Is medication a risk factor for dental caries among older people? Evidence from a longitudinal study in South Australia
Is medication a risk factor for dental caries among older people? Evidence from a longitudinal study in South Australia
复制标题
DOI：
10.1034/j.1600-0528.2002.300309.x
复制
发表时间：
2002-06-01
影响因子：
2.3
通讯作者：
Chalmers, JM
中科院分区：
文献类型：
--
作者：
Thomson, WM;Spencer, AJ;Chalmers, JM
目的：本研究使用一种理论模型，研究了老年人长期药物暴露与 5 年龋齿增加之间的关系，根据该模型，干燥药物被认为会通过以下两种方式导致龋齿增加：(i) 长期降低唾液流量，从而减少牙菌斑酸的唾液缓冲，或 (ii) 产生口干症状，通过使用致龋饮料和食品来缓解症状。方法：数据来自对居住在社区的 60 岁以上南澳大利亚人进行队列研究的 5 年随访阶段的参与者。基线和 5 年时的药物信息均可用，因此只有在这两种情况下服用的药物才能包含在分析中。在基线和 5 年时进行牙科检查，并计算逆转调整的 5 年龋齿增量。多变量模型用于控制潜在混杂因素的影响。结果：在原始样本中，528 名（62.3%）人在 5 年后仍然留下来，留下来的人往往比失访的人更年轻、更健康，用药也更少。五年冠龋发生率为66.9%。调整后的冠状龋齿增量 (AdjCl) 在男性和过去 5 年服用 β 受体阻滞剂或抗哮喘药物的人群中较高。 5年根面龋发生率为59.3%。较低的根表面 AdjCl 与每日服用阿司匹林有关。在早期分析中显示的预测口干的药物中，只有抗哮喘药物与较高的龋齿经历相关，并且它们预测了更严重的口干症状。结论：这项研究没有为药物与龋齿的关系提供强有力的证据，因为只有一种观察到的药物与龋齿的关联可以用理论模型来解释。然而，应该承认，服用抗哮喘药物的老年人可能面临更高的龋齿风险，这可能是通过采取缓解口干症状的措施来实现的。
Objectives: This study examined the association between chronic medication exposure and 5-year dental caries increment among older people, using a theoretical model whereby xerogenic medication is thought to lead to increased caries by either (i) chronically lowering salivary flow, thus reducing salivary buffering of plaque acids, or (ii) producing the symptoms of dry mouth, leading to symptomatic relief through the use of cariogenic drinks and foodstuffs. Methods: Data were obtained from participants remaining at the 5-year follow-up phase of a cohort study of community-dwelling South Australians aged 60 +. Medication information was available at baseline and at 5 years, enabling only those medications taken on both occasions to be included in the analyses. Dental examinations were conducted at baseline and 5 years, and a reversal-adjusted 5-year caries increment was computed. Multivariate modelling was used to control the effects of potential confounders. Results: Of the original sample, 528 (62.3%) remained after 5 years, with those remaining tending to be younger, healthier and less medicated than those lost to follow-up. Five-year coronal caries incidence was 66.9%. The adjusted coronal caries increment (AdjCl) was higher among males and among those taking a beta-blocker or an antiasthma drug for the previous 5 years. The 5-year incidence of root surface caries was 59.3%. A lower root surface AdjCl was associated with taking daily aspirin. Of the medications shown in earlier analyses to predict dry mouth, only the antiasthma drugs were associated with higher caries experience, and they had predicted more severe xerostomia symptoms. Conclusions: This study offers no strong evidence for a medication-caries relationship, as only one of the observed medication-caries associations was explicable in terms of the theoretical model. However, it should be acknowledged that older people taking antiasthma drugs may be at higher risk of coronal caries, possibly through measures taken for the symptomatic relief of dry mouth.