牙周病严重程度与口腔健康相关生活质量的关系

Akiko Yokotani, M. Matsuyama, N. Nakai
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摘要

牙周病的诊断和治疗结果通常是使用诸如探牙深度等生物医学数据来评估的。然而,近年来对医疗生活质量(QOL)的研究越来越受到关注。因此,本研究旨在阐明牙周病严重程度与口腔健康相关生活质量之间的关系。从2014年11月至2017年7月首次到Nakai牙科诊所就诊的30-64岁患者的病历中提取信息。通过基线牙周检查结果诊断牙周病的严重程度,然后根据社区牙周指数评分,并分为四组:(C, P1, P2, P3)。使用口腔健康影响概况简短版(OHIP-14)的总分和七个子域评分来评估生活质量。采用Kruskal-Wallis检验比较四组间OHIP-14总分和7个子域得分的差异。各组OHIP-14总分比较,P1组与P3组、P2组与P3组差异有统计学意义,P3组得分明显高于其他组。比较各组OHIP-14子域得分,发现P1和P3之间、P2和P3之间的“功能限制”、P1和P3之间的“心理不适”存在显著差异,而P3的总分明显高于其他组。其他五个子域得分在组间无显著差异。功能限制被主观地评估为咀嚼困难和食物夹在牙齿之间。心理不适包括焦虑和对牙齿问题的消极态度。口腔功能随牙周病的加重而主观上下降,不适感增加。总体而言,生活质量恶化了。在受试者中,牙周病的严重程度与口腔健康相关的生活质量相关。提示牙周病越严重的患者主观上口腔功能受损越严重,不适程度越高,生活质量越低。
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Relationship between Severity of Periodontal Disease and Oral Health Related Quality of Life of New Dental Patients
: Diagnosis and treatment outcomes of periodontal disease have typically been evaluated using biomedical data such as probing depth. Recently, however, there is greater research focus on quality of life (QOL) in medical treatment. This study therefore aimed to clarify the relationship between periodontal disease severity and oral health-related QOL. Information was extracted from medical records of patients aged 30-64 years and who visited Nakai Dental Office for the first time between November 2014 to July 2017. Severity of periodontal disease was diagnosed by results of a baseline periodontal examina-tion, and then scored in accordance with the Community Periodontal Index and classified into four groups: (C, P1, P2, P3). QOL was assessed using the total score and seven subdomain scores from the Oral Health Impact Profile Short Version (OHIP-14). The Kruskal-Wallis test was then used to compare among the four groups of the total score of OHIP-14 and the seven subdomain scores. Comparison of the groupsʼ total OHIP-14 scores showed significant differences between P1 and P3 and between P2 and P3, while P3 had a significantly higher score than other groups. Comparison of the groupsʼ OHIP-14 subdomain scores showed significant differences between P1 and P3 and between P2 and P3 for “functional limitation,” and between P1 and P3 for “psychological discomfort,” while P3 had a significantly higher total score than other groups. There were no significant between-groups differences for the other five subdomain scores. Functional limitations was assessed subjectively as difficulty in chewing and food getting caught between teeth. Anxiousness and negativity regarding the dental problem were reported among psychological discomfort. Oral function appeared to subjectively decrease, while discomfort increased with worsening of periodontal disease. In general, QOL worsened. Among the subjects, severity of periodontal disease was associated with oral-health-related QOL. It was suggested that patients with more severe periodontal disease had subjectively more impaired oral function, more discomfort, and lower QOL.
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