Oral health status and prevalence of temporomandibular disorders in 65–74-year-olds in Vietnam
Date
2018-04-18
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Abstract
Tervest suust räägitakse siis, kui näo ja lõualuude piirkonnas ei ole valu, hambakaariest, põletikulisi protsesse, kasvajaid, teisi haigusi ega normist kõrvalekaldeid, mis halvendaksid mälumis- ja kõnefunktsiooni ning psühhosotsiaalset heaolu. Eakate inimeste osakaal ühiskonnas suureneb pidevalt paljudes riikides. Vananeva ja nõrgestatud inimese suu tervist võivad mõjutada mitmed riskitegurid. Näo-lõualuude süsteemi tervis oleneb ka hambumusest ja alalõualiigeste seisundist. Erinevate alalõualiigese anatoomiliste ja funktsionaalsete haiguslike seisundite ühisnimetajaks on temporomandibulaarliigese e. alalõualiigese haiguslikud seisundid (TMD).
Vietnami eakad on elanud üle Vietnami sõja (1945–1975). Erinevad majandusmudelid ja globaalsed muutused on mõjutanud nende tervist sh. suutervist ja elukvaliteeti. Käesoleva uuringu eesmärkideks oli kirjeldada vanemaealiste vietnamlaste suutervise seisundit ja suutervise käitumist, alalõualiigese haiguslikke seisundeid ja oklusioonikontaktide mõju näokolju struktuuridele ning uurida näokolju morfoloogia ja TMD vahelisi seoseid. Uuringusse kaasati mitmeastmelise juhusliku kihtvaliku meetodit rakendades Danangi piirkonnast 258 vietnamlast vanuses 65-74 aastat.
Kliiniline uuring hammaste kõvakudede ja tugikudede seisundi hindamiseks teostati vastavalt Maailma Terviseorganisatsiooni soovitatud indekseid ja metoodikat kasutades. Alalõualiigese haigusi diagnoositi kasutades alalõualiigese haiguste diagnostika kriteeriume. Hambumust hinnati Eichner’s klassifikatsiooni järgi, milles on hambakaar jagatud oklusioonikontaktide põhjal neljaks tsooniks, eakate inimeste näokolju muutusi hinnati tsefalomeetriat kasutades.
Uuritutest 97.7% diagnoositi hambakaariest, 83,3% parodondi haigusi ja 56,6% alalõualiigese haiguslikke seisundeid, milliste hulgas prevaleerusid diski asendi häire ja liigese degeneratiivsed muutused. Umbes 16% uuritutest ei olnud ühtegi töötavat hambapaari e. oklusioonikontakti. Risk alalõualiigeste haigestumiseks oli 3,36 korda kõrgem ühepoolse (95% CI = 1,21–9,36, P = 0,020) ja 2,71 korda kahepoolse (95% CI = 1,12–6,56, P = 0,027) oklusioonikontaktide kaotuse korral. Puudulik oklusioonikontaktide arv põhjustab muutusi ala – ja ülalõualuu tasandil ja struktuuris. Muutused mandibulaarsetes struktuurides olid statistiliselt oluliselt seotud alalõualiigese haiguslike seisundite tekkega (P < 0,05).
Saadud informatsioon omab väärtust Vietnami tervishoiusüsteemis suutervise alase ennetustegevuse ja aktiivse ravi planeerimisel.
Oral health is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity of biting, chewing, smiling, speaking, and psychosocial well-being. Health of the stomatognathic system is also related to the status of dental occlusion and temporomandibular structures. The variation in the conditions affecting the anatomic and functional characteristics of temporomandibular structures is known as temporomandibular disorders. The Vietnamese elderly have experienced the Vietnam War (1945–1975) and different economic systems. These upheavals could affect their oral status. The aims of the dissertation were to study oral health status, temporomandibular disorders (TMD), and the role of occlusal support in relation to TMD and the craniofacial structure in the Vietnamese elderly aged 65–74 years. The cross-sectional study covered 258 participants living in Danang, Vietnam. Clinical examination of teeth and the surrounding tissues was performed according to the recommendations of the WHO. Diagnosis of TMD was based on the Diagnostic Criteria for Temporomandibular Disorders; occlusal supports were analysed by using the Eichner classification; cephalometric measurements were used to evaluate the alterations in the craniofacial structures of the elderly. Of the sample, 97.7% had experienced dental caries, 83.3% had periodontal diseases, and 56.6% had TMD. Disc displacement and degenerative joint disease were most prevalent among the elderly Vietnamese. Approximately 16% of the elderly did not have any occlusal supports, the odds of having TMD were positively associated with total unilateral loss of occlusal support (OR = 3.36, 95% CI = 1.21–9.36, P = .020) and total bilateral loss of occlusal supports (OR = 2.71, 95% CI = 1.12–6.56, P = .027). The higher is the number of lost occlusal support zones, the more significant are the changes in the craniofacial structures. The alteration of angles formed by the mandibular plane, gonial angle, cranial base angle, effective mandibular length, and anterior facial height were significantly associated with TMD signs (P < .05). The study suggests that an oral health care programme is required to improve the oral health status of the elderly Vietnamese.
Oral health is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity of biting, chewing, smiling, speaking, and psychosocial well-being. Health of the stomatognathic system is also related to the status of dental occlusion and temporomandibular structures. The variation in the conditions affecting the anatomic and functional characteristics of temporomandibular structures is known as temporomandibular disorders. The Vietnamese elderly have experienced the Vietnam War (1945–1975) and different economic systems. These upheavals could affect their oral status. The aims of the dissertation were to study oral health status, temporomandibular disorders (TMD), and the role of occlusal support in relation to TMD and the craniofacial structure in the Vietnamese elderly aged 65–74 years. The cross-sectional study covered 258 participants living in Danang, Vietnam. Clinical examination of teeth and the surrounding tissues was performed according to the recommendations of the WHO. Diagnosis of TMD was based on the Diagnostic Criteria for Temporomandibular Disorders; occlusal supports were analysed by using the Eichner classification; cephalometric measurements were used to evaluate the alterations in the craniofacial structures of the elderly. Of the sample, 97.7% had experienced dental caries, 83.3% had periodontal diseases, and 56.6% had TMD. Disc displacement and degenerative joint disease were most prevalent among the elderly Vietnamese. Approximately 16% of the elderly did not have any occlusal supports, the odds of having TMD were positively associated with total unilateral loss of occlusal support (OR = 3.36, 95% CI = 1.21–9.36, P = .020) and total bilateral loss of occlusal supports (OR = 2.71, 95% CI = 1.12–6.56, P = .027). The higher is the number of lost occlusal support zones, the more significant are the changes in the craniofacial structures. The alteration of angles formed by the mandibular plane, gonial angle, cranial base angle, effective mandibular length, and anterior facial height were significantly associated with TMD signs (P < .05). The study suggests that an oral health care programme is required to improve the oral health status of the elderly Vietnamese.
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