上海地区孕妇牙科焦虑症及其影响因素分析

Dental anxiety and its influencing factors among pregnant women in Shanghai

目的调查孕妇牙科焦虑症的发生情况并对其影响因素进行分析。方法采用问卷调查和口腔检查的方法对上海地区2638名孕妇的人口社会学资料、口腔健康行为习惯、牙齿数量等情况进行调查,并指导其填写改良牙科焦虑量表(modified dental anxiety scale,MDAS)。量表中5个问题的总分为MDAS分值,MDAS≤11为无牙科焦虑症,MDAS≥12为牙科焦虑症。运用电子数据捕获系统(electronic data capture system,EDC)系统建立数据库录入资料,SPSS 22.0分析焦虑程度及其影响因素。结果共收集有效问卷2638份,孕妇的牙科焦虑症发生率为34.9%。单因素分析结果显示随着年龄、家庭年收入、文化程度、洗牙频率、刷牙频率和牙齿数量的增加,孕妇牙科焦虑症的患病率(P<0.001)和MDAS分值有所下降(P<0.05);随着孕次和刷牙出血频率的增加,孕妇牙科焦虑症的患病率(P<0.05)和MDAS分值有所上升(P<0.05)。Logistic分析结果显示:文化程度“大专”(P=0.003)和“本科及以上”(P<0.001)、洗牙频率“半年或一年一次”(P=0.021)和“两年一次”(P<0.001)、刷牙频率“≥每天两次”(P<0.001)与孕妇牙科焦虑症显著相关且为其保护因素(OR<1);刷牙出血频率“有时或偶尔”(P<0.001)和牙齿数量“≤27”(P<0.001)也与孕妇牙科焦虑症显著相关且为其危险因素(OR>1)。MDAS的负二项回归分析结果表明:洗牙频率和牙齿数量与MDAS得分显著相关,洗牙频率“半年或一年一次”(P<0.001)是孕妇牙科焦虑症的保护因素(OR<1);牙齿数量“≤27”(P<0.001)是孕妇牙科焦虑症的危险因素(OR>1)。结论文化程度、洗牙频率、刷牙频率、刷牙出血、牙齿数量是孕妇牙科焦虑症的影响因素,临床医生在临床实践中应予以高度重视,通过宣讲相关保健知识,增强孕妇的口腔卫生维护意识,以有效降低牙科焦虑症的患病率。

Objective To investigate the incidence of dental anxiety in pregnant women and its influencing factors.Methods A total of 2638 pregnant women in Shanghai were included in this study.Data on demographic and social factors,oral health behaviors and the number of teeth were collected.Participants completed the modified dental anxiety scale(MDAS),and an MDAS score greater than 12 was defined as a dental anxiety disorder.An electronic data capture system(EDC)was used to establish a database,and SPSS 22.0 was used to analyze the degree of anxiety and its influencing factors.Results A total of 2638 valid questionnaires were received.The incidence of dental anxiety in pregnant women was 34.9%.The results of a univariate analysis showed that the prevalence of dental anxiety in pregnant women(P<0.001)and MDAS score decreased(P<0.05)with increasing age,annual family income,educational level,frequency of cleaning,frequency of brushing and number of teeth.Conversely,the prevalence of dental anxiety in pregnant women(P<0.05)and MDAS score increased(P<0.05)as the number of pregnancies and gingival bleeding increased.Logistic analysis showed that education level"college"(P=0.003)and"bachelor and above"(P<0.001),frequency of dental cleaning“semiannually or annually”(P=0.021)and"biennial"(P<0.001),and frequency of brushing"twice a day"(P<0.001)were significantly associated with dental anxiety in pregnant women and were protective factors(OR<1).The frequency of gingival bleeding"Sometimes"(P<0.001)and the number of teeth“≤27”(P<0.001)were also significant risk factors for dental anxiety in pregnant women(OR>1).The results of a negative binomial regression analysis of MDAS showed that the frequency of dental cleaning and the number of teeth were significantly associated with dental anxiety.The frequency of dental cleaning"semiannually or annually"(P<0.001)was a protective factor(OR<1)for pregnant women’s dental anxiety.The number of teeth≤27(P<0.001)was a risk factor(OR>1)for dental anxiety in pregnant women.Conclusion Educational level,teeth cleaning frequency,teeth brushing frequency,gingival bleeding,and the number of teeth influence dental anxiety in pregnant women.To effectively reduce the prevalence of dental anxiety,dentists should attach great importance to it in clinical practice and enhance pregnant women’s awareness of oral hygiene maintenance by disseminating relevant health care knowledge.