Schindler David K, Lopez Mitnik Gabriela V, Soliván-Ortiz Aida M, Irwin Scott P, Boroumand Shahdokht, Dye Bruce A
Tri-Service Center for Oral Health Studies, Uniformed Services University-Southern Region, JBSA-Ft. Sam Houston, TX 78234, USA.
National Institutes of Health, National Institute of Dental and Craniofacial Research, Bethesda, MD 20892, USA.
Mil Med. 2021 Jan 30;186(1-2):e149-e159. doi: 10.1093/milmed/usaa355.
Many veterans qualify for health benefits but generally not dental care. This study examines differences in oral health status between veterans and nonveterans in the U.S. to determine how various factors, including socioeconomic, general health, and tobacco use, impact former service members' oral health.
Data from 11,539 dentate adults participating in the National Health and Nutrition Examination Survey (2011-2014) were used. Outcome variables included decayed teeth (DT), missing teeth (MT), filled teeth (FT), caries experience (DMFT), and periodontitis (PD). Covariates included demographic and socioeconomic factors, deployment, smoking, depression, hypertension, hyperlipidemia, and diabetes. Logistic regression modelling was used to assess associations between these factors and oral health outcomes.
Veterans represent about 9% of the U.S. population. There was a higher prevalence of PD, MT, FT, and DMFT among veterans than nonveterans. Veterans were more likely to have PD (OR, 1.8; 95% CI, 1.3 to 2.5) and higher DMFT (OR, 2.9; 95% CI, 2.4 to 3.4); however, after controlling for other covariates, military service was only associated with FT (OR, 1.3; 95% CI, 1.1 to 1.6) and higher DMFT (OR, 1.6; 95% CI, 1.2 to 1.9).
Because veterans are more likely to originate from groups at a higher risk for poor oral health (older adults, smokers, males, diabetics), the prevalence of adverse oral health conditions are higher among veterans compared to nonveterans. Overall, military service is not associated with PD or untreated dental caries but is associated with indicators suggesting veterans have had more dental treatment (FT and DMFT). There is substantial unmet oral health care need primarily related to periodontitis among veterans.
许多退伍军人有资格享受医疗福利，但通常没有牙科护理福利。本研究调查了美国退伍军人和非退伍军人的口腔健康状况差异，以确定社会经济、总体健康和烟草使用等各种因素如何影响退伍军人的口腔健康。
使用了参加2011 - 2014年国家健康和营养检查调查的11539名有牙成年人的数据。结果变量包括龋齿（DT）、缺牙（MT）、补牙（FT）、龋病经历（DMFT）和牙周炎（PD）。协变量包括人口统计学和社会经济因素、部署情况、吸烟、抑郁、高血压、高脂血症和糖尿病。采用逻辑回归模型评估这些因素与口腔健康结果之间的关联。
退伍军人约占美国人口的9%。退伍军人中牙周炎、缺牙、补牙和龋病经历的患病率高于非退伍军人。退伍军人患牙周炎的可能性更高（比值比[OR]，1.8；95%置信区间[CI]，1.3至2.5），龋病经历也更高（OR，2.9；95% CI，2.4至3.4）；然而，在控制其他协变量后，服役仅与补牙（OR，1.3；95% CI，1.1至1.6）和更高的龋病经历（OR，1.6；95% CI，1.2至1.9）相关。
由于退伍军人更有可能来自口腔健康状况较差风险较高的群体（老年人、吸烟者、男性、糖尿病患者），与非退伍军人相比，退伍军人中不良口腔健康状况的患病率更高。总体而言，服役与牙周炎或未经治疗的龋齿无关，但与表明退伍军人接受过更多牙科治疗的指标（补牙和龋病经历）有关。退伍军人中存在大量未满足的口腔保健需求，主要与牙周炎有关。
