Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine, Weiss Memorial Hospital, Chicago, Illinois.
J Pain. 2024 Sep;25(9):104529. doi: 10.1016/j.jpain.2024.104529. Epub 2024 Apr 6.
Poor oral health conditions in adults are associated with chronic pain. A nationwide cross-sectional study was conducted to investigate the link between tooth loss and chronic pain. The study involved 8,662 participants from the National Health and Nutrition Examination Survey. Tooth count was categorized into 4 groups, and chronic pain was defined as persistent pain lasting over 3 months despite treatment. Location of the chronic pain, demographics, comorbidities, lifestyle determinants, and dietary intake were retrieved. Univariate and multivariate logistic regression were used to explore cross-sectional associations between tooth count and chronic pain. Compared to participants with more than 20 teeth, those with severe tooth loss presented greater odds of chronic pain (adjusted odds ratio [aOR] = 2.111, 95% confidence intervals (CI) = 1.213-3.676 for patients with 1-8 teeth). Edentulous participants presented with significantly higher odds of chronic pain in the lower extremities (78.4%) and buttocks (49.5%). In the multivariate model, apart from rheumatic arthritis (aOR = 4.004, 95% CI = 2.766-5.798), variables of higher chronic pain included smoking (aOR = 1.518, 95% CI = 1.228-1.878), and hypertension (aOR = 1.463, 95% CI = 1.013-2.112). On the contrary, being Mexican American (aOR = .603, 95% CI = .414-.880) was associated with lower odds of chronic pain. The findings suggested a significant link between chronic pain and tooth loss, independent of ethnicity, lifestyle determinants, and immune-mediated inflammatory diseases including rheumatoid arthritis. PERSPECTIVE: A U.S. nationwide study examined tooth loss and chronic pain. Those with severe tooth loss had increased odds of chronic pain. Edentulous individuals presented higher odds of pain in lower extremities and buttocks. This study highlighted the link between tooth loss and chronic pain, independent of comorbidities and lifestyle factors.
成年人的口腔健康状况不佳与慢性疼痛有关。一项全国性的横断面研究调查了牙齿缺失与慢性疼痛之间的联系。该研究涉及来自国家健康和营养检查调查的 8662 名参与者。牙齿计数分为 4 组，慢性疼痛定义为持续疼痛超过 3 个月，尽管进行了治疗。检索慢性疼痛的位置、人口统计学、合并症、生活方式决定因素和饮食摄入。使用单变量和多变量逻辑回归探索牙齿计数与慢性疼痛之间的横断面关联。与拥有 20 多颗牙齿的参与者相比，严重牙齿缺失的患者发生慢性疼痛的几率更高（调整后的优势比[aOR]为 2.111，95%置信区间[CI]为 1.213-3.676，牙齿缺失 1-8 颗的患者）。无牙患者下肢（78.4%）和臀部（49.5%）慢性疼痛的几率明显更高。在多变量模型中，除风湿性关节炎（aOR=4.004，95%CI=2.766-5.798）外，慢性疼痛较高的变量还包括吸烟（aOR=1.518，95%CI=1.228-1.878）和高血压（aOR=1.463，95%CI=1.013-2.112）。相反，墨西哥裔美国人（aOR=0.603，95%CI=0.414-0.880）与慢性疼痛几率较低相关。研究结果表明，慢性疼痛与牙齿缺失之间存在显著关联，与种族、生活方式决定因素以及包括类风湿性关节炎在内的免疫介导的炎症性疾病无关。观点：一项美国全国性研究调查了牙齿缺失与慢性疼痛。牙齿缺失严重的患者发生慢性疼痛的几率增加。无牙患者下肢和臀部疼痛的几率更高。这项研究强调了牙齿缺失与慢性疼痛之间的关联，与合并症和生活方式因素无关。
