年龄和性别对牙科就诊与口腔健康不足和多种疾病的关联的影响：来自加拿大老龄化纵向研究（CLSA）的发现。
Age and sex differences in the association of dental visits with inadequate oral health and multimorbidity: Findings from the Canadian Longitudinal Study on Aging (CLSA).
机构信息
Divisions of Dental Public Health and Oral Medicine, Schulich School of Medicine & Dentistry, Western University, #0071-1511 Richmond St. Dental Sciences Building, London, ON, ON, N6A 3K7, Canada.
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
出版信息
BMC Public Health. 2024 Oct 25;24(1):2968. doi: 10.1186/s12889-024-20412-0.
BACKGROUND
Dental attendance is important for the prevention, diagnosis, and treatment of oral diseases. In this study, we aimed to assess the extent of the association between dental visits, inadequate oral health, and multimorbidity (MM), and whether this association differs by age and sex.
METHODS
We conducted a cross-sectional analysis of the first follow-up wave (2018) of the Canadian Longitudinal Study on Aging (CLSA). Poor self-reported oral health (SROH), oral health problems, and edentulism were used to indicate inadequate oral health. MM was defined as having 2 or more chronic conditions out of cancer, cardiovascular diseases, chronic respiratory diseases, diabetes, and mental illnesses. Dental visiting was determined as the number of visits to a dental professional within the past 12 months. Covariates included socioeconomic, behavioural factors, and the availability of dental insurance. We constructed multivariable Poisson and logistic regression models with interactions terms and estimated the relative excess risk due to interaction prevalence ratio (RERIPR) to assess the effect measure modification of age and sex on the associations of interest. We conducted sensitivity analyses and estimated E-values for unmeasured confounding.
RESULTS
In this sample (n = 44,815), dental visiting was inversely associated with inadequate oral health and MM in adjusted models, reducing the odds/prevalence of poor SROH (OR 0.41, 95% CI 0.34, 0.51), oral health problems (PR 0.89, 95% CI 0.79, 0.94), edentulism (OR 0.10, 95% CI 0.06, 0.15), and MM (PR 0.86, 95% CI 0.79, 0.92). These associations were stronger in older age and females.
CONCLUSION
Dental visiting may contribute to better oral health and reduced chronic diseases in the middle-aged and older population. Our findings suggest the need for age and sex-specific targeted interventions to optimize oral and overall health.
背景
定期看牙医对于预防、诊断和治疗口腔疾病非常重要。本研究旨在评估看牙医的频率、口腔健康状况不佳和多种慢性疾病（MM）之间的关联程度，并探讨这种关联是否因年龄和性别而异。
方法
我们对加拿大老龄化纵向研究（CLSA）的首次随访（2018 年）进行了横断面分析。使用自我报告的口腔健康状况不佳（SROH）、口腔健康问题和无牙来表示口腔健康状况不佳。MM 定义为患有癌症、心血管疾病、慢性呼吸系统疾病、糖尿病和精神疾病以外的两种或多种慢性疾病。看牙医的频率是指过去 12 个月内看牙医的次数。协变量包括社会经济、行为因素以及是否有牙科保险。我们构建了多变量泊松和逻辑回归模型，并加入了交互项，估计了由于交互作用引起的超额相对风险比（RERIPR），以评估年龄和性别对相关关联的效应修饰作用。我们进行了敏感性分析，并估计了未测量混杂因素的有效值（E 值）。
结果
在本样本（n=44815）中，调整后的模型显示，看牙医的频率与口腔健康状况不佳和 MM 呈负相关，降低了 SROH 不良（OR 0.41，95%CI 0.34，0.51）、口腔健康问题（PR 0.89，95%CI 0.79，0.94）、无牙（OR 0.10，95%CI 0.06，0.15）和 MM（PR 0.86，95%CI 0.79，0.92）的可能性。这些关联在年龄较大和女性中更强。
结论
看牙医可能有助于改善中年及以上人群的口腔健康和减少慢性疾病。我们的研究结果表明，需要针对年龄和性别制定特定的干预措施，以优化口腔和整体健康。
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