Slade G D, Spencer A J, Locker D, Hunt R J, Strauss R P, Beck J D
Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450, USA.
J Dent Res. 1996 Jul;75(7):1439-50. doi: 10.1177/00220345960750070301.
Previous studies among older adults have demonstrated that oral disease frequently leads to dysfunction, discomfort, and disability. This study aimed to assess variations in the social impact of oral conditions among six strata of people aged 65 years and older: residents of metropolitan Adelaide and rural Mt Gambier, South Australia; residents of metropolitan Toronto-North York and non-metropolitan Simcoe-Sudbury counties, Ontario, Canada; and blacks and whites in the Piedmont region of North Carolina (NC), United States. Subjects were participants in three oral epidemiological studies of random samples of the elderly populations in the six strata. Some 1,642 participants completed a 49-item Oral Health Impact Profile (OHIP) questionnaire which asked about impacts caused by problems with the teeth, mouth, or dentures during the previous 12 months. The percentage of dentate people reporting impacts fairly often or very often was greatest among NC blacks for 41 of the OHIP items. Two summary variables of social impact were used as dependent variables in bivariate and multivariate least-squares regression analyses. Among dentate people, mean levels of social impact were greatest for NC blacks and lowest for NC whites, while people from South Australia and Ontario had intermediate levels of social impact (P < 0.01). Missing teeth, retained root fragments, root-surface decay, periodontal pockets, and problem-motivated dental visits were associated with higher levels of social impact (P < 0.05), although there persisted a two-fold difference in social impact across the six strata after adjustment for those factors Among edentulous people, there was no statistically significant variation in social impact among strata. The findings suggest that there are social and cultural factors influencing oral health and its social impact, and that those factors differ most between dentate blacks and whites in NC.
先前针对老年人的研究表明，口腔疾病常常会导致功能障碍、不适和残疾。本研究旨在评估65岁及以上六个阶层人群口腔状况的社会影响差异：南澳大利亚州阿德莱德市和甘比尔山农村地区的居民；加拿大多伦多市北约克区和安大略省非都市地区锡姆科-萨德伯里县的居民；以及美国北卡罗来纳州皮埃蒙特地区的黑人和白人。研究对象是这六个阶层老年人群随机样本的三项口腔流行病学研究的参与者。约1642名参与者完成了一份包含49个条目的口腔健康影响程度量表（OHIP）问卷，该问卷询问了过去12个月中牙齿、口腔或假牙问题所造成的影响。在OHIP的41个条目中，报告影响相当频繁或非常频繁的有牙人群比例在北卡罗来纳州黑人中最高。在双变量和多变量最小二乘回归分析中，将社会影响的两个汇总变量用作因变量。在有牙人群中，北卡罗来纳州黑人的社会影响平均水平最高，北卡罗来纳州白人最低，而南澳大利亚州和安大略省的人的社会影响水平处于中间（P<0.01）。缺牙、保留的牙根碎片、根面龋、牙周袋以及因问题而进行的牙科就诊与较高的社会影响水平相关（P<0.05），尽管在对这些因素进行调整后，六个阶层之间的社会影响仍存在两倍的差异。在无牙人群中，各阶层之间的社会影响没有统计学上的显著差异。研究结果表明，存在影响口腔健康及其社会影响的社会和文化因素，并且这些因素在北卡罗来纳州有牙的黑人和白人之间差异最大。
