熊本県内の妊婦の口腔内の健康状態について

[Oral health status of pregnant women in Kumamoto Prefecture].

抄録

目的:

早産予防のための多面的な実施である熊本RAINBOWプロジェクトの一環として、妊婦の口腔衛生状態を調査し、歯科治療と口腔衛生指導の効果について評価した。

OBJECTIVES: As part of Kumamoto RAINBOW Project, which is a multifaceted implementation for the prevention of premature labor, we investigated pregnant women's oral health status and assessed the effects of dental care and oral hygiene instruction.

方法論:

2012年から2014年にかけて、熊本県内の妊娠前期・後期ともに妊婦の口腔内の健康状態を調査した。歯周状態の評価には地域歯周病指数（CPI）を用い、深さ4mm以上の歯周ポケットを有する女性を歯周炎罹患と定義した。本事業では、歯科検診の費用を負担した。

METHODS: We examined the oral health status of pregnant women both in the first and the second half of pregnancy in Kumamoto Prefecture from 2012 to 2014. The Community Periodontal Index (CPI) was used to assess the periodontal condition, and women having periodontal pockets with a depth ≥4 mm were defined as suffering from periodontitis. This project covered the cost of dental checkups.

結果:

本事業に登録された妊婦20,702人のうち、9,527人（46.0%）が妊娠初期に歯科検診を受診していた。熊本県の県庁所在地である熊本市の歯科検診の回答率（63.3％）は、他の地方（32.0％）に比べて有意に高い結果となりました。熊本市では、4,890人（83.4％）が母子手帳の交付を受けた際に市役所で歯科検診を受けた。3,455人（32.0％）の女性が歯周炎を患っていた。歯科診療所で2回口腔診察を受けた女性1,605人のうち、698人が非外科的な介入を受けた。歯科的介入は、妊婦の歯周炎の有病率を有意に減少させた（55.1％→45.1％）。介入を伴わない歯科検診も、歯周炎の有病率を有意に減少させた（44.6％から39.9％）。

RESULTS: Of the 20,702 pregnant women enrolled in this project, 9,527 (46.0%) received dental checkups during the first half of pregnancy. The response rate of dental examinations in Kumamoto City (63.3%), the capital city of Kumamoto Prefecture, was significantly higher than that of the other local areas (32.0%). In Kumamoto City, 4,890 women (83.4%) had dental examinations at the city office when they received a maternal handbook. Three thousand forty-five women (32.0%) had periodontitis. Among 1,605 women who received oral examinations twice at dental clinics, 698 received nonsurgical interventions. Dental interventions significantly decreased the prevalence of periodontitis in pregnant women (55.1% to 45.1%). Dental examinations without interventions also significantly decreased the prevalence of periodontitis (44.6% to 39.9%).

結論:

熊本市に住む妊婦は、他の地域に比べて歯科医院での検診受診率が高い。また、妊婦の3分の1に歯周炎がみられた。歯科介入だけでなく、歯科検診も妊婦の口腔衛生状態を改善する。

CONCLUSIONS: Pregnant women living in Kumamoto City had higher rate of visits to dental clinics for checkups than those in other areas. Periodontitis was found in one-third of pregnant women. Not only dental interventions, but also dental examinations improve pregnant women's oral health status.