Dye Bruce A, Wang Ru, Lashley Ruth, Wei Wenqiang, Abnet Christian C, Wang Guoqing, Dawsey Sanford M, Cong Wei, Roth Mark J, Li Xiaojie, Qiao Youlin
Centers for Disease Control and Prevention/National Center for Health Statistics, Hyattsville, MD, USA.
BMC Oral Health. 2007 Jul 17;7:10. doi: 10.1186/1472-6831-7-10.
The oral health status of rural residents in the People's Republic of China has not been extensively studied and the relationship between poor oral health and esophageal cancer (EC) is unclear. We aim to report the oral health status of adults participating in an EC screening study conducted in a rural high-risk EC area of China and to explore the relationship between oral health and esophageal dysplasia.
National Health and Nutrition Examination Survey (NHANES) oral health examination procedures and the Modified Gingival Index (MGI) were used in a clinical study designed to examine risk factors for esophageal cancer and to test a new esophageal cytology sampling device. This study was conducted in three rural villages in China with high rates of EC in 2002 and was a collaborative effort involving investigators from the National Institutes of Health and the Cancer Institute of the Chinese Academy of Medical Sciences.
Nearly 17% of the study participants aged 40-67 years old were edentulous. Overall, the mean number of adjusted missing teeth (including third molars and retained dental roots) was 13.8 and 35% had 7 contacts or less. Women were more likely to experience greater tooth loss than men. The average age at the time of first tooth loss for those with no posterior functional contacts was approximately 41 years for men and 36 years for women. The mean DMFT (decayed, missing, and filled teeth) score for the study population was 8.5. Older persons, females, and individuals having lower educational attainment had higher DMFT scores. The prevalence of periodontal disease (defined as at least one site with 3 mm of attachment loss and 4 mm of pocket depth) was 44.7%, and 36.7% of the study participants had at least one site with 6 mm or more of attachment loss. Results from a parsimonious multivariate model indicate that participants with poor oral health wemore likely to have esophageal dysplasia (OR = 1.59; 95% CI 1.06, 2.39).
This report describes the first use of NHANES oral health protocols employed in a clinical study conducted outside of the United States. The extent and severity of poor oral health in this Chinese study group may be an important health problem and contributing factor to the prevalence of EC.
中华人民共和国农村居民的口腔健康状况尚未得到广泛研究，口腔健康不佳与食管癌（EC）之间的关系也不明确。我们旨在报告参与中国农村食管癌高危地区一项食管癌筛查研究的成年人的口腔健康状况，并探讨口腔健康与食管发育异常之间的关系。
在一项旨在研究食管癌危险因素并测试一种新型食管细胞学采样装置的临床研究中，采用了美国国家健康与营养检查调查（NHANES）的口腔健康检查程序和改良牙龈指数（MGI）。该研究于2002年在中国三个食管癌高发的农村村庄进行，是美国国立卫生研究院和中国医学科学院肿瘤研究所的研究人员共同开展的合作项目。
40 - 67岁的研究参与者中，近17%无牙。总体而言，调整后的缺失牙平均数量（包括第三磨牙和保留的牙根）为13.8颗，35%的人牙齿接触点为7个或更少。女性比男性更容易出现更多牙齿缺失。对于没有后牙功能接触点的人，男性首次牙齿缺失的平均年龄约为41岁，女性约为36岁。研究人群的平均龋失补（DMFT）得分是8.5。年龄较大者、女性以及受教育程度较低者的DMFT得分较高。牙周病患病率（定义为至少一个部位附着丧失3毫米且牙周袋深度4毫米）为44.7%，36.7%的研究参与者至少有一个部位附着丧失6毫米或更多。一个简约多变量模型的结果表明，口腔健康不佳的参与者更有可能出现食管发育异常（比值比 = 1.59；95%置信区间1.06，2.39）。
本报告描述了NHANES口腔健康方案首次在美国境外进行的一项临床研究中的应用。该中国研究组口腔健康不佳的程度和严重性可能是一个重要的健康问题，也是食管癌患病率的一个促成因素。
