多病共存与牙齿缺失：2019 年巴西国家健康调查。
Multimorbidity and tooth loss: the Brazilian National Health Survey, 2019.
机构信息
School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.
Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil.
出版信息
BMC Public Health. 2021 Dec 20;21(1):2311. doi: 10.1186/s12889-021-12392-2.
BACKGROUND
Little is known about the presence of two or more chronic conditions (multimorbidity) on tooth loss between adults and older adults. Understanding the mechanisms of multimorbidity on tooth loss is essential to inform policy development. This study aims to investigate the association between multimorbidity and severity of tooth loss in Brazilian adults and older adults.
METHODS
We analysed data from a nationally representative sample of 88,531 Brazilian individuals aged 18 and over who participated in the 2019 Brazilian Health Survey. Tooth loss was the outcome by two different classifications: functional dentition (lost 1-12 teeth) and severe tooth loss (lost 23-32 teeth). The presence of multimorbidity was the main exposure and based on 13 self-reported doctor-diagnosed chronic diseases that were further categorised into two groups, i.e., ≥2 or ≥ 3 comorbidities. Sociodemographic covariates included sex, age, race, income, level of education and tobacco smoking and geographic region of residency. Multivariate logistic regression models estimated the OR (Odds Ratios) and 95%CI of the associations between multimorbidity and tooth loss.
RESULTS
For 65,803 adults (aged 18 to 59), the presence of multimorbidity (≥2) was associated with 32% higher odds of having severe tooth loss (95% CI, 1.17; 1.49) and 33% lower odds of having functional dentition (95% CI, 0.60; 0.75). For the 22,728 older adults (aged 60 and older), multimorbidity (≥2) was associated with a 17% higher odds of severe tooth loss (95% CI, 1.06; 1.29) and 23% lower odds of having functional dentition (95% CI 0.70; 0.85). The sensitivity analysis, excluding hypertension, confirmed our findings.
CONCLUSIONS
Brazilian adults and older adults with multimorbidity are more likely to have severe tooth loss and less likely to have functional dentition.
背景
关于成年人和老年人中两种或多种慢性疾病（多种合并症）与牙齿缺失之间的关系知之甚少。了解多种合并症与牙齿缺失之间的机制对于制定政策至关重要。本研究旨在调查巴西成年人和老年人中多种合并症与牙齿缺失严重程度之间的关系。
方法
我们分析了 2019 年巴西健康调查中来自全国代表性样本的 88531 名年龄在 18 岁及以上的巴西人的数据。牙齿缺失是通过两种不同的分类来衡量的：功能性牙列（缺失 1-12 颗牙齿）和严重牙齿缺失（缺失 23-32 颗牙齿）。多种合并症的存在是主要的暴露因素，基于 13 种自我报告的医生诊断的慢性疾病，这些疾病进一步分为两组，即≥2 种或≥3 种合并症。社会人口统计学协变量包括性别、年龄、种族、收入、教育程度和吸烟情况以及居住的地理位置。多变量逻辑回归模型估计了多种合并症与牙齿缺失之间的关联的比值比（OR）和 95%置信区间。
结果
对于 65803 名成年人（年龄在 18 至 59 岁之间），多种合并症（≥2 种）与严重牙齿缺失的几率增加 32%相关（95%CI，1.17；1.49），而功能性牙列的几率降低 33%（95%CI，0.60；0.75）。对于 22728 名老年人（年龄在 60 岁及以上），多种合并症（≥2 种）与严重牙齿缺失的几率增加 17%相关（95%CI，1.06；1.29），而功能性牙列的几率降低 23%（95%CI，0.70；0.85）。排除高血压的敏感性分析结果证实了我们的发现。
结论
巴西成年人和老年人中患有多种合并症的人更有可能出现严重的牙齿缺失，而拥有功能性牙列的可能性较小。
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