喘息とその薬物療法が青年期の唾液特性と口腔の健康に与える影響．横断的比較研究

Impact of asthma and its medication on salivary characteristics and oral health in adolescents: A cross-sectional comparative study.

• Santhiya Bairappan
• Manjunath P Puranik
• Sowmya K R

抄録

目的:

唾液の特徴と口腔内の健康状態を評価・比較し、喘息の有無にかかわらず、喘息とその薬物がう蝕に与える影響を評価することを目的とした。

OBJECTIVE: To assess and compare the salivary characteristics and oral health and to evaluate the impact of asthma and its medication on dental caries among adolescents with and without asthma.

方法:

バンガロール市の12～15歳の喘息性青年50人と非喘息性青年50人を対象に横断的比較研究を実施した。データは構造化質問票を用いて取得した。唾液サンプルを採取し、流量、pH、緩衝能、ストレプトコッカス・ミュータンスおよび乳酸菌数を測定した。口腔内健康評価は、WHO 2013年版プロフォーマを用いて実施した。カイ二乗、学生のt検定、スピアマンの相関、多項ロジスティック、ステップワイズ線形回帰などの推論統計を適用し、P<.05を有意とみなした。

METHODS: A cross-sectional comparative study was conducted among 50 asthmatic and 50 nonasthmatic adolescents aged 12-15 years in Bangalore City. Data were acquired using a structured questionnaire. Salivary samples were collected to determine the flow rate, pH, buffering capacity, and Streptococcus mutans and Lactobacilli counts. Oral health assessment was performed using WHO 2013 proforma. Inferential statistics such as chi-square, student's t-test, spearman's correlation, multinomial logistic. and stepwise linear regression were applied with P < .05 considered as significant.

結果:

喘息患者の参加者は，非喘息患者に比べてう蝕，歯肉出血，歯面侵食を有する平均歯数が有意に高かった（P<.05）．喘息患者におけるフッ素症、外傷性歯科損傷、口腔粘膜病変の有病率はそれぞれ34.0％、38.0％、28.0％であった。喘息患者のほとんどが予防的または日常的な治療（18.0％）と迅速な治療（30.0％）を必要としていた。流量、pH、緩衝能、S. mutansと乳酸菌数、Decayed, Missing, Filled Teeth (DMFT)指数には、喘息患者と非喘息患者の間で統計学的に有意な差が認められた。喘息の重症度、薬の使用、虫歯の経験は、唾液流量、pH、緩衝能の低下、S.ミュータンス菌と乳酸菌の高レベルと有意な相関があった（P<.001）。喘息患者の参加者は、非刺激性唾液流量（オッズ比[OR]=3.2）、緩衝能力（OR=2.94）、強酸性pH（OR=3.65）、S.ミュータンス（OR=6.02）、DMFT≧1（OR=2.06）のリスクが非喘息患者よりも有意に高かった（P<.05）。

RESULTS: Asthmatic participants had significantly higher mean number of teeth with dental caries, gingival bleeding, and dental erosion than nonasthmatics (P < .05). The prevalence of fluorosis, traumatic dental injuries, and oral mucosal lesions in asthmatics were 34.0%, 38.0%, and 28.0%, respectively. Most of the asthmatic participants required preventive or routine (18.0%) and prompt treatment (30.0%). Statistically significant difference was found in the flow rate, pH, buffering capacity, S. mutans and Lactobacilli counts, and Decayed, Missing, Filled Teeth (DMFT) index between asthmatic and nonasthmatic participants. Severity of asthma, medication use, and dental caries experience significantly correlated with low salivary flow rate, pH and buffering capacity, and higher levels of S. mutans and Lactobacilli (P < .001). Asthmatic participants had significantly higher odds of having very low unstimulated salivary flow rate (odds ratio [OR] = 3.2), buffering capacity (OR = 2.94), highly acidic pH (OR = 3.65), high risk of S. mutans (OR = 6.02), and DMFT ≥ 1 (OR = 2.06) than nonasthmatics (P < .05).

結論:

喘息性青年期の唾液特性と口腔内の健康状態は有意に不良であった。喘息とその薬物は喘息性青年期の唾液特性とう蝕歯に有意な影響を与えていた。

CONCLUSION: Salivary characteristics and oral health were significantly poor in asthmatic adolescents. Asthma and its medications had significant impact on salivary characteristics and dental caries among asthmatic adolescents.

© 2020 Special Care Dentistry Association and Wiley Periodicals, Inc.