Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
Psychosom Med. 2013 Feb;75(2):178-86. doi: 10.1097/PSY.0b013e31827d221b. Epub 2013 Jan 16.
This study assessed associations between social relationships and oral health outcomes and whether these associations were explained by demographic, socioeconomic, and behavioral factors, and physical health.
We used the National Health and Nutrition Examination Survey (1999-2004) data on 4014 adults aged 60 years or older. Oral health outcomes were edentulism, number of decayed teeth, root decay, number of sound or filled teeth, and self-rated oral health. Social relationships referred to social networks (marital status, number of close friends) and social support (emotional support need, provision of financial support). Analyses consisted of regression models sequentially adjusting for demographic, socioeconomic, behavioral, and physical health confounders.
In fully adjusted models, widowed or divorced/separated individuals had fewer sound or filled teeth than those married or living with a partner: rate ratio (95% confidence interval)=0.89 (0.82 to 0.97) and 0.90 (0.83 to 0.97), respectively. People with four to six close friends had fewer decayed teeth and lower probability for root decay than those with fewer friends. Emotional support need was associated with 1.41 (1.05 to 1.90) higher odds for root decay and 1.18 (1.04 to 1.35) higher odds for poorer self-rated oral health. Lack of financial support was associated with more decayed teeth. Edentulism was not related to any social network and social support markers.
Social relationships are associated with clinical measures of current disease, markers of good oral function, and subjective oral health, but not with clinical measures of a lifetime history of oral disease among older Americans.
本研究评估了社会关系与口腔健康结果之间的关联，以及这些关联是否可以通过人口统计学、社会经济和行为因素以及身体健康来解释。
我们使用了美国国家健康和营养调查（1999-2004 年）中 4014 名 60 岁或以上成年人的数据。口腔健康结果包括无牙、龋齿数、根龋、有功能或填充的牙齿数以及自我评估的口腔健康。社会关系指的是社交网络（婚姻状况、亲密朋友的数量）和社会支持（情感支持需求、提供经济支持）。分析包括逐步调整人口统计学、社会经济、行为和身体健康混杂因素的回归模型。
在完全调整的模型中，丧偶或离异/分居的人比已婚或与伴侣生活的人有更少的有功能或填充的牙齿：比率比（95%置信区间）=0.89（0.82 至 0.97）和 0.90（0.83 至 0.97）。有四到六个亲密朋友的人比朋友较少的人有更少的龋齿和较低的根龋概率。情感支持需求与根龋发生的几率增加 1.41（1.05 至 1.90）和自我评估的口腔健康较差的几率增加 1.18（1.04 至 1.35）相关。缺乏经济支持与更多的龋齿有关。无牙与任何社交网络和社会支持标志物均无关。
社会关系与当前疾病的临床指标、良好口腔功能的标志物以及主观口腔健康相关，但与美国老年人一生中口腔疾病的临床指标无关。
