The association of psychosocial factors and smoking with periodontal health in a community population
The association of psychosocial factors and smoking with periodontal health in a community population
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DOI：
10.1111/j.1600-0765.2008.01194.x
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发表时间：
2010-02-01
影响因子：
3.5
通讯作者：
Hsu, T. -C.
中科院分区：
文献类型：
--
作者：
Chiou, L. -J.;Yang, Y. -H.;Hsu, T. -C.
背景和目的：心理社会因素和牙周病之间的关联已被广泛报道，并可能通过吸烟状态进行修改。本研究调查了社区人群牙周状况与社会心理因素和吸烟的关系。材料和方法：对1764名平民非机构人员进行了结构化问卷调查，（一般人群，不包括疗养院、疗养院和医院）台湾个体，以评估心理社会因素的存在和严重程度[使用12项中国人健康问卷（CHQ-12）]，吸烟习惯及其他相关因素。结果：心理因素和吸烟与牙周附着丧失有显著相关性（P <0.05），而吸烟与牙周附着丧失无显著相关性（P> 0.05）（比值比= 1.69，95%置信区间= 1.01-2.77，比较CHQ-12评分>= 6与CHQ-12评分0-2，线性趋势p = 0.032;比值比= 2.21，95%可信区间= 1.45-3.37，吸烟者与非吸烟者比较），但与社区牙周指数无关。研究发现，吸烟者之间的这种联系比不吸烟者之间的联系更强。CHQ-12评分>= 6的吸烟者与非吸烟者相比（比值比= 1.43，95%置信区间= 0.76 - 2.58），其依恋丧失的比值比（比值比= 2.49，95%置信区间= 0.91-6.49）更高。对于牙周健康使用社区牙周指数测量，已婚和离婚/丧偶的受试者往往有牙周健康较差（比值比= 3.38，95%可信区间= 1.26-10.81和比值比= 3.83，95%可信区间= 1.21-13.83）。吸烟者心理健康状况不佳与牙周病的关系比不吸烟者更密切，特别是在累积性依恋丧失方面。我们的研究结果表明，心理健康和吸烟可能对患牙周病的风险有协同作用。
Background and Objective: The association between psychosocial factors and periodontal disease has been widely reported and might be modified by smoking status. This study investigated the association of periodontal status with psychosocial factors and smoking in a community population.Material and Methods: A structured questionnaire was administered to a total of 1764 civilian noninstitutional (general population excluding from nursing homes, sanitariums and hospitals) Taiwanese individuals to assess the presence and severity of psychosocial factors [using the 12-item Chinese health questionnaire (CHQ-12)], smoking habits and other related factors. Periodontal status was established using the community periodontal index and by measuring clinical loss of attachment.Results: Psychological factors and smoking were significantly associated with loss of attachment (odds ratio = 1.69, 95% confidence interval = 1.01-2.77, comparing the CHQ-12 score of >= 6 with the CHQ-12 score of 0-2 and p = 0.032 for linear trend; odds ratio = 2.21, 95% confidence interval = 1.45-3.37, comparing smokers with nonsmokers) but not with community periodontal index. The association was found to be stronger among smokers than among nonsmokers. Smokers with a CHQ-12 score of >= 6 had a higher odds ratio of loss of attachment (odds ratio = 2.49, 95% confidence interval = 0.91-6.49) than nonsmokers (odds ratio = 1.43, 95% confidence interval = 0.76 2.58). For periodontal health measured using the community periodontal index, married and divorced/widowed subjects tended to have poorer periodontal health (odds ratio = 3.38, 95% confidence interval = 1.26-10.81 and odds ratio = 3.83, 95% confidence interval = 1.21-13.83, respectively) than single subjects among nonsmokers but not among smokers.Conclusion: Poor mental health had a stronger association with periodontal disease among smokers than among nonsmokers, especially in accumulative attachment loss. Our findings suggest that mental health and smoking might have a synergistic effect on the risk of developing periodontal disease.