Høvik Hedda, Kolberg Marit, Gjøra Linda, Nymoen Line Cathrine, Skudutyte-Rysstad Rasa, Hove Lene Hystad, Sun Yi-Qian, Fagerhaug Tone Natland
Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
BMC Oral Health. 2022 Mar 21;22(1):82. doi: 10.1186/s12903-022-02116-2.
Number of teeth is an established indicator of oral health and is commonly self-reported in epidemiological studies due to the costly and labor-intensive nature of clinical examinations. Although previous studies have found self-reported number of teeth to be a reasonably accurate measure, its accuracy among older adults ≥ 70 years is less explored. The aim of this study was to assess the validity of self-reported number of teeth and edentulousness in older adults and to investigate factors that may affect the accuracy of self-reports.
This study included two different samples of older adults ≥ 70 years drawn from the fourth wave of the Trøndelag Health Study (the HUNT Study), Norway. Sample 1 (n = 586) was used to evaluate the validity of self-reported number of teeth and sample 2 (n = 518) was used to evaluate self-reported edentulousness. Information on number of teeth and background variables (education, smoking, cognitive function, and self-perceived general and oral health) were self-reported in questionnaires, while clinical oral health examinations assessed number of teeth, number of teeth restored or replaced by fixed prosthodontics and edentulousness. Spearman and Pearson correlation coefficients, Bland-Altman plot, chi-square test and kappa statistics were used to assess the agreement between self-reported and clinically recorded number of teeth.
The mean difference between self-reported and clinically recorded number of teeth was low (- 0.22 teeth), and more than 70% of the participants reported their number of teeth within an error of two teeth. Correlations between self-reports and clinical examinations were high for the total sample (0.86 (Spearman) and 0.91 (Pearson)). However, a lower correlation was found among participants with dementia (0.74 (Spearman) and 0.85 (Pearson)), participants having ≥ 20 teeth (0.76 (Spearman) and 0.67 (Pearson)), and participants with ≥ 5 teeth restored or replaced by fixed prosthodontics (0.75 (Spearman) and 0.77 (Pearson)). Self-reports of having teeth or being edentulous were correct in 96.3% of the cases (kappa value 0.93, p value < 0.001).
Among older Norwegian adults, self-reported number of teeth agreed closely with clinical tooth counts and nearly all the edentulous participants correctly reported having no teeth.
牙齿数量是口腔健康的既定指标，由于临床检查成本高且劳动强度大，在流行病学研究中通常采用自我报告的方式。尽管先前的研究发现自我报告的牙齿数量是一种相当准确的测量方法，但在70岁及以上的老年人中其准确性较少被探究。本研究的目的是评估老年人自我报告的牙齿数量和无牙状态的有效性，并调查可能影响自我报告准确性的因素。
本研究纳入了从挪威特隆赫姆健康研究（HUNT研究）第四波中抽取的两个不同的70岁及以上老年人样本。样本1（n = 586）用于评估自我报告的牙齿数量的有效性，样本2（n = 518）用于评估自我报告的无牙状态。牙齿数量和背景变量（教育程度、吸烟情况、认知功能以及自我感知的总体和口腔健康状况）的信息通过问卷进行自我报告，而临床口腔健康检查则评估牙齿数量、通过固定修复体修复或替代的牙齿数量以及无牙状态。使用Spearman和Pearson相关系数、Bland-Altman图、卡方检验和kappa统计量来评估自我报告和临床记录的牙齿数量之间的一致性。
自我报告和临床记录的牙齿数量之间的平均差异较小（-0.22颗牙齿），超过70%的参与者报告的牙齿数量误差在两颗以内。总样本中自我报告与临床检查之间的相关性较高（Spearman相关系数为0.86，Pearson相关系数为0.91）。然而，在患有痴呆症的参与者中（Spearman相关系数为0.74，Pearson相关系数为0.85）、牙齿数量≥20颗的参与者中（Spearman相关系数为0.76，Pearson相关系数为0.67）以及有≥5颗牙齿通过固定修复体修复或替代的参与者中（Spearman相关系数为0.75，Pearson相关系数为0.77），相关性较低。在96.3%的病例中，关于有牙或无牙的自我报告是正确的（kappa值为0.93，p值<0.001）。
在挪威老年成年人中，自我报告的牙齿数量与临床牙齿计数密切一致，几乎所有无牙参与者都正确报告没有牙齿。
