| Summary: | 博士 === 高雄醫學大學 === 牙醫學研究所 === 91 === Abstract
Background: The development of chronic periodontitis (CP) is a multifactorial process. It should be noted that the variation in severity of the CP could not be explained only by few risk factors. Three case-control retrospective studies were conducted among a population of Taiwan adults. The aims were: 1) to explore simultaneously the lifestyle and psychosocial factors of the CP, and 2) to estimate the proportion of total CP cases attributable to one or more risk factors considered.
Methods: Thee study designs were the case-control retrospective study, the matched case-control retrospective study and age-stratified case-control study, 252 cases of CP patients and 309 controls, 250 cases and 250 controls were matched by age (within 3 years) and gender, 129 young adults (18-34 years) and 432 older adults ( ³ 35 years), respectively. For both case and control groups, complete dental examinations were performed based on the clinical criteria for CP. Structured questionnaires were conducted to collect lifestyle and psychosocial factors. Multivariate logistic regression was applied to assess the association between risk factors and chronic periodontitis.
Results: This study showed that tooth-brushing frequency, mental illness and smoking were the most significantly risk factors of CP. For example, pair-matched case-control retrospective study showed that tooth-brushing frequency (OR: 5.77, if rarely; OR: 3.50, if once a day), mental illness (OR: 5.32, if CHQ-12 scores were ³ 6), and smoking (OR: 3.93, if pkyrs smoked was more than 21) are significantly and independently associated with chronic periodontitis. In addition, all these variables reflected a dose-response effect (P trend = <0.001, 0.004, and 0.005, respectively).
Conclusions: For Taiwanese adults, 36.10% of CP cases were presumably attributable to tooth-brushing frequency, mental illness and smoking. These three factors should be the first priority in establishing a preventive program in order to improve periodontal health status.
Key Words: Taiwan; risk factors; attributable risks; periodontitis; mental illness.
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