Joshi A, Douglass C W, Feldman H, Mitchell P, Jette A
Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA.
J Public Health Dent. 1996 Summer;56(4):190-7. doi: 10.1111/j.1752-7325.1996.tb02435.x.
Increased tooth retention coupled with increased numbers of older adults means that the actual number of teeth at risk to dental disease will increase sharply. Whether this increase in the number of teeth will translate into more disease and utilization in unknown. The purpose of this study was to test this "more teeth, therefore more dental disease" theory using cross-sectional data.
In-home personal interview and oral examination data were obtained on a probability sample of elders aged 70 years and older living in the six New England states using the Medicare beneficiary list as a sampling frame. Data on dental utilization, number of teeth, dental caries, and periodontal disease were included in the current analysis.
Analysis of variance on subjects with 1-10 (Group 1), 11-24 (Group 2), and 25-32 (Group 3) teeth show that the extent of bleeding on probing, pocket depth, and loss of attachment all increase as numbers of teeth increase. Similarly, a greater number of restored coronal and root surfaces were found in Group 3 relative to the other two groups. Mean numbers of decayed and filled coronal surfaces were 8.4 in Group 1.33.0 in Group 2, and 50.3 in Group 3. In contrast, unrestored coronal and root surface were significantly higher in Group 1 (mean root DS = 1.3) than Group 3 (mean root DS = 0.3). Utilization patterns of those with successful aging dentitions (Group 3) show that they are visiting dentists more frequently than the compromised group (Group 1).
These cross-sectional data obtained from a probability sample of New England elders show that subjects who retained higher numbers of teeth have more periodontal disease and dental caries experience, and visit the dentist more frequently.
牙齿保留率的提高以及老年人数量的增加意味着患牙病风险的实际牙齿数量将急剧增加。牙齿数量的这种增加是否会转化为更多的疾病和利用情况尚不清楚。本研究的目的是使用横断面数据来检验这种“牙齿越多，牙病越多”的理论。
以医疗保险受益人名单为抽样框架，对居住在新英格兰六个州的70岁及以上老年人的概率样本进行了家庭个人访谈和口腔检查数据收集。当前分析纳入了牙齿利用、牙齿数量、龋齿和牙周病的数据。
对有1 - 10颗牙（第1组）、11 - 24颗牙（第2组）和25 - 32颗牙（第3组）的受试者进行方差分析，结果显示，随着牙齿数量的增加，探诊出血程度、牙周袋深度和附着丧失均增加。同样，与其他两组相比，第3组中修复的冠面和根面数量更多。第1组中龋坏和充填的冠面平均数量为8.4，第2组为33.0，第3组为50.3。相比之下，第1组（平均根面龋DS = 1.3）未修复的冠面和根面显著高于第3组（平均根面龋DS = 0.3）。牙列状况良好（第3组）者的利用模式表明，他们看牙医的频率高于牙列受损组（第1组）。
这些从新英格兰老年人概率样本中获得的横断面数据表明，保留牙齿数量较多的受试者有更多的牙周病和龋齿经历，并且看牙医的频率更高。
