Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 647, Dunedin 9054, New Zealand.
J Am Dent Assoc. 2011 Apr;142(4):415-26. doi: 10.14219/jada.archive.2011.0197.
Studies investigating the role of dental plaque in oral disease have focused primarily on the quantity and quality of plaque at a given point in time. No large-scale epidemiologic research has been conducted regarding the continuity and change in plaque levels across the long term and the association of plaque levels with oral health.
The authors used data from the Dunedin Multidisciplinary Health and Development Study. Collection of dental plaque data occurred at ages 5, 9, 15, 18, 26 and 32 years by means of the Simplified Oral Hygiene Index. The authors assessed oral health outcomes when participants were aged 32 years.
The authors identified three plaque trajectory groups (high, n = 357; medium, n = 450; and low; n = 104) and found substantial, statistically significant differences in both caries and periodontal disease experience among those groups. For example, after the authors controlled for sex, socioeconomic status and dental visiting pattern, they found that participants in the high-plaque-trajectory group lost nearly five times more teeth owing to caries than did those in the low-plaque-trajectory group.
Across the long term, participants in the high-plaque-trajectory group were more likely to experience caries, periodontal disease and subsequent tooth loss than were those in the low- or medium-plaque-trajectory groups, and they experienced all those conditions with greater severity.
Improving oral health requires emphasizing long-term self-care, as well as providing broad public health and health promotion measures that promote and support oral self-care. This study's findings suggest that poor oral hygiene and smoking have a synergistic effect on periodontal disease experience.
研究口腔疾病中牙菌斑作用的研究主要集中在特定时间点的菌斑数量和质量上。目前尚未进行大规模的流行病学研究，探讨长期内菌斑水平的连续性和变化，以及菌斑水平与口腔健康的关系。
作者使用了达尼丁多学科健康与发展研究的数据。通过简化口腔卫生指数在 5、9、15、18、26 和 32 岁时收集牙菌斑数据。作者评估了参与者 32 岁时的口腔健康结果。
作者确定了三种菌斑轨迹组（高，n=357；中，n=450；低，n=104），并发现这些组之间在龋齿和牙周病的经验方面存在显著的统计学差异。例如，在作者控制了性别、社会经济地位和牙科就诊模式后，他们发现高菌斑轨迹组的参与者因龋齿而失去的牙齿数量几乎是低菌斑轨迹组的五倍。
长期来看，高菌斑轨迹组的参与者比低或中菌斑轨迹组更有可能经历龋齿、牙周病和随后的牙齿脱落，而且他们经历这些情况的严重程度更高。
改善口腔健康需要强调长期的自我保健，同时提供广泛的公共卫生和健康促进措施，以促进和支持口腔自我保健。本研究的结果表明，不良的口腔卫生和吸烟对牙周病的经验有协同作用。
