Drake C W, Hunt R J, Koch G G
Department of Diagnostic Sciences, University of North Carolina at Chapel Hill 27599-7450, USA.
J Dent Res. 1995 Feb;74(2):675-80. doi: 10.1177/00220345950740020801.
The distribution and determinants of tooth loss in older adults are poorly defined, especially in Blacks, who have been underrepresented in previous studies. This study investigated, epidemiologically, the distribution and predictors of tooth loss in elder Blacks and Whites by following a random sample of older adults in North Carolina for three years. It was hypothesized that Blacks would be at greater risk of tooth loss and would have different risk factors for tooth loss. Data from 263 Blacks and 228 Whites were collected by dental examinations and interviews conducted in the participants' homes. During the three-year follow-up, 53% of Blacks and 29% of Whites lost at least one tooth. Blacks lost 13% of their remaining teeth compared with 4% for Whites. Logistic regression models showed that factors related to tooth loss for Blacks were: more S. mutans in stimulated saliva, deeper periodontal pockets, more P. intermedia in subgingival plaque, high blood pressure, limited help from others, and few symptoms of depression. For Whites, significant factors were: more lactobacilli in stimulated saliva, history of current oral pain at baseline, more alcohol consumption, no history of past use of calcium or xerostomic medications, higher income, lower occupational prestige, and increased numbers of negative life events. This study showed that older Blacks were at greater risk of tooth loss than older Whites. For both races, factors such as oral bacteria, periodontal conditions, oral symptoms, and psychosocial and economic factors are related to increased risk of tooth loss.
老年人牙齿缺失的分布情况及决定因素尚不明确，尤其是在黑人中，他们在以往研究中的代表性不足。本研究通过对北卡罗来纳州的老年人随机样本进行为期三年的跟踪调查，从流行病学角度研究老年黑人和白人牙齿缺失的分布情况及预测因素。研究假设黑人牙齿缺失的风险更高，且牙齿缺失的风险因素也有所不同。通过在参与者家中进行牙科检查和访谈，收集了263名黑人及228名白人的数据。在三年的随访期间，53%的黑人及29%的白人至少掉了一颗牙。黑人剩余牙齿中有13%缺失，而白人这一比例为4%。逻辑回归模型显示，与黑人牙齿缺失相关的因素有：刺激唾液中变形链球菌更多、牙周袋更深、龈下菌斑中中间普氏菌更多、高血压、他人帮助有限以及抑郁症状较少。对于白人，显著因素有：刺激唾液中乳酸杆菌更多、基线时有当前口腔疼痛史、饮酒量更多、既往无使用钙或口干药物的历史、收入更高、职业声望较低以及负面生活事件数量增加。本研究表明，老年黑人比老年白人牙齿缺失的风险更高。对于两个种族而言，诸如口腔细菌、牙周状况、口腔症状以及心理社会和经济因素等都与牙齿缺失风险增加有关。
