因素
doi:10.3969/j.issn.1674-9316.2016.13.010
老年人由于年龄增大,口腔唾液腺萎缩,在唾液量逐渐降低的情况下,口腔自洁功能便会减弱,从而容易引发龋病。老年恒牙冠龋多发于颈部、邻面等位置[1-2]。为了使老年人的生活质量得到有效保障,对于老年恒牙冠龋病采取有效防止措施极为重要,这是本组对“老年恒牙冠龋相关影响因素”进行分析的原因。现报告如下。
1.1一般资料
采取分层、随机及等容量抽样法,抽取我省6个市县(3个为城市,3个为农村)老年人口360例,男、女各为180例;最小年龄61岁,最大年龄78岁。
1.2方法
以《口腔健康检查方法》及《第三次全国口腔健康流行病学调查方案》[3]为参考标准,对360例老年人中口腔内恒牙冠龋情况采取进一步检查措施。结合问卷调查,相关人员对冠龋老年患者进行现场询问,主要内容涵盖了家庭基本情况、口腔保健、日常生活习惯及对口腔健康的认知等问题[4]。采取CPI探针对全口恒牙牙冠龋病情况进行检查(每次受检5 min),进一步结合调查问卷(每次问卷调查20 min)及龋病进行相关性分析[5]。
1.3统计学分析
文中所有统计数据均使用SPSS 13.0统计学软件进行分析,计数资料使用频数和率(%)表示。计数资料使用χ2检验,并采取多因素Logistic回归分析方法,对老年恒牙冠龋相关影响因素进行分析。
受检人数共360例,城市老年人患龋比率为31.67%,农村老年人患龋比率为43.33%,合计患龋比率为75.00%;农村老年人患龋比率高于城市老年人,两组数据差异有统计学意义(P<0.05)。女性老年人受检人数合计180例,其中女性总患龋比率为40.83%,城市老年人患龋比率为35.00%,农村老年人患龋比率为46.67%;男性老年人受检人数合计180例,其中男性总患龋比率为34.17%,其中城市老年人患龋比率为28.33%,农村老年人患龋比率为40.00%;女性老年人患龋比率高于男性老年人,两组数据差异有统计学意义(P<0.05)。
本组研究将360例受检患者纳入Logistic回归分析,被调查的内容包括性别、生活区域、吸烟史及是否饮茶等。患龋情况与相关因素 logistic回归分析结果为:性别:回归系数0.392,标准差0.204,Wald值3.288,P值0.059,OR值1.482;生活区域:回归系数0.542,标准差0.169,Wald值10.298,P值0.001,OR 值1.681;是否吸烟:回归系数0.142,标准差0.218,Wald值0.438, P值0.501,OR值1.161;是否饮茶:回归系数0.222,标准差0.148,Wald值1.966,P值0.141,OR值1.255。
龋齿导致老年人牙齿脱落,同时该病灶也是影响老年人身心健康的主要因素[6-7]。老年人一旦牙齿发生大量脱落,口腔功能减弱,从而影响到老年人饮食等,进一步对老年人生活质量构成威胁。因此,找出老年恒牙冠龋的相关影响因素便有着极为重要的意义[8]。本研究通过分析可知,农村老年人患龋率高于城市老年人患龋率,两组数据差异有统计学意义(P<0.05)。女性老年人患龋率高于男性老年人患龋率,两组数据差异有统计学意义(P<0.05)。对于老年恒牙冠龋病,相关影响因素主要包括生活在农村、女性、一年前存在牙痛史等。在明确相关影响因素的基础上,需采取有效的防治措施,特别是在农村,需要大力改善口腔卫生条件,以此使老年人口腔保健得到有效强化,进一步提高老年人的生活质量。
[1] 晏志强,谷克晓,林松杉. 不同桩核系统修复年轻恒牙冠折效果比较观察[J].人民军医,2014,57(5):512-513.
[2] 宣桂红,王海花. 酸蚀对自黏结树脂水门汀与牙本质黏结强度的影响[J].上海口腔医学,2015,24(3):302-306.
[3] 张丽虹,田斌,刘刚. 年轻恒前牙冠折后的椅旁CAD/CAM玻璃陶瓷贴面修复[J].临床心身疾病杂志,2015,21(z2):116-117.
[4] 郑淑珍,赵佩端. 青少年恒前牙外伤冠折后不同处理方法对牙(牙合)系统影响研究[J]. 中国实用口腔科杂志,2015,8(5):294-296,301.
[5] 朱翔. 疑因乳牙拔除造成畸形中央尖折断引起根尖周炎1例[J].中国乡村医药,2016,23(2):60.
[6] 张燕,韩金屏,赵勤. Vitapex用于外伤年轻恒牙部份活髓切断术的疗效观察[J]. 医药前沿,2016,6(2):65-66.
[7] 刘丹. 活髓切断术治疗年轻恒牙露髓112例临床疗效观察[J].中国伤残医学,2016,24(4):75-76.
[8] 王俊,林则元. 部分活髓切断术和传统活髓切断术治疗[J]. 中国当代医药,2016,23(2):91-93.
Analysis of Influencing Factors of Elderly Crown Caries
LIU Xiangwu HUANG Dongying WANG Zhong ZHANG Liqun WANG Xue Department of Stomatology,FAW General Hospital,Changchun Jilin 130011,China
【Abstract】
Objective To research on the relevant influence factors of the permanent tooth coronal caries in the elderly,so as to provide further foundation for the preventive oral health care of the elderly. Methods 360 cases were selected across our province as the objects of study,with 180 male and 180 female cases,respectively. CPI probe was utilized for examining the permanent tooth coronal caries in the whole mouth,and correlation analysis was conducted in combination with the questionnaire and the dental caries. Results The prevalence of dental caries in the elderly in the urban area was 31.67%,while that in the rural area was 43.33%,that was higher in the rural area than in the urban area,and the difference in the data between the two groups showed statistically significance(P<0.05). The prevalence of dental caries in the female elderly was 40.83%,while that in the male elderly was 34.17%; that was higher in the female elderly than in the male elderly,with the difference in the data between the two groups being statistically significant (P<0.05). The 360 cases of population for test were incorporated into the Logistic for regression analysis,and the investigated contents of the respondents included sex,living area,smoking history as well as the tea-drinking condition. It could be obtained through analysis that the factors that showed positive correlation with the development of dental caries included living in the rural area,female,and presence of toothache history one year ago,while the factors that were negatively correlated with the development of dental caries included negative smoking history,income of more than¥10 000,positive tea-drinking history and tooth-brushing history. Conclusion Effective control measures should be taken for the permanent tooth coronal caries in the elderly on the basis of determining the relevant influence factors,particularly in the rural area where oral health conditions should be improved greatly,so that effective reinforcement could be obtained for the oral health in the elderly,thus further enhancing the quality of life in the elderly.
Permanent tooth in the elderly,Coronal caries,Relevant influence factors
R78
A
1674-9316(2016)13-0015-02
一汽总医院口腔科,吉林 长春 130011