일부 농촌지역 60세 이상 노인의 생활습관병이 구강건강에 미치는 영향

국문 초록 (Abstract)

당뇨병, 고혈압, 비만, 고콜레스테롤혈증이 노인의 구강건강상태에 미치는 영향을 파악하고 구강질환의 예방 및 치료의 기초자료를 마련하고자 2006년과 2007년에 성주군에 소재한 보건소에서 시행하는 건강검진을 받은 만 60세 이상의 노인을 대상으로 설문조사와 구강검사를 실시하고 이 대상자 중 2000년과 2001년에 조사되어 6년간 추적 관찰된 399명을 대상으로 분석하였다.
당뇨병, 고혈압, 비만과 고콜레스테롤혈증 유병기간에 따라서 당뇨병은 우식치아 수와 우식경험 영구치아 수, 고혈압은 결손치아 수와 우식경험 영구치아 수, 비만과 고콜레스테롤혈증은 결손치아수와 우식경험영구치아 수가 증가하는 것으로 나타났고 (p<0.05), 두 가지 이상 질병 보유군에서결손치아 수와 우식경험영구치아 수가 유의하게 많은 것으로 나타났다(p<0.01).
단순회귀분석 결과 당뇨병의 유병기간이 길수록 우식치아 수가 증가하고, 고혈압과 비만의 유병기간이 길수록 결손치아 수가 증가하는 것으로 나타났으며, 4가지 질병의 유병기간이 길수록 우식경험영구치아 수도 증가하는 것으로 나타났다. 다변량 회귀분석 결과 각 질병의 유병기간이 길수록 결손치아 수가 증가하는 것으로 나타났고, 당뇨병, 고혈압, 비만 등 각 질병의 유병기간이 길수록 그리고 보유질병 수가 많을수록 우식경험 영구치아 수가 증가하는 것으로 나타났다.
이와 같이 당뇨병, 고혈압, 비만, 고콜레스테롤 혈증 환자가 구강질환 발생위험이 상당히 높게 나타났다. 따라서 이들 생활습관병의 예방 및 관리는 구강건강상태에 크게 기여할 것이다.

다국어 초록 (Multilingual Abstract)

Objectives: The purpose of this study was to analyze the influence of four lifestyle-related diseases, diabetes, hypertension, obesity and hypercholesterolemia, on oral health in the rural elderly in Korea.
Methods: We enrolled 399 subjects over 60 years of age over a six year period, year 2000-2006/ year 2001-2007. All subjects received a routine health examination as part of a program conducted by the National Health Insurance Corporation at Seongju-gun Public Health Center in Gyeongsangbuk-do Province, South Korea. All subjects were surveyed and examined to determine their general and oral health statuses.
Results: Our results suggest that the duration of lifestyle-related diseases has a significant influence on oral health. The following factors were all significant in the results of analyses: duration of diabetes, tooth decay, which teeth had decayed, missing and filled teeth(DMFT), duration of hypertension, and duration of obesity and hypercholesterolemia(p<0.05). Our results also suggest that the number of lifestyle related diseases has a significant influence on oral health. Subjects with more than two diseases had significantly greater numbers of missing teeth and greater numbers of DMFT(p<0.01). The results of simple regression analysis indicate that patients exhibiting longer durations of diabetes also exhibit more tooth decay, and that patients exhibiting longer durations of hypertension and obesity are characterized by greater numbers of missing teeth. The longer the duration of any of the four lifestyle-related diseases we considered, the more DMFT we observed. Multiple regression analyses also demonstrated that longer duration of lifestyle-related disease was associated with greater numbers of missing teeth. As the number of lifestyle-related diseases increased, DMFT also increased.
Conclusions: In summary, lifestyle-related diseases such as diabetes, hypertension, obesity and hypercholesterolemia have significant influences on oral health in the elderly. In this context, the prevention and management of lifestyle-related disease is critical for the maintenance and promotion of oral health.

목차 (Table of Contents)

• Abstract
• 서론
• 대상 및 방법
• 결과
• 고찰
• 요약
• 참고문헌

참고문헌 (Reference)

1 이희경, "당뇨병 환자의 구강 상태 및 구강건강증진방안" 한국보건교육·건강증진학회 24 (24): 149-159, 2007

2 보건복지부, "국민구강건강실태조사"

3 Chobanian AV, "seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure" 289 : 2560-2572, 2003

4 Gilbert GH, "Tooth-specific and person-level predictors of 24-month tooth loss among older adults" 27 (27): 372-385, 1999

5 National Cholesterol Education Program/National Heart, "Third of the expert panel on direction, evaluation, and treatment of high blood cholesterol in adults full report" 2002

6 Sheiman A, "The relationship between oral health status and body mass index among older people: A national survey of older people in Great Britain" 192 : 703-706, 2002

7 Seung DK, "The effect of oral diseases on the incidence of cardiovascular diseases" Yonsei University 2003

8 World Health Organization Regional Office for the Western Pacific(WPRO), "The Asia-Pacific Perspective: Redefining Obesity and Its Treatment"

9 The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, "Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus" 26 : s5-s20, 2003

10 Slavkin HC, "Relationship of dental and pathology to systemic illness" 284 (284): 1215-1217, 2000

11 Haddad I, "Reasons for extraction of permanent teeth in Jordan" 49 (49): 343-346, 1999

12 Jorm AF, "Projected increases in the number of dimentia case for 29 developed countries: Application of a new method for making projection" 79 (79): 493-500, 1988

13 Joshipura KJ, "Poor oral health and coronary heart disease" 75 (75): 1631-1634, 1996

14 Loesche WJ, "Periodontal disease as a risk factor for heart disease" 15 (15): 976-991, 1994

15 Research Science and Therapy Committee of the American Academy of Periodontology, "Periodontal disease as a potential risk factor for systemic disease" 69 : 841-850, 1998

16 Beck JD, "Periodontal disease and cardiovascular disease" 67 : 1123-1137, 1996

17 World Health Organization, "Oral health surveys: Basic methods"

18 Buhlin K, "Oral health and cardiovascular disease in Sweden" 29 : 254-259, 2002

19 Fure S, "Incidence of tooth loss and dental caries in 60-, 70-and 80-year old Swedish individuals" 25 (25): 137-142, 1997

20 Shirai K, "Incidence of childhood obesity over the last 10 years in Japan" 10 : s65-s70, 1990

21 Johansson I, "Dental status, diet and cardiovascular risk factors in middle-aged people in northern Sweden" 22 : 431-436, 1994

22 Mattila KJ, "Dental infections as a risk factor for acute myocardial infarction" 14 : 51-53, 1993

23 Mattila KJ, "Dental infection and the risk of new coronary events: Prospective study of patients with documented coronary artery disease" 20 : 588-592, 1995

24 Kweider M, "Dental disease, fibrinogen and white cell count: Links with mycardial infarction?" 38 : 73-74, 1993

25 Kyung-Dong Lee, "DMFT Index, Periodontal Index and Oral Hygiene Status in Diabetic Patients" 22 (22): 62-71, 2005

26 Lee KD, "Associations of missing teeth with health status of rural elderly in Korea" Yeungnam University 2007

27 Wakai K, "Associations of medical status and physical fitness with periodontal disease" 26 : 664-672, 1999

28 Choi YH, "Associations of dental disease with medical status" Yonsei University 2001

29 Mattila KJ, "Age, dental infections and coronary heart disease" 79 : 756-760, 2000

30 Sandberg GE, "A controlled study of oral self-care and self-perceived oral health in type 2 diabetic patients" 59 : 28-33, 2001

31 보건복지부, "2008 국민건강통계 - 국민건강영양조사 제4기 2차년도"