Gibson G, Niessen L C
Geriatric Dental Program, Dallas VA Medical Center, TX, USA.
Med Care. 1995 Nov;33(11 Suppl):NS45-56. doi: 10.1097/00005650-199511001-00007.
This article reviews the research on the oral health status of aging veterans and offers recommendations for a research agenda that will improve their oral health and quality of life. Uniform definitions, or a "composite" measure, of overall oral health status would facilitate oral health status measurement. Because such a measure is not available, traditional oral epidemiologic indexes or treatment-needs data have been used to identify oral health status in aging veterans. Few studies of national scope have been conducted on veterans. A cost-effective alternative may be cooperative studies within the Department of Veterans Affairs (VA) and other organizations. The Department of Veterans Affairs Dental Longitudinal Study (DLS), begun in 1968, provides the richest data on an aging veteran population. More frequently, VA investigators have examined local or regional veteran populations. These studies have examined oral health status and risk factors associated with oral diseases. Unlike the DLS, most studies have been cross-sectional, and a few studies have examined the effect of systemic disease on oral health and vice versa. Key research agenda items and recommendations include: Development and validation of functional measures of oral health status; Implementation of multicenter, cooperative, descriptive, and analytic epidemiologic studies; Implementation of focused cross-sectional and longitudinal studies on oral health status, treatment needs, and patient outcomes; Enumeration of data sets in the VA system that can be shared with non-VA investigators; Implementation of targeted studies of aging populations who have specific comorbidities prevalent in VA; and Use of VA continuum of care to study the relation between oral and systemic diseases.
本文回顾了关于老年退伍军人口腔健康状况的研究,并为改善他们口腔健康和生活质量的研究议程提供建议。统一的整体口腔健康状况定义或“综合”衡量标准将有助于口腔健康状况的测量。由于目前尚无这样的衡量标准,传统的口腔流行病学指标或治疗需求数据已被用于确定老年退伍军人的口腔健康状况。针对退伍军人开展的全国性研究很少。一种具有成本效益的替代方法可能是退伍军人事务部(VA)与其他组织之间的合作研究。始于1968年的退伍军人事务部牙科纵向研究(DLS)提供了关于老年退伍军人人群最丰富的数据。更常见的是,VA的研究人员对当地或地区的退伍军人人群进行了调查。这些研究调查了口腔健康状况以及与口腔疾病相关的风险因素。与DLS不同,大多数研究都是横断面研究,只有少数研究考察了全身性疾病对口腔健康的影响,反之亦然。关键的研究议程项目和建议包括:口腔健康状况功能测量方法的开发与验证;开展多中心、合作性、描述性和分析性流行病学研究;针对口腔健康状况、治疗需求和患者预后开展重点横断面和纵向研究;梳理VA系统中可与非VA研究人员共享的数据集;针对VA中普遍存在的特定合并症的老年人群开展针对性研究;利用VA的连续护理体系研究口腔疾病与全身性疾病之间的关系。