우리나라 청소년의 건강위험요인이 구강건강에 미치는 영향

도경이 ( Kyung Yi Do ) 한국치위생과학회 2016 치위생과학회지 Vol.16 No.3

본 연구는 제9차(2013)청소년건강행태 온라인조사를 바탕으로 우리나라 청소년 총 66,951명을 대상으로 청소년의 건강위험요인과 구강건강과의 관련성을 확인하고, 구강건강에 미치는 위험도를 알아보고자 하였다. 수집된 자료는 통계 분석 프로그램인 PASW Statistics ver. 18.0을 사용하여 분석하였고 주요 결과는 다음과 같다. 남학생은 33,777명(50.5%), 여학생은 33,174명(49.5%)으로 남학생 비율이높았고, 학년 분포는 중학생과 고등학생 모두 1학년이 가장 높았다. 학업성적은 ‘하위권’이 24,468명(36.6%)으로 가장높았고, 경제 상태는 중위권이 32,374명(48.4%)으로 가장높았다. 어머니 학력은 고졸이 가장 높았다. 성별에 따른 6가지 구강증상경험 분포의 차이를 알아본 결과 ‘치아가 깨지거나 부러짐``은 성별의 차이가 유의하지 않았고(p=0.135), ‘먹을 때 치아가 아픔``, ‘치아가 욱신거리고 쑤심’, ‘잇몸이 아프고 피가 남’, ‘혀와 입 안쪽 뺨이 아픔’은 여학생이 남학생보다 더 많이 경험한 것으로 나타났다(p<0.001). 그러나 ‘입 냄새가 남’은 남학생(52.5%)이 여학생(47.5%)보다 더 많이 경험한 것으로 나타났다(p<0.001).건강위험요인과 구강증상경험과의 관련성 분석결과 음주, 흡연, 학교폭력 경험, 주중 인터넷 사용이 관련성이 있었으며 로지스틱 회귀분석 결과 음주경험이 있는 대상자의 구강증상경험 위험도가 OR 1.33배, 흡연 경험이 있는 대상자의 구강증상경험 위험도가 OR 1.2배로 높아졌으며 인터넷 사용시간은 ‘1시간 이내 사용’보다 ‘7시간 이상’ 사용자가 구강증상경험 위험도가 OR 1.25배 높아졌으며 학교폭력 경험도 경험이 없는 대상자에 비해 ‘3∼4번’ 경험이 있는 대상자의 구강증상경험 위험도가 OR 1.54배 높아짐을 알 수 있었다. 따라서 본 연구 결과를 토대로 청소년의 올바른 건강습관을 도모하고, 건강위험요인을 적절히 중재하여 청소년의 구강건강을 증진시킬 수 있는 포괄적 건강증진 프로그램개발에 기여할 수 있을 것이다. The objective of this study was to investigate the relationship between health-risk factors and oral health in Korean adolescents. This cross-sectional study was based on the 9th Korea Youth Risk Behavior Web-Based Survey (2013). The final participation rate in the survey was 96.4%. of a Total of 72,435 adolescents (age, 12∼18 years) who had participated in the survey, 66,951 adolescents (33,777 boys and 33,174 girls) were selected for analysis, after excluding those with missing data. The key variables were oral health factors (one or more of the six oral symptoms), general characteristics (five factors), and health-risk factors (five factors). After adjusting for the general characteristics, frequency analysis, χ2-test using PASW Statistics ver. 18.0, and logistic regression analysis were performed to understand the effects of health risk-factors on the oral symptoms experienced by the study subjects. Subjects who answered ‘Yes’ for alcohol consumption had a 1.33 times higher risk of experiencing oral symptoms. Further, subjects who smoked were at a 1.2 times higher risk of experiencing oral symptoms. With regard to internet use, the risk of experiencing oral symptoms was 1.25 times higher for subjects who used the internet for 7 hours or more than for those who used it for less than 1 hour. Compared to those subjects who had not experienced violence in school, the odds ratio of subjects who had experienced it 3∼4 times was 1.54-fold higher. The study found that health-risk factors were associated with oral symptom experience. Therefore, programs to understand health-risk factors and interventions should be developed for Korean adolescents and provided on a regular basis along with oral health education.

한국 청소년의 주관적 수면의 질과 치주질환관련 구강증상경험과의 연관성

도경이 ( Kyung-yi Do ),이은선 ( Eun-sun Lee ) 한국치위생학회 2021 한국치위생학회지 Vol.21 No.5

Objectives: This study aimed to investigate the relationship between sleep quality and periodontal disease-related symptoms among Korean adolescents. Methods: This cross-sectional study was based on the 16th Korea Youth Risk Behavior Web-Based Survey (2020). A complex sample logistic regression was performed to identify the relationship between sleep quality and periodontal disease-related symptoms after adjusting for all covariates. Results: In model II, to estimate the adjusted odds ratio (AOR) for all covariates, students who answered “not at all sufficient”, indicating sleep quality, were at higher risk of experiencing periodontal disease-related symptoms than those who answered “completely sufficient” (AOR=1.58). As a result of subgroup analysis, for estimating the AOR adjusted for all covariates in boys, students who answered “not at all sufficient”, indicating sleep quality, were at a higher risk of experiencing periodontal disease-related symptoms than those who answered “completely sufficient” (AOR=1.68). In girls, students who answered “not at all sufficient”, indicating sleep quality, were at a higher risk of experiencing periodontal disease-related symptoms than those who answered “completely sufficient” (AOR=1.43). Conclusions: It is necessary to formulate health policies that can promote optimal sleeping habits and oral health behaviors among Korean adolescents.

청소년의 알레르기비염이 구내염에 미치는 영향

도경이 ( Kyung-yi Do ),이은선 ( Eun-sun Lee ) 한국치위생학회 2023 한국치위생학회지 Vol.23 No.6

Objectives: This study aimed to determine whether adolescents with allergic rhinitis are at an increased risk of stomatitis and to ascertain possible sex-specific differences. Methods: The data for this cross-sectional study was obtained from the 18th Korea Youth Risk Behavior Web-based Survey (2022). Of the 56,213 students surveyed, 51,850 (boys 26,397 and girls 25,453) were included in the final analyses. Multivariate logistic regression was performed to identify the impact of allergic rhinitis on the risk of stomatitis among Korean adolescents. Results: In Model II, which was adjusted for allergic disease, boys with allergic rhinitis had a 1.53-fold (adjusted odds ratio [aOR]=1.53, 95% confidence interval [CI]=1.40-1.67), and girls had a 1.35-fold (aOR=1.35, CI=1.25-1.46) elevated risk of stomatitis than in those without. In Model III, after adjusting for all covariates, boys with allergic rhinitis had a 1.48-fold (aOR=1.48, CI=1.36-1.62) elevated risk of stomatitis than in those without, and girls had a 1.32-fold (aOR=1.32, CI=1.22-1.43) elevated risk, which remained statistically significant after adjusting for covariates. Therefore, allergic rhinitis in adolescents exerts a detrimental effect on the risk of experiencing stomatitis symptoms; the risk was higher in boys than in girls. Conclusions: These findings suggest that oral health care attention and intervention are needed for adolescents with allergic rhinitis.

한국 성인 여성의 수면시간과 치주염과의 관련성

도경이 ( Kyung-yi Do ),이은선 ( Eun-sun Lee ) 한국치위생과학회 2017 치위생과학회지 Vol.17 No.4

본 연구는 한국 성인 여성의 수면시간과 치주염과의 관련성을 확인하기 위해 국민건강영양조사 제 6기 2차년도(2014) 자료를 바탕으로, 만 19세 이상의 한국 성인 여성 총 3,292명을 대상으로 연구를 수행하였다. 대상자의 일반적 특성(연령, 교육수준, 소득수준, 당뇨, 고혈압, 비만)에 따라 치주염의 차이를 확인할 수 있었으며, 흡연과는 관련성이 없는 것으로 나타났다. 수면시간이 7시간 이상인 대상자에 비해 7시간 미만인 대상자의 치주염 위험도가 1.37배(crude OR, 1.37; 95% CI, 1.13∼1.65) 높았다. 그러나 대상자의 일반적 특성(연령, 교육수준, 소득수준, 당뇨, 고혈압, 비만)을 보정한 후의 수면시간이 치주염에 미치는 영향력은 더 이상 유의하지 않았다. 따라서 후속연구에서는 두 요인의 직접적인 인과관계를 밝힐 수 있는 전향적 코호트 연구가 수행되어야 하며, 성인 여성의 적절한 수면습관을 도모하고 아울러 구강건강 증진을 위한 포괄적 건강증진 프로그램의 시행이 필요하다고 생각된다. This study aimed to investigate the relationship between sleep duration and periodontitis in adult Korean women. This cross-sectional study was based on the 2014 Korea National Health and Nutrition Examination Survey (KNHNES). We selected the data from 3,292 women (over 19 years of age) out of 7,550 participants for analysis, after excluding data from men. Complex logistic regression analysis was performed to determine the effect of sleep duration on the risk of periodontitis; the crude and adjusted odds ratios (ORs) were calculated. The risk of periodontitis was higher in participants who had a sleep duration of 7 hours or more, than in those with less than 7 hours (crude OR) by 1.37 times (95% confidence interval [CI], 1.13∼1.65). The adjusted OR of the participants after adjusting for the sample characteristics of the participants (age, education level, income level, diabetes, hypertension, obesity) was 1.04 times (95% CI, 0.82∼1.32), but the risk for periodontitis was slightly higher, though not statistically significant. This study confirmed the relationship between sleep duration and the risk of periodontitis in Korean women. Therefore, it is necessary to develop and implement a comprehensive health promotion program that can improve the proper sleeping habits of adult women in Korea and to combine oral hygiene management programs to prevent periodontal disease.

학업을 중단한 경험이 있는 청소년의 성별 우울 관련요인

이지선,도경아,Yi, Jee-Seon,Do, Kyung A 한국학교보건학회 2021 韓國學校保健學會誌 Vol.34 No.2

Purpose: Adolescents are vulnerable to depression; however, many health policies for adolescents tend to target students in schools. This study aims to identify factors related to depression according to gender among adolescents who have ceased attending school either temporarily or permanently. Methods: The data were generated from the 5th Dropout Youth Panel Survey (2017), and this study included 318 students in the survey that had dropped out of school. The data were analyzed using hierarchical multiple linear regression to identify related factors in depression among the participants. The analyses were performed by SPSS 25.0 program. Results: The depression scores of the students who had ceased attending school were: 20.28±5.47 for boys; 21.23±5.88 for girls. Their depression scores are significantly associated with self-esteem (p<.001 for boys; p=.001 for girls) and social stigma (p=.002 for boys; p=.002 for girls). Among those, peer attachment (p=.050), community integration (p=.004), and community disorder (p<.001) were significantly associated with depression only in boys. Conclusion: The findings of this study suggest that strategies for managing depression in adolescents who have dropped out of school should address the differences in contributing factors according to gender. This study also suggests a basis for approaching such a strategy.

한국 여성의 불안 및 우울증상과 치주질환의 관련성

이은선 ( Eun-sun Lee ),도경이 ( Kyung-yi Do ),이강숙 ( Kang-sook Lee ) 한국치위생과학회 2017 치위생과학회지 Vol.17 No.1

본 연구에서는 심리적 요인에 대한 감수성이 높은 여성의 불안 및 우울증상과 치주질환의 관련성을 알아보고자 한다. 본 연구는 우리나라를 대표하는 국민건강영양조사 제 5기 1차년도(2010년) 8,958명 중 만 19세 이상 여자 3,551명의 자료를 분석하였다. 인구사회학적 특성 중 연령, 결혼상태, 소득수준, 교육수준, 경제활동 유무에 따라 불안 및 우울증상과 유의한 차이가 나타났다. 구강건강관련 특성 중 당뇨병 유무, 현재 흡연, 고위험 음주에 따라 불안 및 우울증상과 유의한 차이가 나타났다. 일일 칫솔질 횟수에 따라 불안 및 우울증상과 유의한 차이가 나타났으며, 치실 및 치간칫솔 사용 여부에 따른 유의한 차이는 없었다. 치실 및 치간칫솔을 사용하지 않는 행태가 치주질환 위험도를 증가시키는 것으로 나타났다(OR, 1.49; 95% CI, 1.14∼1.95). 연령, 결혼상태, 소득수준, 교육수준, 경제활동 유무, 당뇨 유무, 현재 흡연, 고위험 음주, 칫솔질 횟수, 치실 및 치간칫솔 사용 여부를 보정한 결과 불안 및 우울증상이 치주질환을 유의하게 증가시키는 것으로 나타났다(OR, 1.47; 95% CI, 1.04∼2.09). 따라서 불안 및 우울증상이 있는 사람이 불안 및 우울증상이 없는 사람에 비해서 치주질환 유병률이 더 높게 나타나 그 위험성이 더 크므로, 치주질환을 더 효율적으로 관리하도록 정기적 치주관리 및 효율적 자가구강건강관리교육의 필요성이 요구된다. Periodontal diseases occur from the interplay between increased bacterial response and the response of the host immune system over time. Anxiety and depression can impair immunological defense mechanisms, causing accumulation of periodontopathogens and thus exacerbating periodontal disease. We investigated the relationship of anxiety and depression to periodontal diseases in Korean women. In this study, 3,551 women aged ≥19 years were evaluated based on data from the first year (2010) of the Fifth Korea National Health and Nutrition Examination Survey. The analysis of the factors that caused periodontal diseases revealed that dental floss or interdental toothbrush nonuse behaviors have been shown to increase the risk of periodontal disease (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.14∼1.95). After adjusting for conditions such as age, marital status, income, educational level, economic activity, diabetes mellitus, smoking, drinking, and frequencies of toothbrushing and interdental cleaning, we found that anxiety and depression increased the risk of developing periodontal diseases (OR, 1.47; 95% CI, 1.04∼2.09). People with anxiety and depression have a higher prevalence of periodontal diseases than people without anxiety and depression. Thus, periodic periodontal care and effective self-care education are needed to manage periodontal diseases.

한국 청소년의 스트레스와 구취의 관련성

이은선 ( Eun-sun Lee ),도경이 ( Kyung-yi Do ) 한국치위생학회 2022 한국치위생학회지 Vol.22 No.2

Objectives: The purpose of this study was to examine the relationship between stress and halitosis in a representative sample of Korean adolescents. Methods: This study was based on the 15th Korea Youth Risk Behavior Survey (2019). The final participation rate in the survey was 95.3%; 57,303 out of 60,100 (95.3%) adolescents aged 13-18 years were selected. Multiple logistic regression with complex samples was performed to identify the correlation between stress and halitosis. Stress level was classified as ‘very much’, ‘a little’, and ‘not much’ and halitosis was defined as the presence of an unpleasant odor in the oral cavity. Results: The prevalence of halitosis among students was 21.3%. As a result of multiple regression analysis, the ‘a little’ [odds ratio (OR); 1.39, 95% confidence interval (CI); 1.29-1.49] and ‘very much’ stress group (OR; 1.78, 95% CI; 1.66-1.90) exhibited significantly higher risk of halitosis than the ‘not much’ stress group. Conclusions: A significant correlation between stress and halitosis exists among Korean adolescents. Therefore, psychological factors such as stress should be considered in managing halitosis in adolescents.

치주질환과 만성신장질환의 연관성: 코호트 연구에 대한 체계적 고찰

이은선 ( Eun-sun Lee ),도경이 ( Kyung-yi Do ) 한국치위생과학회 2017 치위생과학회지 Vol.17 No.2

본 연구는 치주질환과 신장질환의 연관성을 알아보기 위한 체계적 고찰이다. Embase, PubMed, The Cochrane Library데이터베이스에서 2016년 4월 17일 검색을 완료하였다. 문헌의 선택은 코호트 연구 설계를 기준으로 하였으며, 환자군은 치주질환 또는 중증의 치주질환이 있는 대상자로 하였다. 최종 결과는 만성신장질환의 발생이나 신장기능의 저하로 eGFR을 제시한 연구로 하였다. 최종 선정된 문헌의 양적합성을 위하여 Review Manager (RevMan) 통계 분석 소프트웨어를 이용하였다. 고정효과모형 멘텔-헨젤 방법(M-H)을 이용하여 메타분석을 시행하여 치주질환과 만성신장질환의 연관성을 추정하였다. 검색 전략을 이용하여 총 3,018개의 문헌이 검색되었고, 그 중 4개의 문헌이 최종 분석에 포함되어 메타 분석한 결과 치주질환이 만성신장질환 발생위험과 유의한 연관성이 있음이 나타났다(OR, 1.65; 95%CI, 1.44∼1.90; p<0.001). 만성신장질환 발생 및 신장기능저하를 예방하기 위해서는 개인의 삶의 질 저하와 의료비용부담을 줄이기 위해 기존에 알려진 전통적 위험인자 외에 만성신장질환에 영향을 미치는 치주질환의 예방 및 관리의 필요성이 크다. The purpose of this systematic review was to investigate the association between periodontal disease and chronic kidney disease. A search of Embase, PubMed and The Cochrane Library databases was performed up to April 17, 2016. Article selection was based on cohort study design and the study subjects were patients with periodontal disease or severe periodontal disease. The final result was development of chronic kidney disease and kidney function decrease based on the estimated glomerular filtration rate values. The quantitative synthesis of the final selected articles was assessed using Review Manager statistical analysis software. A fixed-effects model meta-analysis was performed to estimate the degree of association between periodontal disease and chronic kidney disease. The search strategy identified 3,018 potentially eligible articles, of these, four studies were finally selected for meta-analysis, revealing that periodontal disease was significantly associated with the risk of developing chronic kidney disease (odds ratio, 1.65; 95% confidence interval, 1.44∼1.90; p<0.001). In order to prevent the development of chronic kidney disease and kidney function decrease it is important to prevent periodontal disease, as well as minimizing the traditional risk factors known to reduce the quality of life of patients and increase disease burden.