Objective: Aiming at preparing the basis for evidence-based dental public health policy making in Slovenia, the objective of the study was to assess the strength of association between oral health status measured by the number of missing teeth and self-rated health (SRH).
Methods: The study was designed as a pooled individual-level data study from four national cross-sectional studies carried out in the period 2001-2012, based on CINDI Health Monitor methodology. Altogether, 34,412 participants were included. A logistic regression model with poor SRH as observed outcome and the number of teeth as explanatory factor (adjusted for selected biologic, socio-economic and health factors) was proposed.
Results: In the sample, women represented 55.7% and men 44.3%, median age was 45 years. Persons with more missing teeth more likely rated their health as poor. The association was persistent even when different confounding variables were included in the model. In the group with 1-5 missing teeth, in comparison to the group with none missing teeth, OR was 1.23 (p=0.049), whereas for the group with 6-10 missing teeth, OR was 1.32 (p=0.019); for the group with >10 missing teeth, but not all, OR was 1.77 (p<0.001), and for the group with all missing teeth, OR was 2.19 (p<0.001).
Conclusions: Study results showed clear association of SRH with dentate status, which confirms the oral-general health connection. This indicates the need for the development of proper dental public health policies for better oral health, and presents a new view on the importance of preserving teeth.
Namen: Z namenom priprave podlage za pripravo na dokazih temelječe politike ustnega javnega zdravja v Sloveniji je bil cilj raziskave ocena povezanosti stanja ustnega zdravja, merjenega s samoporočanim številom manjkajočih zob in samoocene lastnega zdravja.
Metode: Zasnovo raziskave je predstavljala analiza združenih podatkov na individualni ravni, pridobljenih v štirih zaporednih nacionalnih presečnih raziskavah v Sloveniji, izvedenih v obdobju 2001-2012 po metodologiji CINDI Health Monitor. Skupno je bilo v analizo vključenih 34.412 udeležencev. Ženske so predstavljale 55,7% in moški 44,3%, mediana starosti je bila 45 let. V modelu logistične regresije je bila opazovana spremenljivka samoocena lastnega zdravja kot slabega, pojasnjevalna spremenljivka pa samoporočano število manjkajočih zob (upoštevani izbrani biološki, socialno-ekonomski in z zdravjem povezani moteči dejavniki).
Rezultati: Osebe z več manjkajočimi zobmi imajo višje obete za to, da ocenjujejo svoje zdravje kot slabo, kar velja tudi po prilagoditvi za nekatere biološke, socialne in zdravstvene dejavnike. Razmerje obetov za nizko samooceno lastnega zdravja v primerjavi s skupino brez manjkajočih zob je bilo pri osebah z 1-5 manjkajocimi zobmi 1,23 (p=0,049), za skupino s 6-10 manjkajočimi zobmi 1,32 (p=0,019), za skupino z vec kot 10 manjkajočimi zobmi 1,77 (p<0,001) in za skupino z vsemi manjkajocimi zobmi 2,19 (p<0,001).
Zaključki: Raziskava je pokazala jasno povezanost med samoocenjenim splošnim zdravjem in zobnim statusom, kar potrjuje povezanost ustnega in splošnega zdravja. Rezultati tudi nakazujejo potrebo po razvoju primernih politik ustnega javnega zdravja za boljše ustno zdravje in hkrati nakazujejo tudi nov pogled na pomen ohranitve zob.
Keywords: missing teeth; oral health; preserved teeth; public health policy; self-rated health.