目标:探讨是否:(i)患有严重精神疾病(SMI)的人的口腔健康状况比普通人群差,(ii)SMI患者口腔健康不良的危险因素。
方法:横断面数据来自国家健康和营养调查(1999-2016),包括自我评估的口腔健康,口腔疼痛,牙齿脱落,牙周炎阶段,和腐烂的数量,失踪,和填充的牙齿。口腔健康不良的候选危险因素包括人口统计学特征,生活方式因素,身体健康合并症,和牙齿卫生行为。序数逻辑回归和零膨胀负二项模型用于探索口腔健康结果的预测因素。
结果:分析共53,348例,包括718人与SMI。在完全调整的模型中,SMI患者更有可能出现牙齿脱落(OR1.60,95%CI:1.34-1.92).在有SMI的人中,确定的不良口腔健康结果的危险因素是年龄较大,白人种族,收入较低,吸烟史,和糖尿病。参与体育锻炼和日常使用牙线与更好的口腔健康结果相关。
结论:SMI患者的牙齿脱落率高于一般人群,某些亚组尤其处于危险之中。定期进行体育锻炼和使用牙线可能会降低口腔健康不良的风险,而吸烟和糖尿病可能会增加风险。这些发现表明,有针对性的预防和早期干预策略可以减轻SMI患者的不良口腔健康结果。
OBJECTIVE: To explore whether: (i) people with severe mental illness (SMI) experience worse oral health than the general population, and (ii) the risk factors for poor oral health in people with SMI.
METHODS: Cross-sectional data were extracted from the National Health and Nutrition Examination Survey (1999-2016), including on self-rated oral health, oral pain, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. Ordinal logistic regression and zero-inflated negative binomial models were used to explore predictors of oral health outcomes.
RESULTS: There were 53,348 cases included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.60, 95% CI: 1.34-1.92). In people with SMI, risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes.
CONCLUSIONS: People with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Performing regular physical exercise and flossing may lower the risk of poor oral health, while smoking and diabetes may increase the risk. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes in people with SMI.