Han Dong-Hun, Khang Young-Ho, Lee Hye-Ju
Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.
Dental Research Institute, Seoul National University, Seoul, Korea.
Community Dent Oral Epidemiol. 2015 Oct;43(5):479-88. doi: 10.1111/cdoe.12175. Epub 2015 Jun 17.
Evidence suggests that taller individuals have better health than that of shorter individuals. However, evidence for links to tooth loss is scarce. The aim of this study was to examine the association between adult height and tooth loss and to examine the roles of covariates in explaining the association in different birth cohorts in Korea.
Using data from the Fourth and Fifth Korea National Health and Nutritional Examination Survey (KNHANES IV and V), the subjects were grouped into two birth cohorts based on their historical context: born from 1920 to 1945 and 1946 to 1962. The dependent variables were loss of 8 or more teeth and total tooth loss (edentulism), while the independent variable was the height quartile. Demographic factors (survey year, age, and gender), early childhood/adult socioeconomic status (SES) (father's education, own education, income, and place of residence), health behaviors (cigarette smoking, binge drinking, frequency of toothbrushing, and regular dental visit), and health problems (diabetes and hypertension) were included in a series of analytical models.
The survey year-, age-, and gender-adjusted prevalence ratios (PR) of the loss of 8 or more teeth for the shortest quartile were 1.23 (95% confidence intervals, CI: 1.13-1.35) for the 1920-1945 birth cohorts and 1.39 (95% CI: 1.20-1.62) for the 1946-1962 birth cohorts. The PRs for edentulousness were 1.64 (95% CI: 1.34-2.02) for the 1920-1945 birth cohorts and 2.26 (95% CI: 1.31-3.91) for the 1946-1962 birth cohorts. These associations were moderately attenuated after adjusting for own education but still significant in the fully adjusted models. After full adjustment for the covariates, those in the shortest height quartiles in the relatively young birth cohorts (1946-1962 birth cohorts) had a 1.93 (95% CI: 1.09-3.43) times greater prevalence of edentulism than that of their tallest counterparts.
Given that adult height reflects early-life conditions, independent associations between height and tooth loss support the view that early-life circumstances significantly influence oral health outcomes in later life.
有证据表明,身材较高的个体比身材较矮的个体健康状况更好。然而,关于身高与牙齿脱落之间联系的证据却很少。本研究的目的是探讨成人身高与牙齿脱落之间的关联,并研究协变量在解释韩国不同出生队列中这种关联时所起的作用。
利用韩国第四次和第五次全国健康与营养检查调查(KNHANES IV和V)的数据,根据历史背景将受试者分为两个出生队列:1920年至1945年出生的队列和1946年至1962年出生的队列。因变量为牙齿脱落8颗及以上和全口无牙(无牙症),自变量为身高四分位数。人口统计学因素(调查年份、年龄和性别)、儿童早期/成人社会经济地位(SES)(父亲的教育程度、自身教育程度、收入和居住地点)、健康行为(吸烟、暴饮、刷牙频率和定期看牙医)以及健康问题(糖尿病和高血压)被纳入一系列分析模型。
在1920 - 1945年出生队列中,身高最矮四分位数人群牙齿脱落8颗及以上的经调查年份、年龄和性别调整后的患病率比值(PR)为1.23(95%置信区间,CI:1.13 - 1.35);在1946 - 1962年出生队列中为1.39(95% CI:1.20 - 1.62)。无牙症的PR在1920 - 1945年出生队列中为1.64(95% CI:1.34 - 2.02),在1946 - 1962年出生队列中为2.26(95% CI:1.31 - 3.91)。在调整自身教育程度后,这些关联有所减弱,但在完全调整模型中仍具有显著性。在对协变量进行完全调整后,相对年轻出生队列(1946 - 1962年出生队列)中身高最矮四分位数人群的无牙症患病率比身高最高的人群高1.93倍(95% CI:1.09 - 3.43)。
鉴于成人身高反映早年状况,身高与牙齿脱落之间的独立关联支持这样一种观点,即早年环境会显著影响晚年的口腔健康状况。