妊婦の歯周状態に関連する因子の分析

本研究では妊婦と非妊婦との歯周状態の比較および関連する因子を解析することを目的とした．
高知県における2016 ～ 2019 年度の「妊婦への歯科保健調査」受診者3,359 名を妊婦群とし，2020 年度「高知県歯科疾患実態調査」の調査対象者のうち，同年代の女性316 名をコントロール群とした．年齢群別に両群の口腔清掃状態や口腔衛生習慣等の項目を比較した．さらに「妊婦への歯科保健調査」のアンケート項目を独立変数，「歯周ポケット」または「歯肉出血」に関する歯周状態を従属変数とした二項ロジスティック回帰分析を行った．
両群のアンケート項目の比較から，妊婦群では「歯ぐきの腫れ」が有意に高く，診査項目では，歯周ポケットを有する者が多かった．また，16 ～ 24 歳の妊婦群では「歯周ポケット」と「歯肉出血」有所見者の割合が高い一方で，「喫煙者」の項目では有意差を認めなかった．さらに，妊婦群において「歯周ポケット」または「歯肉出血」の有無と「かかりつけ歯科医の有無」「歯ブラシ以外の道具使用」および「歯列咬合所見」で有意な関連性が認められた．
以上の結果から，妊娠期に歯周組織の状態が不良となることが示唆され，妊娠中の良好な口腔状態の維持のためにかかりつけ歯科医をもつこと，および適切な補助清掃用具の使用などの歯科保健指導が有効である可能性が示された．

The aim of this study was to compare factors related to the periodontal condition between pregnant and non-pregnant women, and analyze these factors to improve the oral environment of pregnant women.
Three thousand three hundred and fifty-nine subjects who enrolled in the Dental Health Survey for Pregnant Women during 2016-2019 in Kochi Prefecture were included in the pregnant group, while 316 women of the same age in the 2020 Kochi Prefecture Dental and Oral Health Promotion Survey were included in the control group. Items regarding oral hygiene conditions and oral health behavior of both groups were compared in each age group. Furthermore, a binomial logistic regression analysis of the pregnant group was performed using the periodontal condition regarding “periodontal pocket” or “gingival bleeding” as the dependent variable.
From the comparison of the questionnaire items, the rate of “swelling of the gums” in the pregnant group was significantly higher than that in the control group. From the comparison of the examination items, the rate of subjects with periodontal pockets in the pregnant group was higher than that in the control group. The proportion of pregnant women aged 16 to 24 years with “periodontal pocket” and “gingival bleeding” was larger than in the control group. There was no significant difference in current smoker rates between the two groups. In the pregnant group using the presence or absence of “periodontal pocket” or “gingival bleeding” as the dependent variable, “presence of a family dentist”, “use of adjunctive oral hygiene device”, and “malocclusion” showed significant correlations.
These results suggest that an adverse periodontal condition may arise during pregnancy. It may be necessary to visit a family dentist and receive oral health guidance regarding the use of appropriate adjunctive oral hygiene devices in order to maintain a good oral condition during pregnancy.