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[根据糖尿病状况看口腔健康与口腔护理;2008年欧洲牙周病学调查研究结果]

[Dental health and dental care according diabetic status; results from 2008 ESPS study].

作者信息

Azogui-Lévy S, Rochereau T

机构信息

UFR d'odontologie, université Paris-Diderot, 5, rue Garancière, 75006 Paris, France; Inserm 1018 CESP équipe 11, 94807 Villejuif cedex, France.

Institut de recherche et de documentation en économie de la santé (IRDES), 75018 Paris, France.

出版信息

Rev Epidemiol Sante Publique. 2014 Dec;62(6):329-37. doi: 10.1016/j.respe.2014.09.005. Epub 2014 Nov 15.

Abstract

BACKGROUND

Poorly controlled diabetes leads to serious complications including periodontal disease, oral disease leading to tooth loss. Diabetics benefit from care facilitated follow-up. Social inequalities are observed in oral health and diabetes. The objective of this study was to estimate the effect of the social factors on oral health and use of dental care for people with diabetes from the Health and Social Protection Survey 2008 (ESPS) and to compare it with that observed among non-diabetic people.

METHODS

The ESPS is a representative survey of the French population. In 2008, data were derived from a self-administered health questionnaire given to all household members aged 16 or older. The scope of this study was restricted to persons aged 35 and over (12.082) having filled out their health survey (8961). Diabetes was defined from self-reports of disease or use of anti-diabetic medication. Oral health was estimated from perceived oral health and the number of missing teeth not replaced. Use of dental care was measured by self-report of a visit within the last two years. Socio-demographic and social coverage indicators were collected.

RESULTS

The participation rate was 74.1% and prevalence of diabetes was 7.2% (648). People with diabetes had a poorer dental status (42.7% vs 26.5% - OR=1.22, 95% CI [1.01-1.47]), related to social characteristics. The effect of level of precariousness on dental health was equivalent in diabetic and non-diabetic populations. The use of dental care (73.4% of participants) was associated with social factors. Diabetics were less likely to consult dentists than non-diabetics (61.5% vs 74.4%), but this difference was not statistically significant (OR=0.86, 95%CI [0.72-1.04]). The effect of the level of precariousness on use of dental care was the same in both populations.

CONCLUSION

This study raises the question of the impact of recommendations on monitoring dental health among diabetics especially for vulnerable populations despite better management and coverage.

摘要

背景

糖尿病控制不佳会导致严重并发症,包括牙周病,口腔疾病会导致牙齿脱落。糖尿病患者可从便利的后续护理中获益。在口腔健康和糖尿病方面存在社会不平等现象。本研究的目的是根据2008年健康与社会保护调查(ESPS)评估社会因素对糖尿病患者口腔健康和牙科护理使用情况的影响,并将其与非糖尿病患者中观察到的情况进行比较。

方法

ESPS是对法国人口的一项代表性调查。2008年,数据来自向所有16岁及以上家庭成员发放的一份自我管理的健康问卷。本研究的范围限于35岁及以上填写了健康调查问卷的人群(12082人)(8961人)。糖尿病通过疾病自述或抗糖尿病药物的使用情况来定义。口腔健康通过自我感知的口腔健康状况和未镶复的缺失牙数量来评估。牙科护理的使用情况通过过去两年内就诊的自述来衡量。收集了社会人口统计学和社会覆盖指标。

结果

参与率为74.1%,糖尿病患病率为7.2%(648人)。糖尿病患者的牙齿状况较差(42.7%对26.5% - 比值比=1.22,95%置信区间[1.01 - 1.47]),这与社会特征有关。不稳定程度对牙齿健康的影响在糖尿病和非糖尿病人群中相当。牙科护理的使用情况(73.4%的参与者)与社会因素有关。糖尿病患者咨询牙医的可能性低于非糖尿病患者(61.5%对74.4%),但这种差异无统计学意义(比值比=0.86,95%置信区间[0.72 - 1.04])。不稳定程度对牙科护理使用情况的影响在两个人群中相同。

结论

本研究提出了一个问题,即尽管管理和覆盖情况有所改善,但针对糖尿病患者尤其是弱势群体监测牙齿健康的建议的影响如何。

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