| Objectives:The aim of this study was to evaluate the oral health among the elderly in Kunming.It was the first time to study the spatial distribution of tooth loss among the elderly in Kunming by using geographic information system(GIS),which could discover the "hot spots" and " cold spots" of the disease.By the geographical weighted regression model,the factors which influencing missing teeth in different districts were analyzed.This study could provide a more scientific reference for the prevention and improvement measures of tooth lossMethods:From 2013 to 2017,a cross-sectional survey was carried out among 1690 subjects(?60 years'old)in 12 districts of Kunming,We used the method of stratified random sampling.According to the Third National Epidemiological Survey of Oral Health,We maked the survey of?Oral Health Assessment Form?and?Oral Health Knowledge-attitude-practice Form?,which were changed after pre-experiment.The data were double-recorded into Epidata software.Statistical analysis was performed using SPSS.The spatial analysis was carried out with GIS.Results:A total of 1690 subjects were investigated in our study,and 37 unqualified questionnaires were excluded.The effective samples were 1653(97.8%).799 subjects(48.3%)were male and 854 subjects(51.7%)were female,the mean age was 69.7±6.4 years(aged 60?93 years)1.In our research,the prevalence of caries among the elderly(>60 years'old)in Kunming was 85.6%,84.0%in males and 87.0%in females,the difference was not statistically significant.The prevalence of caries ranged from 74.5%?93.2%in different districts.Chenggong was the lowest and Dongchuan was the highest,the difference was statistically significant.2.The results of community periodontal index(CPI)showed that the prevalence of PD?6mm was 23.8%,27.8%in males and 20.1%in females,and the difference was not statistically significant,the prevalence of PD?6mm which ranged from 9.3%?43.8%in different districts.Xundian was the lowest and Yiliang was the highest,there were statistically significant difference between different districts.3.The total number of missing teeth was 1582(95.7%),dentition defect was 90.1%(1490),5.6%(92)of the subjects in the survey were edentulous.A total number of 16546 missing teeth were detected,and missing teeth on average was 10(the number of missing teeth ranged from 1?32).The average rate of missing teeth ranged from 90.1%?97.8%.The areas with higher rate of missing teeth were Kunming,Fumin and Luquan.The areas with lower rate of missing teeth were Chenggong,Songming and Dongchuan.There was no statistical difference in the average rate of missing teeth in each region.The missing teeth on average ranged from6.5?15.3,of which Jinning,Fumin and Luquan were the high-affected areas,Chenggong,Songming and Dongchuan were the low-risk areas,There was statistical difference in missing teeth on average in each region.The prevalence of more than 20 residual teeth in the elderly over 60 years old in Kunming was 80.0%,and there was statistical difference among different regions.The prevalence of more than 20 residual teeth in the elderly over 80 years old in Kunming was 45.9%,and there was no statistical difference among different regions4.The global spatial autocorrelation analysis showed that the global Moran's I index of missing teeth on average was-0.007(P=0.376>0.05).The difference was not statistically significant.It suggests that missing teeth on average from the global range may not be aggregated.LISA showed that the local autocorrelation of missing teeth on average showed a negative correlation,showing a "low-low aggregation form,in which Yiliang was located in the "low-low" aggregation area,indicating that missing teeth on average in Yiliang was low and which was surrounded by a low missing teeth on average5.Geographic weighted regression analysis showed that gender,elderly,rate of intaking sugar were the main influencing factors of tooth loss(P<0.05).Female,elderly,intaking sugar frequently have a negative influence on missing teeth on average.The regression coefficient of gender and intaking sugar frequently showed decreasing trend from north to south.The regression coefficient of elderly population showed increasing trend from north to south.Conclusions:1.The oral health of the elderly in Kunming is poor.The prevalence of caries is more than the average of the Fourth National Epidemiological Survey of Oral Health.Periodontal status is not optimistic,and there are significant differences in periodontal status between different regions.In addition,tooth loss is common in all regions,and the retention rate of functional teeth is low.2.The spatial distribution of missing teeth on average in the elderly in Kunming is quite different,and the influencing factors are heterogeneity in spatial distribution,which suggesting that the key prevention and control areas are mainly concentrated in Luquan,Dongchuan,Jinning,and the prevention and control measures should be different in different areas. |
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