歯科診療所における長期メインテナンス中の中高年期の歯の喪失に関連する要因

本研究の目的は, 歯科診療所において長期間のメインテナンスケアーを利用している, 中高年期の受診者の歯の喪失に関連する危険因子を明らかにすることである。 大阪市内の2つの歯科医院のいずれかにおいて, 15年間以上メインテナンスを受け, かつ2004年7月-10月の4カ月間に来院した者のすべてを対象とした。対象者の1年あたり喪失歯数は, 初期治療終了後の1回目のメインテナンス受診開始時(ベースライン時)と, 上記期間最終の来院時の歯の本数の差により算出した。 最終来院時の対象者平均年齢は67.5歳で, 対象者371人の平均メインテナンス期間は, ベースライン時年齢が40歳未満は27.5年間, 4...

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Published inRonen Shika Igaku Vol. 24; no. 1; pp. 10 - 19
Main Authors 新庄, 文明, 川村, 泰行, 福田, 英輝
Format Journal Article
LanguageJapanese
Published 一般社団法人 日本老年歯科医学会 2009
Japanese Society of Gerodontology
Subjects
Online AccessGet full text
ISSN0914-3866
1884-7323
DOI10.11259/jsg.24.10

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Abstract 本研究の目的は, 歯科診療所において長期間のメインテナンスケアーを利用している, 中高年期の受診者の歯の喪失に関連する危険因子を明らかにすることである。 大阪市内の2つの歯科医院のいずれかにおいて, 15年間以上メインテナンスを受け, かつ2004年7月-10月の4カ月間に来院した者のすべてを対象とした。対象者の1年あたり喪失歯数は, 初期治療終了後の1回目のメインテナンス受診開始時(ベースライン時)と, 上記期間最終の来院時の歯の本数の差により算出した。 最終来院時の対象者平均年齢は67.5歳で, 対象者371人の平均メインテナンス期間は, ベースライン時年齢が40歳未満は27.5年間, 40歳以上は25.8年間であった。 第三大臼歯を除く, 年平均喪失歯数は40歳未満が0.040本, 40歳以上が0.115本であった。重回帰分析の結果, ベースライン時年齢が40歳未満は, 現在歯数が少ないことと4mm以上の歯周ポケットの有無が年喪失歯数との関連が示された。一方, ベースライン時年齢が40歳以上は, 失活歯数, 4mm以上の歯周ポケットの有無, および糖尿病の有無と喫煙習慣が年喪失歯数との関連が示された。本研究の結果, 長期メインテナンスを継続的に実施する場合でも, 40歳以降の受診者については歯周病だけではなく, 喫煙習慣および糖尿病などの健康管理に配慮するとともに, 生涯を通じて歯髄の失活を防ぐことが中高年期における歯の喪失の予防に重要であることを示唆している。
AbstractList 本研究の目的は, 歯科診療所において長期間のメインテナンスケアーを利用している, 中高年期の受診者の歯の喪失に関連する危険因子を明らかにすることである。 大阪市内の2つの歯科医院のいずれかにおいて, 15年間以上メインテナンスを受け, かつ2004年7月-10月の4カ月間に来院した者のすべてを対象とした。対象者の1年あたり喪失歯数は, 初期治療終了後の1回目のメインテナンス受診開始時(ベースライン時)と, 上記期間最終の来院時の歯の本数の差により算出した。 最終来院時の対象者平均年齢は67.5歳で, 対象者371人の平均メインテナンス期間は, ベースライン時年齢が40歳未満は27.5年間, 40歳以上は25.8年間であった。 第三大臼歯を除く, 年平均喪失歯数は40歳未満が0.040本, 40歳以上が0.115本であった。重回帰分析の結果, ベースライン時年齢が40歳未満は, 現在歯数が少ないことと4mm以上の歯周ポケットの有無が年喪失歯数との関連が示された。一方, ベースライン時年齢が40歳以上は, 失活歯数, 4mm以上の歯周ポケットの有無, および糖尿病の有無と喫煙習慣が年喪失歯数との関連が示された。本研究の結果, 長期メインテナンスを継続的に実施する場合でも, 40歳以降の受診者については歯周病だけではなく, 喫煙習慣および糖尿病などの健康管理に配慮するとともに, 生涯を通じて歯髄の失活を防ぐことが中高年期における歯の喪失の予防に重要であることを示唆している。
The present study was conducted in order to identify risk-factors for tooth loss among patients in a long-term maintenance program at dental clinics, as well as factors specifically related to the elderly. Subjects were selected from patients who had been in a maintenance program more than 15 years and who made their last dental visit between July and October 2004. The patients attended one of two private dental clinics where one of the authors has been working in Osaka. Annual tooth loss for each subject was calculated from the difference of tooth loss between the first visit and the last visit.The average length of maintenance, between the base line and the last visit, was 27.5 years for those younger than 39 years, and 25.8 years for those older than 40 years at the base line. The annual average tooth loss was 0.040 for the younger group and 0.115 for the older group, not including wisdom teeth. Multiple regression analysis showed that individuals aged 40 and older with more non-vital teeth and more teeth with periodontal pocket depth at the first visit, as well as retaining a smoking habit and suffering diabetes mellitus during the maintenance period had a higher rate of annual tooth loss, whereas individuals with fewer teeth and more teeth with periodontal pockets showed co-relation with higher rate of annual tooth loss for the younger age group.The results suggested that not only periodontal disease but also pulpectomy, as well as smoking and diabetes mellitus, could be the risk-factors of tooth loss in the later years even if a long-term maintenance program could be provided after 40 years of age. 本研究の目的は, 歯科診療所において長期間のメインテナンスケアーを利用している, 中高年期の受診者の歯の喪失に関連する危険因子を明らかにすることである。大阪市内の2つの歯科医院のいずれかにおいて, 15年間以上メインテナンスを受け, かつ2004年7月-10月の4カ月間に来院した者のすべてを対象とした。対象者の1年あたり喪失歯数は, 初期治療終了後の1回目のメインテナンス受診開始時(ベースライン時)と, 上記期間最終の来院時の歯の本数の差により算出した。最終来院時の対象者平均年齢は67.5歳で, 対象者371人の平均メインテナンス期間は, ベースライン時年齢が40歳未満は27.5年間, 40歳以上は25.8年間であった。第三大臼歯を除く, 年平均喪失歯数は40歳未満が0.040本, 40歳以上が0.115本であった。重回帰分析の結果, ベースライン時年齢が40歳未満は, 現在歯数が少ないことと4mm以上の歯周ポケットの有無が年喪失歯数との関連が示された。一方, ベースライン時年齢が40歳以上は, 失活歯数, 4mm以上の歯周ポケットの有無, および糖尿病の有無と喫煙習慣が年喪失歯数との関連が示された。本研究の結果, 長期メインテナンスを継続的に実施する場合でも, 40歳以降の受診者については歯周病だけではなく, 喫煙習慣および糖尿病などの健康管理に配慮するとともに, 生涯を通じて歯髄の失活を防ぐことが中高年期における歯の喪失の予防に重要であることを示唆している。
Author 川村, 泰行
新庄, 文明
福田, 英輝
Author_FL Shinsho Fumiaki
Kawamura Yasuyuki
Fukuda Hideki
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  fullname: 福田, 英輝
  organization: 長崎大学大学院口腔保健学
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6) Cahen, P. M., Frank, R. M. and Turlot, J. C. : A survey of the reasons for dental extraction in France, J. Dent. Res., 64 : 1087-1093, 1985.
22) McFall, W.T. Jr. : Tooth loss in 100 treated patients with periodontal disease : a long-term study, J. Periodontol., 53 : 539-549, 1982.
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10) Shinsho, F. and Fukuda, H. : Annual tooth loss of participants for regular oral health check-ups in a rural community in Japan, Dent. Jpn., 39 : 93-95, 2003.
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14) Shinsho, F. : An evaluation of preventive dentistry in the clinic for prolongation of teeth life. In : Proceedings of the 3rd World Congress on Preventive Dentistry, ed. Morioka, T., p.264-266. Fukuoka, Committee for 3rd WCPD, 1991.
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26) Wood, W.R., Greco, G.W. and McFall, W.T. Jr. : Tooth loss in patients with moderate periodontitis after treatment and long-term maintenance care, J. Periodontol., 60 : 516-520, 1989.
28) Papapanou, P.N., Wennstrom, J.L. and Grondahal, K.A. : 10-year retrospective study of periodontal disease progression, J. Clin. Periodontol., 6 : 403-411, 1989.
29) Niessen, L.C. and Weyant, R.J. : Causes of tooth loss in a veteran population, J. Public Health Dent., 49 : 19-23, 1989.
3) Agerberg, G. and Carlsson, G. E. : Chewing ability in relation to dental and general health, Acta Odontol. Scand., 39 : 147-153, 1981.
11) Wilson, T.G., Glover, M.E., Malik, A.K., Schoen, J.A. and Dorsett, D. : Tooth loss in maintenance patients in a private periodontal practice, J. Periodontol., 58 : 231-235, 1987.
18) Jette, A.M., Feldman, H.A. and Tennstedt, S.L. : Tobacco use : a modifiable risk factor for dental disease among elderly. Am. J. Public Health, 83 : 1271-1276, 1993.
31) Axelsson, P., Nystrom, B. and Lindhe, J. : The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance, J. Clin. Periodontol., 31 : 749-757, 2004.
7) Kay, E. J. and Blinkhorn, A. S. : The reasons underlying the extraction of teeth in Scotland, Br. Dent. J., 160 : 287-290, 1980.
16) Osterberg, T. and Mellstrom, D. : Tobacco smoking : a major risk factor for loss of teeth in three 70-year-old cohorts, Community Dent. Oral Epidemiol., 14 : 367-370, 1986.
33) Kawamura, Y., Shinsho, F., Fukuda, H., : Factors related to tooth loss during a long-term maintenance program at dental surgeries, J. Dent. Health, 57 : 159-165, 2007. (in Japanese
32) Fardal, O., Johannessen, A.C. and Linden, G.J. : Tooth loss during maintenance following periodontal treatment in a periodontal practice in Norway, J. Clin. Periodontol., 31 : 550-555, 2004.
17) Ragnarsson, E., Eliasson, S.T. and Olafsson, S.H. : Tobacco smoking, a factor in tooth loss in Reykjavik, Iceland, Scand. J. Dent. Res., 100 : 322-326, 1992.
23) Lindhe, J. and Nyman, S. : Long-term maintenance of patients treated for advanced periodontal disease, J. Clin. Periodontol., 11 : 504-514, 1984.
34) Konig, J., Plagmann, H.C., Ruhling, A. and Kocher, T. : Tooth loss and pocket probing depths in compliant periodontally treated patients : a retrospective analysis, J. Clin. Periodontol., 29 : 1092-1100, 2002.
2) Manly, R. S. and Braley, L. C. : Masticatory performance and efficiency, J. Dent. Res., 20 : 448-462, 1950.
12) Sheiham, A., Maizels, J. and Maizels, A. : New composite indicators of dental health, Community Dent. Health, 4 : 407-414, 1987.
27) Axelsson, P., Lindhe, J. and Nystrome, B. : On the prevention of caries and periodontal disease : results of a 15-year longitudinal study in adults, J. Clin. Periodontol., 18 : 182-189, 1991.
13) Shinsho, F., Suzuki, N. and Ikeda, M. : An effect of dental health instructions for preventing periodontal diseases of the adults and the elderly in dental clinics-effects on tooth loss, Jpn. J. Gerodontol., 3 : 15-19, 1989. (in Japanese
References_xml – reference: 37) Tonetti, M.S., Steffen, P., Muller-Campanile, V., Sevan, J. and Lang, N.P. : Initial extraction and tooth loss during supportive care in a periodontal population seeking comprehensive care, J. Clin. Periodontol., 27 : 824-831, 2000.
– reference: 3) Agerberg, G. and Carlsson, G. E. : Chewing ability in relation to dental and general health, Acta Odontol. Scand., 39 : 147-153, 1981.
– reference: 11) Wilson, T.G., Glover, M.E., Malik, A.K., Schoen, J.A. and Dorsett, D. : Tooth loss in maintenance patients in a private periodontal practice, J. Periodontol., 58 : 231-235, 1987.
– reference: 29) Niessen, L.C. and Weyant, R.J. : Causes of tooth loss in a veteran population, J. Public Health Dent., 49 : 19-23, 1989.
– reference: 33) Kawamura, Y., Shinsho, F., Fukuda, H., : Factors related to tooth loss during a long-term maintenance program at dental surgeries, J. Dent. Health, 57 : 159-165, 2007. (in Japanese)
– reference: 14) Shinsho, F. : An evaluation of preventive dentistry in the clinic for prolongation of teeth life. In : Proceedings of the 3rd World Congress on Preventive Dentistry, ed. Morioka, T., p.264-266. Fukuoka, Committee for 3rd WCPD, 1991.
– reference: 5) Axelsson, P. and Lindhe, J. : Effect of controlled oral hygiene procedures on caries and periodontal disease in adults, J. Clin. Periodontol., 8 : 239-248, 1981.
– reference: 22) McFall, W.T. Jr. : Tooth loss in 100 treated patients with periodontal disease : a long-term study, J. Periodontol., 53 : 539-549, 1982.
– reference: 24) Goldman, M.J., Ross, I.F. and Goteiner, D. : Effect of periodontal therapy on patients maintained for 15 years or longer : a retrospective study, J. Periodontol., 57 : 347-353, 1986.
– reference: 9) Shinsho, F., Tatara, K., Takatorige, T., Nakanishi, N. and Kuroda, K. : The effect of professional dental health care in the prevention of periodontal diseases in adults, Jpn. J. Public Health, 37 : 551-558, 1990. (in Japanese)
– reference: 26) Wood, W.R., Greco, G.W. and McFall, W.T. Jr. : Tooth loss in patients with moderate periodontitis after treatment and long-term maintenance care, J. Periodontol., 60 : 516-520, 1989.
– reference: 13) Shinsho, F., Suzuki, N. and Ikeda, M. : An effect of dental health instructions for preventing periodontal diseases of the adults and the elderly in dental clinics-effects on tooth loss, Jpn. J. Gerodontol., 3 : 15-19, 1989. (in Japanese)
– reference: 34) Konig, J., Plagmann, H.C., Ruhling, A. and Kocher, T. : Tooth loss and pocket probing depths in compliant periodontally treated patients : a retrospective analysis, J. Clin. Periodontol., 29 : 1092-1100, 2002.
– reference: 31) Axelsson, P., Nystrom, B. and Lindhe, J. : The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance, J. Clin. Periodontol., 31 : 749-757, 2004.
– reference: 28) Papapanou, P.N., Wennstrom, J.L. and Grondahal, K.A. : 10-year retrospective study of periodontal disease progression, J. Clin. Periodontol., 6 : 403-411, 1989.
– reference: 1) Shinsho, F. : New strategy for better geriatric oral health in Japan : 80/20 Movement and Healthy Japan 21, Int. Dent. J., 51 : 200-206, 2001.
– reference: 7) Kay, E. J. and Blinkhorn, A. S. : The reasons underlying the extraction of teeth in Scotland, Br. Dent. J., 160 : 287-290, 1980.
– reference: 12) Sheiham, A., Maizels, J. and Maizels, A. : New composite indicators of dental health, Community Dent. Health, 4 : 407-414, 1987.
– reference: 32) Fardal, O., Johannessen, A.C. and Linden, G.J. : Tooth loss during maintenance following periodontal treatment in a periodontal practice in Norway, J. Clin. Periodontol., 31 : 550-555, 2004.
– reference: 4) Reisine, S.T., Fetig, J., Weber, J. and Ledeer, S. : Impact of dental conditions on patients' quality of life, Community Dent. Oral Epidemiol., 17 : 7-10, 1989.
– reference: 25) Nabers, C.L., Stalker, W.H., Esparze, D., Naylor, B. and Canales, S. : Tooth loss in 1535 treated periodontal patients, J. Periodontol., 59 : 297-300, 1988.
– reference: 30) Chauncey, H.H., Glass, R.L. and Alman, J.E. : Dental caries : Principal cause of tooth extraction in a sample of US male adults, Caries Res., 23 : 200-205, 1989.
– reference: 15) Alvesalo, I., Reisine, S., Hay, J. and Bailit, H.L. : Effects of fluoride and regular dental care on personal dental expenditures of young adults in Finland, Community Dent. Oral Epidemiol., 10 : 15-22, 1982.
– reference: 6) Cahen, P. M., Frank, R. M. and Turlot, J. C. : A survey of the reasons for dental extraction in France, J. Dent. Res., 64 : 1087-1093, 1985.
– reference: 18) Jette, A.M., Feldman, H.A. and Tennstedt, S.L. : Tobacco use : a modifiable risk factor for dental disease among elderly. Am. J. Public Health, 83 : 1271-1276, 1993.
– reference: 21) Hirschfeld, L. and Wasserman, B. : A long-term survey of tooth loss in 600 treated periodontal patients, J. Periodontol., 49 : 225-237, 1976.
– reference: 10) Shinsho, F. and Fukuda, H. : Annual tooth loss of participants for regular oral health check-ups in a rural community in Japan, Dent. Jpn., 39 : 93-95, 2003.
– reference: 16) Osterberg, T. and Mellstrom, D. : Tobacco smoking : a major risk factor for loss of teeth in three 70-year-old cohorts, Community Dent. Oral Epidemiol., 14 : 367-370, 1986.
– reference: 2) Manly, R. S. and Braley, L. C. : Masticatory performance and efficiency, J. Dent. Res., 20 : 448-462, 1950.
– reference: 19) Quteish, T. : Periodontal reasons for tooth extraction in an adult population in Jordan, J. Oral Rehabil., 30 : 110-112, 2003.
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Snippet 本研究の目的は, 歯科診療所において長期間のメインテナンスケアーを利用している, 中高年期の受診者の歯の喪失に関連する危険因子を明らかにすることである。 大阪市...
The present study was conducted in order to identify risk-factors for tooth loss among patients in a long-term maintenance program at dental clinics, as well...
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SubjectTerms long-term maintenance
number of non-vital teeth
number of present teeth
tooth loss
失活歯数
平均喪失歯数
現在歯数
長期メインテナンス
Title 歯科診療所における長期メインテナンス中の中高年期の歯の喪失に関連する要因
URI https://www.jstage.jst.go.jp/article/jsg/24/1/24_1_10/_article/-char/ja
https://cir.nii.ac.jp/crid/1390001204330727808
Volume 24
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ispartofPNX 老年歯科医学, 2009, Vol.24(1), pp.10-19
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