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측두하악장애에 대한 치과 내원환자의 인지도와 이해도에 관한 설문조사 연구

A Research on the Basis of Questionnaires about the Dental Patients' Awareness and Understanding of TMDs

  • 김경희 (인제대학교 부산백병원 구강내과)
  • Kim, Kyung Hee (Department of Oral Medicine, Busan Paik Hospital, Inje University)
  • 투고 : 2013.07.24
  • 심사 : 2013.09.02
  • 발행 : 2013.09.30

초록

본 연구는 측두하악장애에 대한 치과 내원환자의 인지도와 이해도를 조사, 분석하기 위해 시행되었다. 인제대학교 부산백병원 치과 혹은 울산광역시 소재 한빛치과병원을 방문한 총 243명의 환자에게 설문조사를 시행하였고, 설문지의 모든 문항에 대해 성실히 답한 195명을 대상으로 하여 다음과 같은 결과를 얻었다. 1. "측두하악장애"란 용어를 인지하고 있는 환자는 전체 대상자의17.4%였고, 총 12년 이상의 학력을 가진 군(82.4%, p<0.01)은 다른 군에서 보다 "측두하악장애"에 대한 인지도가 유의하게 높았다. "턱관절질환"이란 용어를 인지하고 있는 환자는 전체 대상자의 81.0%였고, 30-49세 연령군(45.6%, p<0.05)과 총 12년 이상의 학력을 가진 군(60.1%, p<0.01)에서 다른 군보다 "턱관절질환"이란 용어에 대한 인지도가 유의하게 높았다. 2. 전체의 과반수 이상인 50.6%가 턱관절질환의 개념으로 "턱을 무리하게 사용해서 생기는 병이다"를 선택했다. 3. 턱관절질환에 대해 들은 경로로TV, 라디오(41.4%)가 가장 많았고, 가족과 친구(20.2%), 병원 및 병원관계자(18.2%), 인터넷(15.7%) 및 신문과 잡지(4.5%)순이었다. TV, 라디오를 통해서 턱관절질환에 대해 들어본 응답자 중 30-49세 연령군이 다른 군보다 유의하게 높은 비율(52.4%, p<0.05)을 보였다. 인터넷을 통해서 턱관절질환에 대해 들어본 응답자 중 18-29세 연령군이 다른 군보다 유의하게 높은 비율(61.3%, p<0.01)을 보였다. 병원과 병원관계자를 통해서 턱관절질환에 대해 들어본 응답자 중 총 12년 이상의 학력을 가진 군(75%, p<0.05)이 다른 군보다 유의하게 높은 비율을 보였다. 4. 환자들은 입을 벌리고 다물 때 턱에서 나는 소리(26.9%), 입을 크게 벌리지 못한다(25.1%), 귀 앞쪽 부위의 통증(13.7%)을 턱관절질환의 증상과 징후로 골랐다. 턱관절질환의 원인으로는 딱딱하거나 질긴 음식을 즐겨먹기(19.5%), 아래, 윗니가 잘 안 맞물림(19.0%), 한쪽 어금니로 음식씹기(18.5%)를 많이 선택했다. 턱관절질환의 치료법으로 턱관절수술(28%)을 가장 많이 꼽았고, 구강내 장치치료(23.9%), 물리치료(14.6%)가 그 뒤를 따랐다. 턱관절질환의 예방법으로 딱딱한 음식의 섭취를 줄인다(21.1%), 입을 너무 크게 벌리지 않는다(17.0%), 양쪽 어금니로 음식을 씹는다(15.4%)를 많이 선택했다.

This study was conducted to investigate and analyze the dental patients' awareness and understanding about TMDs. Among the total number of 243 patients who had visited the department of dentistry of Busan Paik Hospital, Inje University or Hanvit dental hospital in Ulsan metropolitan city and participated in the survey, 195 patients who filled in all parts of the questionnaire were selected as the subjects. The results were as follows. 1. The subjects who were aware of the term, "TMDs" were 17.4%. The group with total education period of 12 years and over was significantly more aware of "TMD"(82.4%, p<0.01) than the other group. The subjects who were aware of the term, "jaw joint disease" were 81.0%. 30 to 49 age group(45.6%, p<0.05) and the group with total education period of 12 years and over(60.1%, p<0.01) were significantly more aware of "jaw joint disease" than other groups. 2. More than half of the subjects chose "overuse of the jaws" as the concept of jaw joint disease(50.6%). 3. TV, radio(41.4%) was the most frequent source of awareness about jaw joint disease followed by family and friends(20.2%), hospitals and health professionals(18.2%), internet(15.7%) and newspapers, magazines(4.5%). Among the respondents who were aware of jaw joint disease through TV, radio, 30 to 49 age group showed significantly higher percentage(52.4%, p<0.05) than other age groups. Among the respondents who were aware of jaw joint disease through internet, 18 to 29 age group showed significantly higher percentage(61.3%, p<0.01) than other age groups. Among the respondents who were aware of jaw joint disease from hospitals and health professionals, the group with total education period of 12 years and over showed significantly higher percentage(75.0%, p<0.05) than the other group. 4. Noise during mouth opening and closing(26.9%), mouth opening difficulty(25.1%) and jaw pain(13.7%) were the most frequently responded sign and symptoms of jaw joint disease. For the causes of jaw joint disease, enjoying hard food chewing(19.5%), occlusal discrepancy(19.0%) and chewing with one side only(18.5%) were responded in sequence. TMJ surgery(28%) was the most frequently responded treatment method for jaw joint disease, followed by occlusal appliance therapy(23.9%) and physical therapy(14.6%). For preventive method of jaw joint disease, avoid eating hard food(21.1%), avoid opening mouth wide(17.0%) and simultaneous using of molar of both side when chewing food(15.4%) were chosen frequently.

키워드

참고문헌

  1. The American Academy of Orofacial Pain, edited by Okeson JP. Orofacial pain: guidelines for assessment, diagnosis, and management. Illinois, 1996, Quintessence Publishing Co, Inc, pp. 116, 142.
  2. Okeson JP. Bell's Orofacial Pains. 5TH ed., Chicago, 1995, Quintessence Publishing Co, Inc, pp. 123-133.
  3. Solberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults. J Am Dent Assoc 1979;98(1):25-34. https://doi.org/10.14219/jada.archive.1979.0008
  4. Ingervall B, Mohlin B, Thilander B. Prevalence of symptoms of functional disturbances of the masticatory system in Swedish men. J Oral Rehabil 1980;7(3):185-197. https://doi.org/10.1111/j.1365-2842.1980.tb00435.x
  5. Rieder CE, Martinoff JT, Wilcox SA. The prevalence of mandibular dysfunction. Part I: Sex and age distribution of related signs and symptoms. J Prosthet Dent 1983;50(1):81-88. https://doi.org/10.1016/0022-3913(83)90171-3
  6. Gazit E, Lieberman M, Eini R, et al. Prevalence of mandibular dysfunction in 10-18 year old Israeli schoolchildren. J Oral Rehabil 1984;11(4):307-317. https://doi.org/10.1111/j.1365-2842.1984.tb00581.x
  7. Pullinger AG, Seligman DA, Solberg WK. Temporomandibular disorders. Part II: Occlusal factors associated with temporomandibular joint tenderness and dysfunction. J Prosthet Dent 1988;59(3):363-367. https://doi.org/10.1016/0022-3913(88)90191-6
  8. Agerberg G, Inkapool I. Craniomandibular disorders in an urban Swedish population. J Craniomandib Disord 1990;4(3):154-164.
  9. Magnusson T, Carlsson GE, Eagermark I. Changes in subjective symptoms of craniomandibular disorders in children and adolescents during a 10-year period. J Orofac Pain 1993;7(1):76-82.
  10. Tanne K, Tanaka E, Sakuda M. Association between malocclusion and temporomandibular disorders in orthodontic patients before treatment. J Orofac Pain 1993;7(2):156-162.
  11. Hiltunen K, Schmidt-Kaunisaho K, Nevalainen J, et al. Prevalence of signs of temporomandibular disorders among elderly inhabitants of Helsinki, Finland. Acta Odontol Scand 1995;53(1):20-23. https://doi.org/10.3109/00016359509005939
  12. Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed., Missouri, 2013, Elservier Mosby, pp. 102-107.
  13. National Health Insurance Service: http://www.nhis.or. kr/portal/site/main/MENU_WBDCC01
  14. Kim SH. Study of general public's knowledge of TMD: how predominantly is TMD understood by people. J KAOM 2000;25(4):371-382.
  15. Ok SJ, Suh BJ, Tae IH, Ko MY, Ahn YW. The effects of established-knowledge of temporomandibular disorders on initial treatment. J KAOM 2008;33(1):75-83.
  16. Von KM, Dworkin SF, le RL, Kruger A. An epidemiologic comparison of pain complaints, Pain 1988;32(2):173-183. https://doi.org/10.1016/0304-3959(88)90066-8
  17. Dworkin SF, LeResche L, Von KMR. Diagnostic studies of temporomandibular disorders:challenges from an epidemiologic perspective. Anesth Prog 1990;37(2-3):147-154.
  18. De Kanter RJ, Truin GJ, Burgersdijk RC, ET AL. Prevalence in the Dutch adult population and a meta-analysis of signs and symptoms of temporomandibular disorders. J Den Res 1993;72(11):1509 -1518. https://doi.org/10.1177/00220345930720110901
  19. Carlsson GE. Long-term effects of treatment of craniomandibular disorders. J Craniomand Pract 1985; 3:337-342.
  20. Randolph CS, Greene CS, Moretti R, et al. Conservative management of temporomandibular disorders: A posttreatment comparison between patients from a university clinic and from private practice. Am J Orthod Dentofac Orthop 1990;98; 77-82. https://doi.org/10.1016/0889-5406(90)70035-B
  21. Skeppar J, Nilner M. T reatment of craniomandibular disorders in children and young adults. J Orofac Pain 1993;7:362-369.
  22. Brown DT, Gaudet EL. Outcome measurement for treated and untreated TMD patients using the TMJ scale. J Craniomand Pract 1994;12:216-221.
  23. Lund JP, Lavigne GJ, Dubner R, Sessle BJ. Orofacial pain: from basic science to clinical management. Illinois, 2001, Quintessence Publishing Co, Inc, pp. 245.