Chen Mei-Yen
College of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC.
Hu Li Za Zhi. 2019 Feb;66(1):4. doi: 10.6224/JN.201902_66(1).01.
In rapidly aging societies, it is commonly found that the limited number of remaining teeth in elders results in chewing difficulties that cause health problems and malnutrition. Surprisingly, even the latest high-tech oral medical care achieves health maintenance results that are inferior to those regularly achieved by healthy natural teeth. Oral health issues are particularly serious in rural areas. The literature supports a close association between oral hygiene and general health. Because oral microorganisms are known to cause infections and inflammation reactions, people with poor oral hygiene often have high incidences of periodontal disease and tooth loss and an even higher prevalence of cardiometabolic-related chronic diseases, poorer life quality, and higher mortality than their peers with better oral hygiene (Ma et al., 2017; Tsai et al., 2015; World Health Organization, 2018). Although promoting oral hygiene may be done on a minimal budget and with high efficacy, many people retain improper oral-hygiene concepts and behaviors. For instance, many do not recognize the relationship between real teeth and general health, brush their teeth for inadequate durations, and/or apply improper methods. Furthermore, many do not make use of the regular dental cleaning resources available through the National Health Insurance program, leading to poor oral hygiene care outcomes such as tooth decay in school-age children, periodontal disease and tooth loss in adulthood, and the current average of fewer than 20 real teeth in adults 65~80 years of age. All of these poor oral-hygiene realities lead to Taiwan falling far short of WHO oral-health-related goals. Based on the perspective of prevention and health promotion, this column presents the important role of the nursing profession in improving the quality of oral hygiene care through the three critical phases of life: school age, active adulthood, and elderly adulthood. We look to advance national oral hygiene in Taiwan to a standard exceeding that of the World Health Organization in order to demonstrate the practical benefit of Taiwan's two-decade-long National Health Insurance system.
在快速老龄化的社会中，人们普遍发现，老年人剩余牙齿数量有限会导致咀嚼困难，进而引发健康问题和营养不良。令人惊讶的是，即使是最新的高科技口腔医疗护理，其维持健康的效果也不如健康的天然牙齿。口腔健康问题在农村地区尤为严重。文献支持口腔卫生与总体健康之间存在密切关联。由于已知口腔微生物会引发感染和炎症反应，口腔卫生差的人往往比口腔卫生较好的同龄人患牙周病和牙齿脱落的几率更高，与心脏代谢相关的慢性病患病率更高，生活质量更差，死亡率也更高（Ma等人，2017年；Tsai等人，2015年；世界卫生组织，2018年）。尽管促进口腔卫生可以以最低的预算高效完成，但许多人仍持有不正确的口腔卫生观念和行为。例如，许多人没有认识到真牙与总体健康之间的关系，刷牙时间不足，和/或采用不正确的方法。此外，许多人没有利用通过国民健康保险计划提供的定期牙齿清洁资源，导致口腔卫生护理效果不佳，如学龄儿童龋齿、成年人牙周病和牙齿脱落，以及目前65至80岁成年人平均真牙数不足20颗。所有这些口腔卫生不佳的现实情况导致台湾远远未能实现世界卫生组织与口腔健康相关的目标。基于预防和健康促进的视角，本专栏阐述了护理专业在人生三个关键阶段（学龄期、成年活跃期和老年期）改善口腔卫生护理质量方面的重要作用。我们希望将台湾的国民口腔卫生提升到超过世界卫生组织的标准，以展示台湾长达二十年的国民健康保险制度的实际效益。
