Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, PO Box 9101HB, Nijmegen, The Netherlands.
BMC Public Health. 2012 Oct 2;12:839. doi: 10.1186/1471-2458-12-839.
In order to adapt oral care and treatment to the demands of the growing group of frail dentulous older people, it is important to understand how and to which extent having natural teeth contributes to the quality of life (QoL) of frail older people and how frailty influences their perspective.
A qualitative approach was used. Interviews with 38 Dutch frail older dentulous people were tape-recorded, transcribed, coded for content and analyzed. Additional information was collected which included age, gender, living situation, use of dental prostheses, self-reported oral health status, chronic disorders, and an index for frailty.
Seven themes were identified in the relationship between natural teeth and the QoL of the participants: pride and achievement; intactness; sense of control; oral function; appearance; comfort; along with coping and adapting to disabilities. Having natural teeth generally had a positive effect on QoL. Positive effects through pride and achievement, intactness, and sense of control were most apparent for the most severely frail. They compared themselves with peers who are more often edentate, and valued the good state of their teeth against the background of their declining health, especially those with disabilities causing severe chronic pain or impaired fine-motor skills. The effect of coping with and adaptation to tooth loss was also most apparent for the most severely frail. There was a gender effect in that the men generally cared less about having natural teeth than women, regardless of their level of frailty.
QoL of frail older people is positively influenced by natural teeth, and this effect seems to increase with increasing frailty. Preservation of teeth contributes to a positive body image and self-worth. Oral care for frail people should aim to preserve natural teeth if possible.
为了使口腔护理和治疗能够满足日益增多的体弱无牙老年人的需求，了解天然牙如何以及在何种程度上有助于体弱老年人的生活质量（QoL），以及虚弱如何影响他们的观点非常重要。
采用定性方法。对 38 名荷兰体弱无牙老年人进行了录音采访、转录、内容编码和分析。收集了其他信息，包括年龄、性别、居住情况、使用义齿、自我报告的口腔健康状况、慢性疾病以及虚弱指数。
在天然牙与参与者 QoL 之间的关系中确定了七个主题：自豪感和成就感；完整性；控制感；口腔功能；外观；舒适度；以及应对和适应残疾。拥有天然牙齿通常对 QoL 有积极影响。通过自豪感和成就感、完整性和控制感产生的积极影响在最虚弱的人群中最为明显。他们将自己与更多无牙的同龄人进行比较，并将自己牙齿的良好状况与健康状况下降的背景进行比较，尤其是那些因残疾而导致严重慢性疼痛或精细运动技能受损的人。应对和适应缺牙的影响在最虚弱的人群中也最为明显。存在性别影响，即无论虚弱程度如何，男性通常比对拥有天然牙齿的关注度要低。
天然牙会对体弱老年人的 QoL 产生积极影响，而且这种影响似乎随着虚弱程度的增加而增加。保留牙齿有助于形成积极的身体形象和自我价值感。对于体弱的人来说，口腔护理的目标应该是尽可能保留天然牙齿。
