Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Epidemiology and Health Informatics, Korea University, Seoul, Korea.
J Korean Med Sci. 2023 Aug 7;38(31):e241. doi: 10.3346/jkms.2023.38.e241.
Although poor oral health is a common comorbidity in individuals with airflow limitation (AFL), few studies have comprehensively evaluated this association. Furthermore, the association between oral health and the severity of AFL has not been well elucidated.
Using a population-based nationwide survey, we classified individuals according to the presence or absence of AFL defined as pre-bronchodilator forced expiratory volume in 1 second/forced vital capacity < 0.7. Using multivariable logistic regression analyses, we evaluated the association between AFL severity and the number of remaining teeth; the presence of periodontitis; the Decayed, Missing, and Filled Teeth (DMFT) index; and denture wearing.
Among the 31,839 participants, 14% had AFL. Compared with the control group, the AFL group had a higher proportion of periodontitis (88.8% vs. 79.4%), complete denture (6.2% vs. 1.6%), and high DMFT index (37.3% vs. 27.8%) ( < 0.001 for all). In multivariable analyses, denture status: removable partial denture (adjusted odds ratio [aOR], 1.12; 95% confidence interval [95% CI], 1.04-1.20) and complete denture (aOR, 1.52; 95% CI, 1.01-2.05), high DMFT index (aOR, 1.13; 95% CI, 1.02-1.24), and fewer permanent teeth (0-19; aOR, 1.32; 95% CI, 1.12-1.52) were significantly associated with AFL. Furthermore, those with severe to very severe AFL had a significantly higher proportion of complete denture (aOR, 2.41; 95% CI, 1.11-3.71) and fewer remaining teeth (0-19; aOR, 2.29; 95% CI, 1.57-3.01).
Denture wearing, high DMFT index, and fewer permanent teeth are significantly associated with AFL. Furthermore, a reduced number of permanent teeth (0-19) was significantly related to the severity of AFL. Therefore, physicians should pay attention to oral health in managing patients with AFL, such as chronic obstructive pulmonary disease.
尽管口腔健康不良是气流受限(AFL)个体的常见合并症,但很少有研究全面评估这种关联。此外,口腔健康与 AFL 严重程度之间的关系尚未得到充分阐明。
我们使用基于人群的全国性调查,根据存在或不存在预支气管扩张剂 1 秒用力呼气量/用力肺活量 < 0.7 来定义的 AFL 将个体分类。使用多变量逻辑回归分析,我们评估了 AFL 严重程度与剩余牙齿数量、牙周炎、龋齿、缺失和补牙(DMFT)指数以及义齿佩戴之间的关系。
在 31839 名参与者中,14%患有 AFL。与对照组相比,AFL 组牙周炎的比例更高(88.8% vs. 79.4%),全口义齿(6.2% vs. 1.6%)和高 DMFT 指数(37.3% vs. 27.8%)(均<0.001)。在多变量分析中,义齿状况:可摘局部义齿(调整后的优势比 [aOR],1.12;95%置信区间 [95%CI],1.04-1.20)和全口义齿(aOR,1.52;95%CI,1.01-2.05)、高 DMFT 指数(aOR,1.13;95%CI,1.02-1.24)和较少的恒牙(0-19;aOR,1.32;95%CI,1.12-1.52)与 AFL 显著相关。此外,严重至非常严重 AFL 的患者全口义齿的比例显著更高(aOR,2.41;95%CI,1.11-3.71)和较少的剩余牙齿(0-19;aOR,2.29;95%CI,1.57-3.01)。
戴义齿、高 DMFT 指数和较少的恒牙与 AFL 显著相关。此外,恒牙数量减少(0-19)与 AFL 的严重程度显著相关。因此,医生在治疗患有 AFL(如慢性阻塞性肺疾病)的患者时应注意口腔健康。