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老年养老院居民的后牙咬合与吞咽困难风险:一项横断面观察性研究。

Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross-sectional observational study.

作者信息

Okabe Y, Takeuchi K, Izumi M, Furuta M, Takeshita T, Shibata Y, Kageyama S, Ganaha S, Yamashita Y

机构信息

Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.

Kizuna-kai, Aso-kizuna Dental Clinic, Aso, Japan.

出版信息

J Oral Rehabil. 2017 Feb;44(2):89-95. doi: 10.1111/joor.12472.

Abstract

The total number of natural teeth was related to swallowing function among older adults; however, limited information is available regarding the impact of occluding pairs of teeth on swallowing function. This study aimed to examine the association between posterior teeth occlusion and dysphagia risk in older nursing home residents. This cross-sectional study included 238 residents aged ≥60 years from eight nursing homes in Aso City, Japan. Swallowing function was evaluated using the modified water swallowing test (MWST); the primary outcome was dysphagia risk (MWST score ≤3). Posterior teeth occlusion was assessed using number of functional tooth units (FTUs), determined based on number and location of the remaining natural and artificial teeth on implant-supported, fixed or removable prostheses. Univariate and multivariate logistic regression analyses were performed to examine the association between posterior teeth occlusion and dysphagia risk, adjusted for the covariates of number of natural teeth, demographic characteristics, comorbidities, physical function, body mass index and cognitive function. Of the 238 subjects, 44 (18·5%) were determined to be at risk of dysphagia based on the MWST scores. The odds ratio (OR) of dysphagia risk decreased in subjects with higher total FTUs [OR = 0·92, 95% confidence interval (CI) 0·87-0·98]. After adjusting for covariates, this association remained significant (OR = 0·90, 95% CI 0·84-0·97). Loss of posterior teeth occlusion was independently associated with dysphagia risk in older nursing home residents. Maintaining and restoring posterior teeth occlusion may be an effective measure to prevent dysphagia.

摘要

老年人的天然牙总数与吞咽功能有关;然而,关于咬合牙齿对吞咽功能的影响,目前可用信息有限。本研究旨在探讨老年疗养院居民后牙咬合与吞咽困难风险之间的关联。这项横断面研究纳入了日本阿苏市八家疗养院的238名年龄≥60岁的居民。使用改良水吞咽试验(MWST)评估吞咽功能;主要结局是吞咽困难风险(MWST评分≤3)。后牙咬合情况通过功能性牙单位(FTU)数量进行评估,FTU数量根据种植支持式、固定或可摘义齿上剩余天然牙和人工牙的数量及位置确定。进行单因素和多因素逻辑回归分析,以检验后牙咬合与吞咽困难风险之间的关联,并对天然牙数量、人口统计学特征、合并症、身体功能、体重指数和认知功能等协变量进行了调整。在238名受试者中,根据MWST评分,有44名(18.5%)被确定有吞咽困难风险。FTU总数较高的受试者吞咽困难风险的比值比(OR)降低[OR = 0.92,95%置信区间(CI)0.87 - 0.98]。在对协变量进行调整后,这种关联仍然显著(OR = 0.90,95% CI 0.84 - 0.97)。后牙咬合丧失与老年疗养院居民的吞咽困难风险独立相关。维持和恢复后牙咬合可能是预防吞咽困难的有效措施。

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