The relation between family socioeconomic trajectories from childhood to adolescence and dental caries and associated oral behaviours

OBJECTIVES: To investigate the influence of family socioeconomic trajectories from childhood to adolescence on dental caries and associated behaviours. DESIGN: Population-based birth cohort. SETTING: Representative sample of the population of subjects born in 1982 in Pelotas, Brazil. PARTICIPANTS: Adolescents (n = 888) aged 15 years old were dentally examined and interviewed. MAIN OUTCOME MEASURES: Dental caries index (DMFT), care index (F/DMFT), tooth brushing, flossing and pattern of dental services use. MAIN RESULTS: Adolescents who were always poor showed, in general, a worse pattern of dental caries, whereas adolescents who never were poor had a better pattern of dental caries. Adolescents who had moved from poverty in childhood to non-poverty in adolescence and those who had moved from non-poverty in childhood to poverty in adolescence had similar dental pattern to those who were always poor except for the pattern of dental services use, which was higher in the first group. In all groups girls had fewer carious teeth, better oral hygiene habits and higher dental services use than boys. CONCLUSION: Poverty in at least one stage of the lifespan has a harmful effect on dental caries, oral behaviours and dental services use. Belonging to upwardly mobile families between childhood and adolescence only contributed to improved dental care.     

Utilization of dental services among the elderly in Brazil]

OBJECTIVE: To investigate the pattern of dental services use and its determinants among the elderly in Brazil. METHODS: The study included the elderly participating in the Ministry of Health of Brazil's oral health survey carried out in 2002 and 2003 who had used dental services at least once in their lifetime. Dentulous and edentulous individuals were compared and analyzed separately using multiple logistic regression. RESULTS: Of 5,009 participants, 46.0% were dentulous and 54.0% edentulous. The prevalence of dental services use in the year right before the survey was 26.6% and 10.4%, respectively. Among dentulous participants, the utilization rate was higher in those with more years of schooling, those who perceived their chewing as poor/very poor, and those who reported feeling oral pain; and lower in those who did not have information on oral health, who perceived their oral health as poor/very poor, those with lower per capita income, those who required prostheses and used them, and who required prostheses and did not use them, those with periodontal problems, and with a higher number of extracted teeth. Among edentulous participants, the utilization rate was higher in those with more years of schooling and those reporting oral pain; and lower in non-whites and in those who did not have information on oral health. CONCLUSIONS: The oral health of the elderly in Brazil is deficient and the use of dental services was lower among those who needed them most. The factors associated with dental services utilization differ for dentulous and edentulous individuals. The only similarities are schooling, having information on oral health, and having experienced pain in the teeth and gums in the previous three months. Public investment in oral health is needed to turn around this scenario.     

Oral health follow-up studies in the 1993 Pelotas (Brazil) birth cohort study: methodology and principal results

The aim of this study was to describe oral health follow-up studies nested in a birth cohort. A population-based birth cohort was launched in 1993 in Pelotas, Rio Grande do Sul State, Brazil. Two oral health follow-up studies were conducted at six (n = 359) and 12 (n = 339) years of age. A high response rate was observed at 12 years of age; 94.4% of the children examined at six years of age were restudied in 2005. The mean DMF-T index at age 12 was 1.2 (SD = 1.6) for the entire sample, ranging from 0.6 (SD = 1.1) for children that were caries-free at age six, 1.3 (SD = 1.5) for those with 1-3 carious teeth at six years, and 1.8 (SD = 1.8) for those with 4-19 carious teeth at six years (p < 0.01). The number of individuals with severe malocclusions at 12 years was proportional to the number of malocclusions at six years. Oral health problems in early adolescence were more prevalent in individuals with dental problems at six years of age.     

Characteristics associated with use of dental services by dentate and edentulous elders: the SB Brazil Project

This study focused on the characteristics associated with use of dental services during the previous year by Brazilian elderly (with and without teeth) participating in the Brazilian oral health survey (Ministry of Health, 2002/2003). 345 were dentate and 669 edentulous. Prevalence of use was 32% and 11%, respectively. Multivariate logistic regression showed that for dentate elders, use of dental services was more frequent among those who perceived their voices as influenced by oral health. Less frequent use was associated with: residence in rural areas; low income; current oral problems; fewer than two teeth in at least one sextant of the arch; need for dentures; and worse self-perceived appearance. Among edentulous elders, more frequent use was associated with: 5 to 8 years of schooling; pain; and poor self-perceived appearance. Use was less frequent among elders with current oral problems and those who perceived that their personal relations were influenced by oral health. The analysis reviewed the differences between dentate and edentulous individuals. Use of dental services was less common among individuals who needed them the most, suggesting inequality in access to such services among the Brazilian elderly.     

Relationship between cigarette smoking and oral health status]

The purpose of the study was to examine the relationship between the smoking habit and oral health status, while adjusting for age and some aspects of dental health behavior. The data used were based on a cross-sectional study on dental checkup in the worksite, which included a self-reported questionnaire and oral examination by a dentist. The oral health status variables were CPITN scores, missing teeth/filled teeth/decayed teeth, and self-reported gum bleeding. In addition, the subjects reported in a questionnaire concerning their smoking habit and dental health behavior. Of a total of 7,713 of workers, 5,232 (67.8%) participated in the dental checkup of the worksite. From the population, only the data for 3,303 men were analyzed. We used multiple logistic regression to calculate the odds ratio (OR) for each oral health status according to the smoking habit. Current smokers, compared to subjects who had never smoked, had a higher risk of periodontal disease (OR = 2.3; 95% CI: 1.9-2.7), missing teeth (OR = 1.6; 95% CI: 1.3-1.9) and decayed teeth (OR = 1.5; 95% CI: 1.3-1.8), but they had a reduced risk of gum bleeding (OR = 0.7; 95% CI: 0.6-0.8). Dose response relationships between smoking and these variables were also observed. The results indicated that cigarette smoking was associated with oral health status independent of some aspects of dental health behavior.     

阿坝州某卫生学校一年级学生患龋情况的调查

目的 调查阿坝州学生患龋现状和影响因素,为当地开展口腔卫生保健工作提供科学依据。方法 分层整群抽取阿坝州某卫校一年级学生共224名,对其患龋情况进行现场口腔健康检查,并对其家庭环境、饮食习惯和口腔卫生保健习惯进行问卷调查。结果 一年级学生患龋率为50.89%,龋均(1.50±2.09),龋齿充填率为6.53%。纳入的男生90人,女生134人,不同性别学生患龋率、充填率和龋均差异无统计学意义(P>0.05)。纳入藏族152人,羌族43人,汉族20人,回族7人,彝族2人,不同民族新生龋均、患龋率差异均有统计学意义(P<0.05)。食用糖果的频率、每天刷牙次数、睡前刷牙后进食情况不同的学生患龋率、龋均差异有统计学意义(P<0.05)。结论 阿坝州学生患龋率高,口腔卫生意识较差,需要加强对龋病和口腔健康知识的宣传,倡导健康的饮食习惯、口腔护理习惯和就医习惯。     

Oral health conditions and frailty in Mexican community-dwelling elderly: a cross sectional analysis

ABSTRACT: BACKGROUND: Oral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly. METHODS: Analysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate), utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factors RESULTS: Of the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Groups who had a higher probability of being frail included women (OR = 1.9), those who reported myocardial infarction (OR = 3.8), urinary incontinence (OR = 2.7), those who rated their oral health worse than others (OR = 3.2), and those who did not use dental services (OR = 2.1). For each additional year of age and each additional drug consumed, the probability of being frail increased 10% and 30%, respectively. CONCLUSIONS: Utilization of dental services and self-perception of oral health were associated with a higher probability of being frail.     

Utilization of dental care services by Asians and native Hawaiian or other Pacific Islanders: United States, 1997-2000

OBJECTIVE: This report describes national estimates of dental care service utilization and unmet dental care needs due to cost for six Asian ethnic subgroups and the native Hawaiian or other Pacific Islander (NHOPI) population. METHODS: Combined data from the 1997-2000 National Health Interview Surveys (NHISs), conducted by the Centers for Disease Control's National Center for Health Statistics, were analyzed to produce estimates for Asians and NHOPIs aged 2 years and over. Information on dental care service utilization and unmet dental care needs due to cost was self-reported by persons aged 18 years and over. For children aged 2-17 years, the information was collected from an adult who was knowledgeable about the child's health. RESULTS: Approximately 64% of Asian and 56% NHOPI persons had visited a dentist at least once in the past year. Utilization of dental care services, however, varies significantly by ethnic subgroup. Asian Indians were most likely to have never had a dental visit and the NHOPIs were most likely to experience unmet dental care needs in the past year. Among adults, Japanese Americans (68.2%) were most likely and NHOPIs (49.3%) were least likely to have had a dental visit in the past year. Underutilization of dental care services was most prevalent among Asian adults with poor or near poor poverty status, without health insurance coverage, and who had resided in the United States for less than 5 years. Among children, NHOPIs (82.0%) were most likely and Asian Indians (60.1%) were least likely to have had a dental visit in the past year. Underutilization was most prevalent among Asian children who were not living with their parents or living with a single parent, who had no insurance coverage, who had poor or near poor poverty status, and whose parents had less than 12 years of education. CONCLUSIONS: Utilization of dental care services and unmet dental care needs due to cost vary among the Asian ethnic subgroups and the NHOPI population.     

Smoking and oral health in older adults.

This paper examines the relationship between smoking and oral health in older adults. The data are taken from a cross-sectional study of oral health and treatment needs among persons aged 50 years and over living independently in four Ontario communities. Data were obtained from 907 subjects. Half of these reported a history of smoking and one fifth were current smokers. Current smokers were more likely to have lost all their natural teeth than those who had never smoked. Among those retaining one or more natural teeth, current smokers had fewer teeth, fewer functional units, more crown surfaces with decay and more decayed root surfaces. Periodontal indicators showed that the extent and severity of periodontal disease were more marked among current smokers when compared with those who had never smoked. Current smokers also showed a higher prevalence of mucosal disorders and needed more dental treatment. Regression analysis suggested that the links between smoking and oral disorders differ according to the disease in question.     

Oral health practices among adolescents: a study from family practice clinics in Israel

Dental caries and periodontal disease are highly prevalent among adolescents. Preventive dental visits and proper oral health practices effectively reduce the occurrence of these entities. The objective of this study was to determine the rates of tooth brushing, flossing, and visits to dentists and hygienists among Israeli adolescents in a family practice setting. One hundred and eighty-four 7th and 10th graders who attended preventive health visits completed questionnaires that included questions regarding dental visits and personal oral health habits. Structured counseling by the family nurse was provided following completion of the questionnaire. Ninety-seven percent of the teenagers brushed their teeth at least once a day, but only 7% used dental floss daily, 44.5% never flossed, and another 10% didn't know what dental floss was. Eighty-three percent had visited a dentist, but only 33% had been to a dental hygienist in the past two years. Twenty-nine percent did not know what a hygienist was. We conclude that primary care providers can promote oral health by screening and providing counseling to their adolescent patients.     

张家港市学龄前儿童患龋情况及口腔健康行为分析

目的 了解张家港市学龄前儿童患龋情况及口腔健康行为,为龋病防治提供依据。方法 采取分层、随机、整群抽样的方法,选择张家港市16所幼儿园的1 405名学龄前儿童,对其进行口腔检查并发放问卷,由家长填写后统一收回。结果 学龄前儿童患龋率为 61.99%,龋均为2.81,龋失补充填率为3.54%;男、女童患龋率分别为63.21%、60.63%,差异无统计学意义(P＞0.05),城、乡患龋率分别为60.86%、63.36%,差异无统计学意义(P＞0.05);随着年龄的增长,患龋率升高,在不同年龄组间患龋率差异有统计学意义(χ²=39.470,P＜0.05);3岁以前开始刷牙的儿童占30.25%,从长第一个牙就开始刷牙的仅占1.00%, 18.78%的儿童只是偶尔刷牙甚至不刷牙。饮食方面仅有23.42%的儿童不在睡前吃甜食。睡前高频进食甜食和开始刷牙的年龄较大是儿童龋病发生的重要危险因素,结果均有统计学意义(χ²=9.740、14.913,P＜0.05)。结论 张家港市学龄前儿童的患龋率较高,口腔健康行为较差,应加强对儿童和家长的口腔健康教育。     

Relationship between intake of sweet drinks and candies and oral health status in the adult population

PURPOSE: The purpose of the study was to examine the relationship between intake of sweets (sweet drinks/candies of chewing gum) and oral health status, while adjusting for age and other dental health behavior. METHODS: The data used were based on a cross-sectional study regarding dental checkup of a worksite. Of a total of 7,713 workers, 5,232 (67.8%) participated in the dental checkup. From this population, data for only 5,034 were analyzed. The dental checkup included a self-reported questionnaire and oral examination by a dentist. The oral health status variables were the CPITN score, missing teeth/filled teeth/decayed teeth, and self-reported gum bleeding. We used multiple logistic regression to calculate odds ration (OR) and 95% confidence interval (95% CI) for each oral health status according to intake of sweets. RESULTS: Among males, subjects who took sweet drinks almost every day, compared to subjects who hardly took, had higher risk of missing teeth (OR = 1.4; 95% CI: 1.2-1.7), filled teeth (OR = 1.7; 95% CI: 1.4-2.0) and gum bleeding (OR = 1.5; 95% CI: 1.2-1.8). Dose response relationships were also observed between intake of sweet drinks and these variables. No significant association was recognized between intake of candies of chewing gum and oral health status. CONCLUSIONS: The results indicated that intake of sweet drinks is a determinant of oral health status, independent of dental health behavior, particularly among males.     

Thirty years of evolution of oral health behaviors in the working-age Poles

Introduction

In an average Polish person aged 35–44, more than 16 teeth have or had been affected by dental caries. Of that number, almost half of the teeth have already been extracted. Oral health behaviours contribute to this civilization disease in 50%. Such poor oral health status limits the ability of the affected people to take many social and professional roles.

Objectives

To evaluate current oral health behaviours and their trends among 35–44 year old Polish people during the period of recent 30 years.

Material and Methods

The data were obtained from the International Collaborative Studies conducted in 1978 and 1988 at the Nofer Institute of Occupational Medicine, ?ód?, Poland, under the auspices of the World Health Organization (WHO) as well as from 3 stages of the study on Nationwide Monitoring of Oral Health Status and Its Conditioning performed in 1998, 2002 and 2010. The researchers evaluated oral health behaviours and oral health condition of 5425 subjects.

Results

Despite a noticeable improvement, poor oral health behaviours are observed in 30%–40% of the adults. In the analysed period, the number of people brushing their teeth at least twice a day increased by more than 10% and the number of people using dental floss increased by 38%. Only 60% of the adults visited a dentist at least once a year. Reduced accessibility of state-run, free-of-charge dental care has caused that over 58% of Poles paid for their dental services. Every 3rd person of working age has not visited a dentist for longer than 2.5 half years, primarily due to behavioural and financial reasons. Oral health behaviours of Polish people are among the poorest in Europe.

Conclusions

Despite a noticeable improvement of the behaviours, gap between the Poles and citizens of other highly developed countries is around 20 years. A health promotion programme including oral health issues, if implemented in workplaces, might considerably reduce this gap.     

Government subsidies for dental care in Australia

OBJECTIVES: To evaluate the impact of recent changes in public subsidies for oral health care in Australia, and to propose more effective and equitable uses of Commonwealth Government subsidies. METHODS: Review of literature and Australian Research Centre for Population Oral Health information. RESULTS: Commonwealth subsidies for oral health care services in Australia have been moved from public dental services to private dental health insurance. This has resulted in a redistribution of funds from people on low incomes with poor oral health, to people on middle to high incomes with relatively better oral health. CONCLUSIONS: Public funding for dental care in Australia favours the financially and orally better off at the expense of disadvantaged and orally unhealthy Australians. Current approaches to public funding for oral health services in Australia are unlikely to result in a substantial improvement in oral health. IMPLICATIONS: Maximum gains in oral health are likely to be achieved by a reorientation of Commonwealth subsidies towards preventive and basic treatment services. This reorientation needs to occur within a primary health care framework. Whereas the Commonwealth plays a national leadership role in the provision of general health services, this is not apparent in relation to oral health. This lack of leadership leaves many vulnerable Australians without basic preventive services and at high risk of losing teeth that might otherwise have been preserved. Channelling the funding now used to subsidise private dental services for the well off and dentally healthy to community-wide and targeted preventive services for vulnerable and low-income Australians would have a larger impact on oral health and represent a more equitable use of these funds.     

Oral health and access to dental care – a comparison of elderly migrants and non-migrants in Germany

Objectives: To compare oral health, access barriers to dental care, oral health behavior and oral hygiene behavior of elderly German residents with and without immigration background.

Design: In this cross-sectional explorative study, a convenience sample (N?=?112, age?≥?60 years, 54% immigrants) was recruited in four dental practices in Hamburg, Germany. Oral health was assessed with Decayed/Missing/Filled Teeth (DMFT), Papillary Bleeding Index (PBI), and Approximal Plaque Index (API). Dental health was operationalized as number of decayed teeth, and poor oral hygiene based on a PBI?≥?40%. Access barriers and oral health behavior were assessed with a standardized questionnaire.

Results: While caries experience was similar in migrants and non-migrants (DMFT mean: 24.8 vs. 23.4, n.s.), significantly more teeth were decayed (5.3 vs. 2.1, p?p?=?0.002) and PBI (46.3% vs. 30.5%, p?=?0.016) were significantly higher in migrants. After adjusting for age, sex, income, education, and number of teeth, migrants still had on average 3 decayed teeth more than non-migrants. However, impact of migration background on poor oral health changed from OR?=?3.61 (p?=?0.007) to OR?=?1.05 (n.s.) after adjusting for confounders, mainly due to lower income in migrants. Fewer migrants had visited a dentist within the past 12 months, and migrants were less likely to have a regular dentist that they visit and more often indicated language or cost barriers than non-migrants.

Conclusion: Elderly German migrants have higher treatment needs than non-migrants. Likely causes are poorer oral hygiene and lower utilization of dental care services. Specific prevention programs targeting migrants are warranted to improve oral health in this disadvantaged group.     

Investigating Hong Kong's Filipino domestic workers' healthcare behavior, knowledge, beliefs and attitudes towards cervical cancer and cervical screening

The aim of this study was to investigate Hong Kong Filipino domestic workers health behaviors, knowledge, beliefs and attitudes about cervical screening and cancer. A concurrent cross sectional survey design used a snowball method of recruitment was used because of the acknowledged problematic access to a random sample of immigrant women. A total of 98 female domestic helpers were actively recruited through designated recreation centers. The women were between 24-45 years old (mean = 37.9, SD = 7.7). The majority of these women were employed as full-time domestic helpers (91%), were earning less than dollar 4000 Hong Kong dollars/month (92%), were married (82%), with children (91%), were non-smokers (88%), and had at least a secondary level of education (100%), with 66% of these women having completed post-secondary education. While the majority of women had previously heard about cervical smears (78%) more than half (53%) reported never having a cervical smear taken. Women who had a prior cervical smear had significantly more knowledge about cervical smears and cervical cancer (mean = 51.34, SD = 2.5) than those who never had a cervical smear (mean = 49.72, SD = 3.2). Recommendations are made for culturally tailored mass screening programmers out of office hours and health information to be provided in both written and oral Tagalong. Doctors and nurse ideally of Filipino origin should be used to deliver health messages that prioritize the importance of self protection for the family and future fertility issues, culturally prized within Filipino society.     

Daily living activities and oral condition among care facility residents with severe intellectual disabilities. Comparative analyses between residents receiving tooth-brushing assistance and those not receiving tooth-brushing assistance

OBJECTIVES: To clarify 1) differences in daily living activities and oral condition among care facility residents with severe intellectual disabilities and 2) chronological changes in daily living activities and oral condition for residents receiving tooth-brushing assistance and those never receiving tooth-brushing assistance. METHODS: Subjects were 44 residents at a care facility for individuals with severe intellectual disabilities, who underwent dental screening in July 1994 and October 2003. At each time point, daily living activities, behavior during oral health guidance, behavior during dental health screening and oral condition were compared between residents receiving tooth-brushing assistance (assistance group) and those not receiving tooth-brushing assistance (independent group). Furthermore, chronological changes were analyzed for residents requiring assistance at both screenings, those requiring assistance only at the second screening, and those not requiring assistance at either screening. RESULTS: 1) In the assistance group, 100% and 36.4% of residents were unable to brush their teeth independently in 1994 and 2003, respectively. Significant differences between the assistance and independent groups were observed in all items of behavior during dental health screening in 1994, but not in 2003. No significant intergroup differences in oral condition were observed in 1994, but differences were seen in 2003; when compared to the assistance group, the number of lost teeth was significantly higher in the independent group, while the number of remaining teeth was lower. 2) Regarding changes over the nine-year period, a significantly greater proportion of residents not requiring assistance at either screening and those requiring assistance only at the second screening finally required assistance in bathing. As for oral condition, no significant changes in healthy teeth were observed in residents requiring assistance at both screening time points, while significant increases in dental caries and filled teeth and a significant decrease in the number of healthy teeth were observed in residents requiring assistance only at the second screening and those not requiring assistance at either screening. CONCLUSIONS: Over the nine-year period, the subjects of tooth-brushing assistance changed, and assistance was given to those able to brush their teeth independently in addition to those unable to brush their teeth independently. The number of healthy teeth did not change in residents receiving tooth-brushing assistance during this period, but in residents never receiving tooth-brushing assistance, decrease was noted. Therefore, even for individuals able to brush their teeth independently, some form of tooth-brushing assistance is needed to sufficiently prevent oral diseases.     

唐山市大学生口腔健康知识、行为抽样调查

[目的]了解唐山市大学生的口腔健康知识和健康行为,为高校开展口腔健康课程提供参考资料。[方法]对唐山市4所高校1011名大学生进行口腔健康知识和行为的问卷调查。[结果]唐山市大学生口腔健康的一般性知识知晓率和口腔卫生措施实施率较高,但对龋病和牙周病的防治知识欠缺,定期口腔检查,洁牙的意识薄弱,口腔疾病发生时就医率普遍较低,多数学生在遇到口腔疾病后就医意识淡漠。86.8%从未洁过牙,牙线和含氟牙膏的使用者也相当少。[结论]唐山市大学生对口腔健康知识认知不足,口腔健康行为有待改进,在高校开展口腔健康教育十分必要。     

口腔卫生与非吸烟非饮酒女性口腔癌关系研究

目的 研究口腔卫生状况与非吸烟非饮酒女性口腔癌的关系。 方法 收集2012年10月－2017年9月我院口腔颌面外科经术后病理确诊的非吸烟非饮酒女性口腔癌患者162例,同期选取在该院体检的214位非吸烟非饮酒健康女性作为对照组。口腔卫生考察指标包括刷牙频率、牙齿缺失数、口腔不良修复体、规律性看牙医、复发性口腔溃疡。应用多因素logistic回归模型分析口腔卫生评分与非吸烟非饮酒女性口腔癌的关联。 结果 刷牙频率<2次/d、牙齿缺失≥5颗、有口腔不良修复体、无规律性看牙医、有复发性口腔溃疡是非吸烟非饮酒女性口腔癌的危险因素(均P<0.05),OR(95%CI)值分别为1.49(1.09~2.08)、1.80(1.16~2.84)、1.51(1.04~2.23)、1.74(1.16~2.57)、7.29(3.98~13.35)。多因素 logistic回归模型分析结果显示,口腔卫生评分与非吸烟非饮酒女性口腔癌发生存在关联,分值越大,危险程度就越高(χ²=24.179,P<0.001)。 结论 口腔卫生状况与非吸烟非饮酒女性口腔癌发生具有一定的关系