人口老化已成為全球趨勢，當然台灣也不例外。口腔健康是老人健康和福祉的重要因素，隨著老人年齡的增加，生理機能逐漸退化，造成說話、咀嚼和吞嚥的困難，亦會間接影響全身健康。本研究的目的為調查大台北地區老人口腔狀況並探討影響老人口腔健康生活品質的因素。
本研究以橫斷式研究方法，立意取樣大台北地區醫院健檢及牙科門診之老人，調查對象為65歲（含）以上之老人，行動方便且可溝通者，調查人數共計409位。以結構式問卷訪談及臨床牙醫師的口腔檢查之資料收集。研究工具有：(1)口腔檢查表；(2)老人口腔健康生活評量表（GOHAI）；(3)面孔量表（Face Scale）及(4)基本問卷表等。
研究對象平均年齡為73.77?b7.34歲，年齡以65至74歲人數居多（55.8％）。老人口腔健康生活評量方面，健檢老人的分數為52.35±4.56分、門診老人為46.7±7.71分，顯示健檢老人有較佳的口腔健康生活品質；面孔量表方面，擁有好的生活品質者（健檢老人佔82.7%、門診老人佔74.2%），顯示健檢老人有較佳的生活品質。齒列狀況方面，健檢老人平均剩餘牙齒數目為21.36±8.17顆、門診老人則為19.37±9.53顆；咬合分類（A類）方面，健檢老人佔60.6%、門診老人佔53.5%；全口無牙方面，健檢老人佔4.3%、門診老人佔6.5%。結果顯示，健檢老人有較佳的口腔健康狀況。
影響因素而言，不論以主觀或客觀方式測得之咀嚼能力，是影響老人的口腔健康相關生活品質最主要因素，其他因素還包括年齡、婚姻狀況、罹患慢性病數及慢性用藥種類、每日潔牙習慣及裝戴假牙情形。本研究對象以大台北地區老人為主，期盼未來能擴及全國，調查瞭解老人之口腔健康問題，做為老人口腔健康促進之參考指標。

The aging of the population has been a global trend, with no exception of Taiwan. Oral health status is an important factor affecting health and well-being of the elderly. With the increasing of the age of the elderly, their physical function is gradually declining, causing difficulty in speaking, chewing and swallowing and also indirectly affecting the general health. The purpose of the present study was to investigate the oral health status of the elderly in Taipei region and to confer the factor affecting oral health-related quality of life (OHRQOL) of the elderly.
A cross-sectional study technique and a convenient sampling method was used in the present study. A total of 409 elderly, individuals who were over 65 years old and were easy to communicate with, were include in this study. The data regarding the questionnaire, which was collected by face-to-face interview, and the clinical oral examination gathered by the dentists. The assessment tools were (1)Dental clinic charts, (2)Geriatric Oral Health Assessment Index (GOHAI), (3)Face scale, and (4)Basic questionnaire.
The average age was 73.77?b7.34 years old and the major of the survey subjects were between 65 to 74 years old (55.8％). With the respect of GOHAI, the average score in the elderly from physical checkup group was 52.35±4.56 while the elderly from clinical dental group was 46.7±7.71, which showed better OHRQOL in the elderly from physical checkup group. With the respect of Face Scale, subjects with high quality of life (82.7% were from physical checkup group and 74.2% were from clinical dental group), which showed better QOL in the elderly from physical checkup group. With respect to dentition status, the average residual teeth were 21.36±8.17 in the elderly from physical checkup group while the other was 19.37±9.53. The A type in the Eichner Index classification was 60.6% of the elderly from physical checkup group and in 53.5% the other. The 4.3% of the elderly from physical checkup group was edentulism while the 6.5% of the elderly from clinical dental group was edentulism. The result showed that the elderly from physical checkup group had better oral health status.
The major factor affecting OHRQOL in the elderly was chewing ability, no matter measured in subjective or objective way, while other minor factors included the age, marital status, chronic systemic disease, medication, daily oral hygiene activity and whether the subject wore denture or not. This survey subjects lived almost in Taipei region. We hope, however, we can expand the sampling data to the whole country, and investigate the oral health problems in the elderly in the future, as the reference to promote the elderly oral health.

致謝……………………………………………………………………I
中文摘要…………………………………………………………….......Π
英文摘要………………………………………………………………IV
目錄……………………………………………………………………VI
第一章、 緒論
第一節 研究背景……………………………………………… 1
第二節 研究目的…………………………………………………5
第三節 名詞定義…………………………………………………6
第二章、 文獻查證
第一節 老人口腔狀況分析……………………………………….9
第二節 老人咀嚼能力分析………………………………………12
第三節 口腔健康相關生活品質…………………………………14
第四節 影響老人口腔狀況及其相關生活品質之因素探討……17
第三章、 研究材料與方法
第一節 研究架構…………………………………………………19
第二節 研究假說…………………………………………………20
第三節 研究設計及工具…………………………………………20
第四節 研究變項及其操作型定義………………………………27
第五節 統計分析…………..……………………………………30
第四章、 分析與結果
第一節 資本資料特性之分析……………………………………31
第二節 口腔健康狀況及咀嚼能力分佈情形之分析……………33
第三節 口腔健康相關生活品質之分析…………………………35
第四節 影響口腔健康相關生活品質之因素分析………………36
第五節 口腔健康相關生活品質之預測因子……………………39
第五章、 討論
第一節 與國內外老人口腔狀況及健康相關生活品質之比較…41
第二節 影響口腔健康相關生活品質之因素……………………44
第六章、 結論與建議
第一節 結論………………………………………………………49
第二節 建議與限制………………………………………………50
第七章、 參考文獻
中文部分…………………………………………………………52
英文部分…………………………………………………………53
附 錄

內政部全球資訊網。老人狀況調查結果摘要分析。2005，取自http://www.moi.gov.tw/stat/survey.aspx。
內政部全球資訊網。內政部戶籍人口統計年報。2007，取自http://www.moi.gov.tw/stat/。
姚開屏。台灣版世界衛生組織生活品質問卷之發展與應用。 2002，台灣醫學6(3):193-199。
楊奕馨。台灣地區成年與老年人口腔健康調查。2006，行政院衛生署國民健康局。
顧建娟。台北市長期照護機構老人咀嚼能力與口腔健康相關生活品質之探討。2007，碩士論文。
李易蓁。老人口腔健康狀態與生活品質之關係暨其影響因素之探討。2007，博士論文。

Agerberg. G. Mandibular function and dysfunction in complete denture wearers – a literature review. J Oral Rehabil 1988;15:237.
Ainamo J, Tervonen T, Ainamo A. CPITN-assessment of periodontal treatment needs among adults in Ostrobothnia, Finland. Community Dent Health 1986;3:153-161.
Ajawani S, Tervonen T, Narhi TO, Ainamo A. Periodontal health status and treatment needs among the elderly. Spec Care Dent 2001;21:98-103.
Akifusa S, Soh I, Ansai T, Hamasaki T, Takata Y, Yohida A, Fukuhara M, Sonoki K and Takehara T. Relationship of number of remaining teeth to health-related quality of life in community-dwelling elderly. Gerodontology 2005;22:91-97.
Ansai T, Hamasaki T, Awano S et al. Relationship between oral health and exercise function of elderly persons 80 years old in Fukuoka prefecture. J Dent Health 2000;50:783-789.
Appollonio I, Carabellese C, Frattola A, Trabucchi M. Dental status, quality of life, and mortality in an older community population: a multivariate approach. J Am Geriat Soc 1997;45:1315-1323.
Atchison KA, Dolan TA. Development of the Geriatric Oral Health Assessment Index. J Dent Edu 1990;54:680-7.
Avlund K, Holm-Pedersen P, Schroll M. Functional ability and oral health among older people: a longitudinal study from 75 to 80. J Am Geriater Soc 2001;49:1000-1001.
Battistuzzi PG, Kayser AF, Kanters. Partial edentulism, prosthetic treatment and oral function in a Dutch population. J Oral Rehabil 1987;14:549-555.
Biazevic MGH, Michel-Crosato E, Iagher F. et al. Impact of oral health on quality of life among the elderly population of Joaçaba, Santa Catarina, Brazil. Braz Oral Res 2004;18:85-910
Chauncey HH, Muench ME, Kapur KK, Wayler AH. The effect of the loss of teeth on diet and nutrition. Int Dent J 1984;34(2):98-104.
Dini EL, McGrath C, Bedi R. An evaluation of the oral health quality of life (OHQoL) instrument in a Brazilian population. Community Dent Health 2003;20:40-44.
Eichner K. Über eine Gruppeneinteilung des lückengebisse für die Prothetik. Dtsch Zahnarztl Z 1955;10:1831-1834.
Ekelund R. Dental state and subjective chewing ability of institutionalized elderly people. Community Dent Oral Epidemiol 1989;17:24-27.
Elias AC, Sheiham A. The relationship between satisfaction with mouth and number, position and condition of teeth: studies in Brazilian adults. J Oral Rehabil 1999;26(1):53-71.
Gift HC, Atchison KA, Dayton CM. Conceptualizing oral health and oral health-related quality of life. Soc Sci Med 1997;44:601-608.
Gina T. Risk factors for the prevention of root caries in order adults. Spec Care Dentist 1994;14:68-70.
Hirai T, Ishijima T, Koshino H, Anzai T. Age‐related change of masticatory function in complete denture wearers: evaluation by a sieving method with peanuts and a food intake questionnaire method. International Journal of Prosthodontics 1994;7:454.
Hobdell M, Petersen PE, Clarkson J, Johnson N. Global goals for oral health 2020. International Dental Journal 2003;53:285-288.
Inglehart MR, Bagramian RA. Oral health-related quality of life: an introduction. Quintessence Publishing, Inc.,2002.
Jessica Swoboda, H Asuman, Rigmor E, G Rutger, David K, Michael I., Cristopher CL. Predictors of oral health quality of life in older adults. Spec Care Dentist 2006;26(4):137-44.
John MT, Koepsell TD, Hujoelp P et al. Demographic factors, denture ststus and oral health-related quality of life. Community Dent Oral Epidemiol 2004;32:125-132.
Judith A, Michelle B, Avron Spiro & Nancy R. Tooth loss and dentures: patients’ perspectives. International Dental Journal 2003;53:327-334.
Kayser AF, Witter DJ. Overtreatment in removable partial dentures in cases of shortened dental arches. Journal de parodontologie 1984;3(4):409-417.
Kayser AF. Shortened dental arch: a therapeutic concept in reduced dentitions and certain high-risk groups. The International journal of periodontics & restorative dentistry 1989;9(6):426-449.

Kazunori Ikebe, Takashi Nokubi, Ronald L, Hidekazu Namba, Nozomu Tanioka, Kateuya Iwase and Takahiro Ono. Dental status and satisfaction with oral function in a sample of community-dwelling elderly people in Japan. Special Care in Dent 2002;22(1):33-40.
Kelly M, Steel J, Nuttall N et al. Adult dental health survey: oral health in the UK in 1998. London: UK Office for National Statistics, 2000.
Kinsella K, Velkoff V. US Census Bureau. An aging world: 2001. Washing-ton (DC): US Government Printing Office, 2001. P95/01-1.
Kossioni AE, Karkazis HC. Jaw reflaxes in healthy old people. Age Ageing 1998;27:689-695.
Kressin N, Spiro A III, Bosse R et al. Assessing oral health-related quality of life: findings from the normative aging study. Med Care 1996;34:416-427.
Krall E, Hayes C, Garcia R. How dentition ststus and masticator function affect nutrient intake. JADA 1988;129:1261-1269.
Lee IC, Shich TY, Yang YH, Tsai CC, Wang KH. Individual’s perception of oral health and its import on the health-related quality of life. J Oral Rehabil 2007;34:79-87.
Lewis S, Jagger RG, Treasure E. The role health of psychiatric in-patients in South Wales. Spec Care Dent 2001;21:182-186.
Lin HC, Corbet EF, Lo ECM, Zhang HG. Tooth loss, occluding pairs, and prosthetic status of Chinese adult. J Dent Res 2001;80(5):1491-5.
Locker D. Measuring oral health: a conceptual framework. Community Dent Health 1988;5:3-18.
Locker D, Jokovic A. Using subjective oral health status indicators to screen for dental care needs in older adults. Community Dent Oral Epidemiol 1996;24:398-402.
Locker D, Jokovic A. Three-year changes in self-perceived oral health status in an older Canadian population. J Dent Res 1997;76:1292-1297.
Locker D, Mastear D, Stephens M, Jokovic A. Oral health-related quality of life of a population of medically compromised elderly people. Community Dent Health 2002;19:90-97.
Locker D, Allen PF. Developing short-form measures of oral health-related quality of life. J Public Health Dent 2002; 62: 13–20.
Lorish CD, Maisiak R. The face scale: brief, nonverbal method for assessing patient mood. Arthritis Rheum 1986;29:906-909.
Mathews DC, Smith CG, Hanscom SL. Tooth loss in periodontal patients. JDR 2001;67:207-210.
McGrath C, Bedi R. The importance of oral health to older people quality of life. Gerodontology 2001;16:59-63.
McGrath C, Bedi R. Population based norming of the UK oral health related quality of life measure(OHQoL-UK). Br Dent J 2002;193:521-524.
McMillan AS, Wong MC, Lo EC et al. The impact of oral disease among the institutionalized and non-institutionalized elderly in Hong Kong. J Oral Rehabil 2003;30:46-54.
Michael H. Walter, John I. Woronuk, Han-Kuang Tan, Ulrike Lenz, Rainer Koch, Klaus W. Boening, Yvonne J. Pinchbeck. Oral health related quality of life and its association with sociodemographic and clinical findings in 3 Northern outreach clinics. JCDA 2007;73(2):153-153e.
Miura H, Miura K, Mizugai H, Arai Y, Umenal T, Isogai E. Chewing ability and quality of life among the elderly residing in a rural community in Japan. J Oral Rehabil 2000;27:731-734.
Miura H, Kariyasu M, Tamasaki K, Arai Y, Sumi Y. Relationship between general health status and the change in chewing ability: a longitudinal study of the frail elderly in Japan over a 3-year period. Gerodontology 2005;22:200-205.
Oral health in American: A report of the Surgeon General. 1998:1-28.
Österberg T, Steen B. Relationship between dental state and dietary intake in 70-year-old males and females in Goteborg, Sweden: a population study. J Oral Rehabil 1982;509-521.
Österberg T, Mellstrom D & Sundh V. Dental health and functional aging. Community Dent Oral Epidemiology 1990;18:313.
Österberg T, Carlsson GE, Tsuga K, Sundh V. and Steen B. Associations between self-assessed masticatory ability and some general health factors in a Swedish population. Gerodontology 1996;13(2):110-117.
Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century-the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31(1):3-24.
Ressine ST, Fertig J, Weber J, Leder S. Impact of dental conditions on patients’ quality of lift. Community Dent Oral Epidemiol 1989;17:7-10.
Sheiham A. Impact of dental treatment on the incidence of dental caries in children and adult. Community Dent Oral Epidemiol 1996;25:104-112.
Sheiham A, Steele JG, Marcenes W, Taskos G et al. Prevalence of impacts of dental and oral disorders and their effects on eating among older people: a national survey in Great Britain. Community Dent Oral Epidemiol 2001;29:195-203.
Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health 1994:11:3-11.
Slade GD. Measuring oral health and quality of life. Chapel Hill, NC: University of North Carolina. Dental Ecology 1997.
Steele JG, Sanders AE, Slade GD et al. How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples. Community Dent Oral Epidemiol 2004;32:107-114.
Suzuki Miho. Dental treatment improves the activities of daily living of the disabled elderly- A stratified randomized controlled trail. Japan Journal of Gerodontology 2007;12(3):265-279.
Takata Y, Ansai T, Awano S, Fukuhara M, Sonoki K, Wakisaka M, Fujisawa K, Akifusa S, Takehara T. Chewing ability and quality of life in an 80-year-old population. J Oral Rehabil 2006;33:330-334.
Vargas CM, Kramarow EA, Yellowitz JA. The Oral Health of Older Americans. Aging Trends:3 Hyattsville, Maryland: National Center for Health Statistics. 2001.
Walter MH, Wolf BH, Rieger C, Boening KW. Prosthetic treatment need in a representative German sample. J Oral Rehabil 2001;28(8):708-716.
Warren JJ, Watkins CA, Cowen HJ et al. Tooth loss in the very old: 13-15-yeay incidence among elderly lowans. Community Dent Oral Epidemiol 2002;30:29-37.
Wong MC, McMillan AS. Tooth loss, denture wearing and oral health-related quality of life in elderly Chinese people. Community Dent Health 2005;22(3):156-61.
Yuji Kamashita, Tomomi Sonoda, Yumiko Kamada, Yasuhiro Nishi, Eiichi Nagaoka. Reliability, validity and preference of an Original Faces Scales for assessing the mood of patients with dentures. Prosthodont Res Pract 6:93-98, 2007.