Unell L, Söderfeldt B, Halling A, Birkhed D
Community Dental Health Unit, Orebro County Council, Sweden.
Community Dent Health. 1998 Sep;15(3):155-61.
To develop explanatory models for oral health expressed as the number of remaining teeth.
Socio-economic attributes, health factors, dental attitudes and behaviours were used as explanatory variables in a logistic regression. Cross-sectional validated questionnaire data from all 50-year-old residents in two Swedish counties were collected from 8,888 persons, a response rate of 71.4% (n = 6,343). Adjusted number of teeth and three dichotomies of edentulousness and remaining teeth in various combinations were used as the dependent variables.
Social class was unrelated to edentulousness, while individual and health factors were covariants. Individuals with < or = 8 teeth had a social class and education gradient, while those with > or = 25 teeth had class and education gradients as well as a relation to dental care utilisation. There were only three variables showing a consistent and stable relation to the various dependent variables, these were use of tobacco, having only junior high school education and satisfaction with dental care. The multiple and logistic regression models revealed different results.
The main conclusions from this study were, first, that there were different mechanisms for different states of the dentition, interpreted as signs of disease and signs of health, corresponding to the ideas of patho- and salutogenesis, and secondly, that number of teeth present is not usable as a continuous variable, since it does not reflect the same mechanisms across the whole scale.
建立以剩余牙齿数量表示的口腔健康解释模型。
社会经济属性、健康因素、口腔态度和行为被用作逻辑回归中的解释变量。从瑞典两个县所有50岁居民中收集经过验证的横断面问卷调查数据,共8888人,回复率为71.4%(n = 6343)。调整后的牙齿数量以及无牙和剩余牙齿的三种不同组合作为因变量。
社会阶层与无牙状态无关,而个人和健康因素是协变量。牙齿数量≤8颗的个体存在社会阶层和教育梯度,而牙齿数量≥25颗的个体不仅存在阶层和教育梯度,还与牙科护理利用情况有关。只有三个变量与各种因变量呈现出一致且稳定的关系,即吸烟、仅接受初中教育以及对牙科护理的满意度。多元回归模型和逻辑回归模型得出了不同的结果。
本研究的主要结论是,第一,牙列的不同状态存在不同机制,可解释为疾病迹象和健康迹象,这与病理发生学和健康发生学的观点相对应;第二,现存牙齿数量不能用作连续变量,因为它在整个范围内并未反映相同的机制。