Determinants of the Utilization of Dental Services in a Community-Dwelling Elderly Japanese Population
Determinants of the Utilization of Dental Services in a Community-Dwelling Elderly Japanese Population
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DOI：
10.1620/tjem.218.241
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发表时间：
2009-07-01
影响因子：
2.2
通讯作者：
Watanabe, Makoto
中科院分区：
文献类型：
--
作者：
Ohi, Takashi;Sai, Motoyuki;Watanabe, Makoto
口腔保健不仅是预防、早期诊断和治疗口腔面部疾病和失调的有效策略，而且是一般健康促进计划的重要组成部分。目前的研究旨在确定日本老年人口使用牙科服务的决定因素。一项以社区为基础的综合老年评估，包括身体、心理和社会功能的测量，在老年人中进行。70岁，居住在日本仙台郊区。口腔健康状况和功能、对生活质量的影响以及牙齿的使用情况也进行了调查。在1170名参与者中，418名有特殊牙病治疗需求且报告不规律看牙医的受试者被建议去看牙医，并在1年后通过问卷调查评估他们对建议的依从性。多元logistic回归分析显示，剩余牙数和活动义齿的使用是1年内牙齿使用的显著预测因素。定期使用与剩余牙齿数量较多、年龄较小、存在全身性疾病、没有抑郁症状和较高的教育程度有关。相反，不遵守治疗建议与前一年剩余牙齿减少、吸烟和不利用牙科服务有关。牙科就诊行为决定因素的差异可能与牙科服务的保险覆盖范围部分相关，这表明需要针对不同的牙科利用行为制定具体的口腔健康促进策略。
Oral health care is not only an effective strategy for the prevention, early diagnosis, and treatment of orofacial disease and disorders, but also an essential component of general health promotion programs. The current study aimed to identify the determinants of the utilization of dental services in an elderly population in Japan. A community-based comprehensive geriatric assessment, including the measurements of physical, mental, and social functioning, was conducted among elderly people aged ! 70 years residing in a suburban area of Sendai, Japan. Oral health status and functioning, their impact on the quality of life, and dental utilization were also surveyed. Of the 1,170 participants, 418 subjects who had specific treatment needs for dental problems and reported irregular dental attendance were recommended a dental visit, and 1 year later, their compliance with the recommendation was assessed by using questionnaire. Multiple logistic regression analysis demonstrated that a higher number of remaining teeth and the use of removable dentures were significant predictors of dental utilization within 1 year. Regular utilization was associated with a higher number of remaining teeth, younger age, presence of systemic disease, absence of depressive symptoms, and higher educational attainment. Conversely, noncompliance with the treatment recommendations was associated with fewer remaining teeth, smoking, and non-utilization of dental services during the previous year. The differences in the determinants of dental attendance behavior, which may be partially associated with the insurance coverage for dental services, suggest the need for specific strategies for oral health promotion for different behavior of dental utilization.