Zimmermann Heiko, Zimmermann Nils, Hagenfeld Daniel, Veile Annette, Kim Ti-Sun, Becher Heiko
Unit of Epidemiology and Biostatistics, Institute of Public Health, University of Heidelberg, Germany.
Community Dent Oral Epidemiol. 2015 Apr;43(2):116-27. doi: 10.1111/cdoe.12126. Epub 2014 Sep 26.
The epidemiology of periodontitis regarding oral-hygiene practices particularly the frequency of tooth brushing has been the subject of relatively few dedicated studies. This paper provides a systematic review of available relevant epidemiological studies and a meta-analysis of the effect of tooth brushing frequency on periodontitis. To review and to quantify the risk for periodontitis associated with frequency of tooth brushing.
Systematic literature search was conducted in nine online resources (PUBMED, ISI and 7 additional databases). Related and cross-referencing publications were reviewed. Papers published until end of March 2013 reporting associations between tooth brushing frequency and periodontitis were considered. A meta-analysis was performed to quantify this association.
Fourteen studies were identified. The test of heterogeneity for cross-sectional studies was not significant (P = 0.31). A fixed-effects model yielded a significant overall odds ratio estimate of 1.41 (95%CI: 1.25-1.58, P < 0.0001) for infrequent compared to frequent tooth brushing. For all fourteen studies, there was a slight indication for heterogeneity (I² = 48%, P = 0.02) and the corresponding result with a random-effects model was 1.44 (95%CI: 1.21-1.71, P < 0.0001).
There are relatively few studies evaluating the association between tooth brushing frequency and periodontitis. A clear effect was observed, indicating that infrequent tooth brushing was associated with severe forms of periodontal disease. Further epidemiological studies are needed to precisely estimate the effect of key risk factors for periodontitis and their interaction effects.
关于口腔卫生习惯尤其是刷牙频率的牙周炎流行病学，专门研究相对较少。本文对现有相关流行病学研究进行系统综述，并对刷牙频率对牙周炎的影响进行荟萃分析。以回顾和量化与刷牙频率相关的牙周炎风险。
在九个在线资源（PUBMED、ISI和另外七个数据库）中进行系统文献检索。对相关及交叉引用的出版物进行综述。纳入截至2013年3月底发表的报告刷牙频率与牙周炎之间关联的论文。进行荟萃分析以量化这种关联。
共识别出14项研究。横断面研究的异质性检验无显著性（P = 0.31）。固定效应模型得出，与频繁刷牙相比，不频繁刷牙的总体优势比估计值为1.41（95%置信区间：1.25 - 1.58，P < 0.0001）。对于所有14项研究，存在轻微异质性迹象（I² = 48%，P = 0.02），随机效应模型的相应结果为1.44（95%置信区间：1.21 - 1.71，P < 0.0001）。
评估刷牙频率与牙周炎之间关联的研究相对较少。观察到明显的效应，表明不频繁刷牙与严重形式的牙周疾病相关。需要进一步的流行病学研究来精确估计牙周炎关键风险因素的影响及其相互作用效应。
