Kocher Thomas, Meisel Peter, Baumeister Sebastian, Holtfreter Birte
Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany.
Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany.
Periodontol 2000. 2024 Sep 25. doi: 10.1111/prd.12592.
In high-income countries, the oral health of the population is influenced by public health interventions, widespread use of oral care products, dental practice measures, and the cost of dental treatment. We compiled information on changes of the prevalence of proximal and upstream determinants of periodontitis, caries, and tooth loss over the last three decades to outline their potential effects on changes of oral health during this period. Information was retrieved from repeated cross-sectional studies and from published literature. While both the prevalence of edentulism and the number of missing teeth (from the DMF-T index) decreased, the number of sound teeth as well as the total number of teeth increased. The prevalence of severe periodontitis was unchanged, whereas the prevalence of periodontal health and moderate periodontitis may have increased to a minor extent. Concerning oral health risk factors, the proportion of individuals with tertiary education increased, while smoking prevalence declined. More and more people used oral care products. Whether one reimbursement system worked better than another one in terms of tooth retention could not be elucidated. In tooth retention, population-wide use of fluoridated toothpastes had the greatest impact. To some extent, the higher number of teeth present may be related to the more frequent use of interdental cleaning aids and powered toothbrushes. Since there was no decrease in severe periodontitis in most cohorts, periodontal interventions probably contributed little to improved tooth retention.
在高收入国家，民众的口腔健康受到公共卫生干预措施、口腔护理产品的广泛使用、牙科诊疗措施以及牙科治疗费用的影响。我们汇总了过去三十年中牙周炎、龋齿和牙齿缺失的近端及上游决定因素患病率变化的相关信息，以概述它们在此期间对口腔健康变化的潜在影响。信息来源于重复横断面研究及已发表的文献。无牙颌患病率和（DMF-T指数中的）缺失牙数量均有所下降，而完好牙齿数量及牙齿总数有所增加。重度牙周炎患病率未变，而牙周健康和中度牙周炎患病率可能有小幅上升。关于口腔健康风险因素，受过高等教育的个体比例增加，而吸烟率下降。越来越多的人使用口腔护理产品。在牙齿保留方面，无法阐明一种报销系统是否比另一种更有效。在牙齿保留方面，全民使用含氟牙膏的影响最大。在一定程度上，现存牙齿数量较多可能与更频繁使用牙间隙清洁辅助工具和电动牙刷有关。由于大多数队列中重度牙周炎患病率并未下降，牙周干预措施可能对改善牙齿保留的作用不大。
