歯および義歯の状態が全身の健康に及ぼす影響に関する施設入居高齢者の追跡研究

抄録

In 1994/95, a follow-up survey of a 1988/89 survey about the oral health conditions and treatment needs of dental disease was carried out for institutionalized elderly people. Base line survey comprised 1, 959 persons aged ≥59 years in 29 institutions in Kitakyushu, Japan. The purpose of this study is to observe changes in tooth and denture conditions with advancing age and to clarify tooth and denture conditions contributing to general health. Dentition, wearing of and need for dentures were assessed according to WHO guidelines (Oral health Survey-Basic Method, 3rd Ed., 1987). Interviews were also conducted and data on general health status were obtained from the subjects' medical histories. Seven hundred and nineteen people were re-examined for the baseline survey. One thousand two hundred and forty persons were dropped from the present survey because of death (878), of hospitalization (191), they left the institution (147), and they refused and oral examination (24). Percentage of edentulous persons increased 8.5% from 47.7% at baseline to 56.2% in 1994/95. In dentate persons, mean number of teeth, mean number of DF(decayed and filled) teeth, D(decayed) teeth and F(filled) teeth was 10.6, 6.6, 0.8, and 5.8 in 1988/89, and 9.1, 7.0, 1.7, and 5.4 in 1994/95, respectively. Percentage of persons needing denture treatment increased 10% from 74% at baseline to 84% in 1994/95 and the worse general health status was, the more denture needs increased. Denture conditions of persons who received denture treatment at least once during the 6 years improved. General health status including, physical and mental health, of institutionalized elderly people got worse with increasing age. In multivariate analyses general health status became worse with decreasing number of teeth and with worsening denture conditions when the effects of other factors were controlled. Especially, physical health conditions in edentulous, no denture wearing, subjects became about 10 times more serious than that of persons with ≥20 teeth. During the same period, the mental health conditions of subjects became 3 times worse. In dentate persons, persons with severe carious teeth had a 1.7 times higher risk to physical health than persons without severe carious teeth. Mortality increased with worsening physical and mental health. The risk of mortality of persons with no denture wearing increased with decreasing number of teeth, but mortality of persons with denture wearing did not increased even if the dentures needed repair or remaking. The results suggest that healthier oral health conditions might contribute to maintaining better health in older age cohort. So, keeping more teeth is the most important for keeping good general health status of institutionalized elderly people, and if elderly people loose some teeth, it's necessary to wear good dentures. But, institutionalized elderly revealed poor dental health conditions and high treatment needs of their mouth. The results emphasize the necessity of improving the dental health system for the institutionalized sector of the population and also the importance of preventive programs for dental diseases and dental health education in the younger generations.