牙冠延长术改善前牙修复美观效果的临床观察

目的探讨对过短前牙行牙冠延长术的手术方法、术后修复时间、适应证及美学效果。方法对22例患者的148颗过短前牙行牙冠延长术后再行修复治疗，用改良Ryge标准动态评价牙龈、牙周情况，用Kay牙齿美学分类标准评价患牙治疗前后的美观效果。结果牙冠延长术结合修复治疗后，22例患者牙齿的美观效果均达Kay牙齿美学分类ClassⅡ-Ⅰ（化妆）或ClassⅡ-Ⅰ标准。修复后2周复查时约7．4％患牙的牙龈有较明显的炎症。经治疗及口腔卫生保健指导后，98．6％的患牙在修复6个月以上复查时，牙龈、牙周健康状况良好。2例患者随访4年余，其牙龈、牙周均无炎症表现，牙冠比例保持正常。结论通过正确的适应证选择、准确的修复设计、精细的手术操作、术后足够的牙龈恢复期及正规的口腔卫生保健，牙冠延长术结合修复治疗可获得满意的前牙修复美观效果。     

A comparison of perceived and actual dental needs of a select group of children in Texas.

Dental caries (DMFS) evaluations were made for 150 children in Grades 2 to 7. Three months later, a trained interviewer questioned 120 children from 100 families to determine atitudes toward oral hygiene and dental health on the part of (a) the child, (b) the parent, along with (c) the child's perception of the parent's attitude, and (d) the parent's perception of the child's attitude. Evaluation of the perceived attitudes toward oral hygiene revealed a statistically significant correlation between the child's attitude and the degree of dental health as well as between the attitudes of child and parent. Conclusions were: (1) parents were not accurate in their perception of the dental health habits of their children, (2) children were not performing acceptable routine oral hygiene procedures, (3) children accurately perceived the attitudes of their parents toward dental health, and (4) children's actual dental health behavior as manifested by dental health status was related to the attitudes of their parents.     

Effectiveness of a dental education program on oral cleanliness of schoolchildren in Israel

The purpose of this study was to examine the effectiveness of a dental health education program providing dental health information and toothbrushing instruction on oral cleanliness. Two methods of instruction, individual and group instruction, are presented in this study. The plaque situation was assessed in a group of 175 children, 11-14 years of age, by the Patient Hygiene Performance (PHP) method at the beginning of the study and at 1, 2, and 12 months. It was found that immediately after instruction the dental health education program resulted in improved oral hygiene home care for the two experimental groups. However, the improvement noted was achieved regardless of the method of toothbrushing instruction (individual versus group). Moreover, it was demonstrated that maintenance of a satisfactory level of oral hygiene home care was dependent upon review of educational programs and toothbrushing instruction and not related to the method of instruction.     

Impact of a periodontal course on oral hygiene and gingival health among senior dental students

This survey attempted to determine the impact of the periodontal course on oral hygiene and gingival health among 50 senior dental students. The course included the following: patient motivation, instruction in oval hygiene procedures and plaque control, scaling and curellage, temporary splinting and occlusal adjustment. Without advance notice, plaque deposits were scored using the Plaque Index and gingival health was determined using the Gingival Index. The results were collected at the beginning and at the end of the periodontal course (about 2 months). The results were analyzed using the paired t-test. No improvement of either oral hygiene or gingival health was noted at the end of the periodontal course. It seems that even some dental students, who should know the direct relationship between bacterial plaque and periodontal diseases and should be better motivated than the average patient, failed to demonstrate effective oral hygiene. It is difficult to expect an improvement of patient oral hygiene, when the patients have been motivated by students who are unable to perform satisfactory personal oral hygiene themselves. It is suggested that a greater emphasis be placed on patient motivation and instruction in oral hygiene throughout the dental curriculum.     

Oral hygiene and gingival health in Danish dental students and faculty

This survey attempted to determine the status of oral cleanliness and gingival health in 150 dental students and 101 faculty members in a dental school. Without advance notice, plaque deposits were scored, using the Plaque Index System, and gingival health was determined using the criteria of the Gingival Index System. The 1st-year students had the poorest hygiene and gingival health. An improvement (P less than 0.01) was noted in the 2nd-year students who were still not in clinical training but had completed a course in preventive dentistry including oral hygiene techniques. Further improvement (P less than 0.05) was found in students participating in the clinical courses (3rd and 4th years). However, some deterioration of both hygiene and gingival status occurred in the senior 5th year. Among the faculty, the best oral hygiene and gingival state were found in members of departments in which clinical work centered around patient motivation toward prevention and tooth conservation. The scores for plaque and gingivitis were worse in the departments of oral surgery, dental materials, orthodontics and the basic science departments. Almost all departments and every class showed a few individuals with very poor oral hygiene. It is suggested that regular patient contact influences the personal attitude toward oral hygiene, and that professional activity and emphasis on different aspects of the curriculum may be reflected in the attitude of health professionals toward oral health.     

Oral hygiene program for orthodontic patients

The gingival and periodontal health of 62 adolescent orthodontic patients was assessed before and again after orthodontic treatment in a controlled clinical study. Before the commencement of orthodontic treatment, the experimental group received an oral hygiene program consisting of 4 weekly sessions of oral health education, instruction on plaque-control techniques and reviews in plaque removal performance. The control group did not receive this program. It was found that there was a general trend in the study population for improved gingival health as measured by the bleeding index, gingival index, plaque index and gingival crevicular fluid volume. Furthermore, the oral hygiene program induced in the experimental group significantly lower scores in the measured clinical indices compared to the control group. However, no significant difference was noted in the measured probing depths in all subjects before or after the study period.     

Oral health status of 5 years and 12 years school going children in Chennai city--an epidemiological study

India, a developing country, faces many challenges in rendering oral health needs. The majority of Indian population resides in rural areas of which more than 40% constitute children. The purpose of this study was to assess the oral health status of 5 years and 12 years school going children in Chennai city. The study population consisted of 1200 school children of both the sexes (600 private and 600 corporation school children) in 30 schools, which had been selected randomly. The survey is based on WHO, 1999 Oral Health Assessment, which has been modified by including gingival assessment, enamel opacities/ hypoplasia for 5 years. Evaluation of the oral health status of these children revealed, dental caries is the most prevalent disease affecting permanent teeth, more than primary teeth and more in corporation than in private schools, thereby, correlating with the socioeconomic status. It may be concluded that the greatest need of dental health education is at an early age including proper instruction of oral hygiene practices and school based preventive programs, which would help in improving preventive dental behaviour and attitude which is beneficial for life time.     

The Rural Dental Health Program: Long-term Impact of Two Dental Delivery Systems on Children''s Oral Health

This paper addresses the long-term effect of two dental delivery systems established during the Rural Dental Health Program (RDHP) in 1975. At that time 725 children in grades K-2 were assigned randomly to an enriched dental health education program or regular health education program and to a SCHOOL- or COMMUNITY-based dental delivery system. Seven years after funding for RDHP ended, children originally assigned to the COMMUNITY group utilized more professional services and showed a higher level of dental knowledge than children assigned to the SCHOOL group. In addition, COMMUNITY-based children had, on average, twice as many sealed teeth. While the follow-up study did not reveal any statistically significant difference in the clinical oral health indices (DMFS, gingival index, calculus index, plaque index, periodontal probing depth, and orthodontic treatment priority index) the COMMUNITY-based children's higher level of professional dental service utilization, greater number of sealed teeth, and increased dental knowledge should lead to a higher level of oral health in the long run.     

Risk factors of dental caries in 9-10-year-old mentally retarded Finnish children

Abstract Mentally retarded children from one age cohort and their randomly selected controls in one Finnish county were examined for standard of oral hygiene, and their parents and nurses interviewed for information on dental health habits and for other relevant background information. The mentally retarded consumed sugar containing products less frequently than the mentally normal controls. Toothbrushing and fluoride supply was also less common in the retarded than in the healthy. Among the retarded, the dental health habits were most favorable in registered outpatients and least favorable in administratively unknown retarded not included in special welfare. Differences in dental health habits between these subgroups of the retarded were large. In contrast to the findings in the healthy children, frequency of toothbrushing was not associated with the observed standard of oral hygiene in the mentally retarded. The toothbrushing subgroup of the mentally retarded consumed sugar more frequently than the toothbrushing healthy children and commonly used drugs which reduced saliva flow or promoted gingival hyperplasia.     

Dental status of patients with mental disorders in a Nigerian teaching hospital: a preliminary survey

Although individuals with mental disorders are reported to experience dental problems similar to the general population, evidence suggests they actually have higher risks of dental disease and increased oral health needs. This study describes the dental status of 105 psychiatric outpatients in a Nigerian hospital. Information was obtained from subject interviews, medical records, and an oral examination to determine their dental caries and periodontal disease status. The oral hygiene status of the study participants was poor; the mean oral hygiene index score was 2.7 ± 1.20. The decayed, missing, and filled teeth ranged from 0 to 9 with a mean of 2.3 ± 2.28. Only five subjects (4.9%) had restorations and the mean number of filled teeth was .14 ± .67. The subjects’ age was significantly related to the mean oral hygiene score (p= .005), the mean gingival score (p= .006), and caries occurrence (p= .047). The oral health status of psychiatric patients in Nigeria is poor, indicating the need to provide oral health education and increase access to dental care for these patients.     

Effect on caries and gingivitis of a preventive program based on oral hygiene measures and fluoride application

Abstract The present investigation was performed to estimate the effect on caries and gingivitis of a plaque control program delivered at different intervals and supplemented with different fluoride compounds. The study ran for 2 years and was completed by 260 children who were 13–14 years old at the beginning. Professional toothcleaning in combination with detailed oral hygiene instructions repeated once a month or every 3 months significantly improved their oral hygiene status and reduced clinical signs of gingivitis. The addition of fluoride (NaF or MFP) in mouthrinses and toothpastes significantly reduced the number of new carious lesions. No significant differences were observed in gingival health and caries activity between the programs delivered once a month and every 3 months.     

Effect of oral hygiene instruction and professional toothcleaning on caries and gingivitis in schoolchildren

Abstract The present study was performed lo assess the effect on caries and gingivitis of plaque control measures such as oral hygiene instruction, toothcleaning practice and professional toothcleaning. 104 children, 13-14 years old, participated in the trial. Prior to the start of the preventive treatment all children were examined regarding oral hygiene, gingivitis and caries. The caries examination was limited to the proximal surfaces of molars and premolars. Following this baseline examination the children were randomly divided into two treatment groups, A and B. Both groups of children were recalled for professional toothcleaning once every 2 weeks during an 18-month period. In each child the professional toothcleaning was restricted to either the right or the left jaws by random selection. In addition, the children of Group A at each recall appointment received careful oral hygiene instruction and practice in proper toothcleaning methods. In conjunction with the professional toothcleaning an abrasive paste was used including fluoride. The children were re-examined 18 months after the baseline examination. The result of the present investigation demonstrated that professional toothcleaning repeated every second week is a prophylactic measure which in children substantially improves the oral hygiene status, and effectively reduces clinical signs of gingivitis and caries. It was also observed that while oral hygiene instruction and practice in proper toothcleaning techniques reduced plaque and gingivitis, no such effect could be detected regarding the development of caries.     

Oral health status among hospitalized patients

To cite this article:
Int J Dent Hygiene 9 , 2011; 21–29
DOI: 10.1111/j.1601‐5037.2009.00423.x
Carrilho Neto A, De Paula Ramos S, Sant’ana ACP, Passanezi E. Oral health status among hospitalized patients. Abstract: Aim: To investigate into oral health status and its association with health status in hospitalized patients. Methods: A total of 82 patients were examined and 49 (59.7%) patients were men. The patients answered a survey and oral examinations to detect the number of teeth, oral hygiene index, prostheses hygiene, oral lesions, caries, dental plaque index (DPI), gingival inflammation index (GI), gingival bleeding index, periodontitis and periodontal index. Results: Oral hygiene was associated with age, but it was not related to physical disability. Difficulty eating was mainly associated with age and tooth loss. All full and partially dentate patients presented dental plaque, 38 (69%) poor oral hygiene, 58 (98.1%) gingival inflammation, 41 (74.5%) periodontal disease and 33 (60%) caries. Oral lesions were detected in 30 (36.5%) and candidiasis (n = 16, 19.6%) was the most frequent mucous lesion. Caries were associated with smoking and poor oral hygiene. Hospital length of stay and age were associated with increased DPI and GI. Conclusions: The majority of hospitalized patients did not present satisfactory oral hygiene. Caries and periodontal diseases are associated with health behaviours. Increased time length at hospital could increase gingival inflammation and dental plaque accumulation.     

Relationship of socioeconomic background to oral hygiene, gingival status, and dental caries in children.

OBJECTIVE: The aim of this study was to assess the relationship between socioeconomic status and oral hygiene, gingival condition, and dental caries among 12- to 15-year-old children. METHOD AND MATERIALS: Poor children of low-to-moderate socioeconomic status (n = 674) attending 10 public schools were chosen randomly from each of the five geographic areas in Irbid, Jordan. Rich children of high socioeconomic status (n = 347) attending 10 private schools were also included. Schoolchildren were examined for oral hygiene, gingival condition, and dental caries. RESULTS: Significantly higher proportions of children attending public schools had bleeding on brushing and calculus. Mean plaque and gingival scores were higher in public school children than in private school children, but the difference was not statistically significant. The public school children had higher overall scores for decayed, missing, or filled teeth and surfaces as well as higher scores for decayed teeth and surfaces, but there was no statistically significant difference between groups. However, children attending private schools had significantly more missing and filled teeth and surfaces. CONCLUSION: The findings for oral hygiene, gingival status, and dental caries were worse, but not significantly worse, among poor children than they were among rich children. Therefore, dental health education is recommended for both socioeconomic groups.     

Oral health status of children with Treacher Collins syndrome

There is a lack of data on the oral health status of individuals with craniofacial syndromes. A group of 15 children with Treacher Collins syndrome, aged 5 to 15 years old, was examined and evaluated for plaque, caries and gingival problems. The ability of the patients to clean their teeth was also investigated. A high plaque index and poor efficacy of tooth‐brushing was recorded. The caries and gingival indexes were not proportionally as high as the plaque accumulation. There was no association between the gingival index and presence of mouth breathing. There was predominance of the D component in both the dmft and DMFT indexes; this was associated with a need for restorative dental treatment in 60% of the patients, which indicated the need for dental care for these patients. Caretakers should be informed of the importance of oral health and oral hygiene and encouraged to take responsibility for the oral care of the children living at home.     

Dental health of 9–10-year-old mentally retarded children in Eastern Finland

Abstract All 9–10-year-old children in one Finnish county were screened with a standardized set of tasks for their mental performance. 58 verified mentally retarded and 58 randomly selected healthy children were examined for dental and gingival status and level of oral hygiene Comparisons were made between the retarded and the healthy, as well as between subgroups of the retarded. Similar DFS-values, higher DS-values and an inferior level of oral hygiene in terms of VPI were found in mentally retarded when compared with healthy children. No evident difference was found in gingival status (by GBI) between the retarded and the healthy. The mildly or moderately retarded found by the screening and not yet included in special welfare had the highest DFS-scores, the highest prevalence of untreated caries and the poorest gingival health among the retarded.     

Eating disorders and oral health: a matched case-control study

The aim was to compare the oral health status of patients with eating disorders (EDs), with sex- and age-matched controls, with a view to identify self-reported and clinical parameters that might alert the dental healthcare professional to the possibility of EDs. All patients who entered outpatient treatment in an ED clinic during a 12-month period were invited to participate. Of 65 ED patients who started psychiatric/medical treatment, 54 agreed to participate. Eating disorder patients and controls answered a questionnaire and underwent dental clinical examinations. Multivariate analysis identified significantly higher ORs for ED patients to present dental problems (OR = 4.1), burning tongue (OR = 14.2), dry/cracked lips (OR = 9.6), dental erosion (OR = 8.5), and less gingival bleeding (OR = 1.1) compared with healthy controls. Sensitivity and specificity for the correct classification of ED patients and controls using the five variables was 83% and 79%, respectively. The ED patients with vomiting/binge eating behaviors reported worse perceived oral health (OR = 6.0) and had more dental erosion (OR = 5.5) than those without such behavior. In ED patients with longer duration of the disease, dental erosion was significantly more common. In conclusion, oral health problems frequently affect ED patients, and this needs to be considered in patient assessment and treatment decisions.     

Effect of specially designed oral health preventive programme on oral health of visually impaired children: use of audio and tactile aids

Introduction: Contemporary methods of teaching oral hygiene for the removal of dental plaque are not beneficial for visually impaired children, who depend on tactile sensations and hearing for learning. The present study was conducted to educate and motivate visually impaired children to maintain their oral health using specially designed methods that are easy for these children to understand. Additionally, the study evaluated the effectiveness of these methods over a 6-month period. Methodology: The investigation was done on 148 visually impaired children who were residents of two institutes for the visually impaired. The efficacy of a specially designed oral health education programme and two different motivational techniques utilising tactile (Group I: braille + plastic models) or auditory sensations (Group II: audio story + JAWS®, i.e. Job Access With Speech) was evaluated over 6 months based on the children’s plaque and gingival scores. Results: Significant improvement in mean plaque and gingival scores was evident in both the groups at the 6-month evaluation, validating the effectiveness of both the programmes. In Group I, the mean plaque score decreased from 1.34 ± 0.29 at baseline to 1.09 ± 0.26 at 3 months, with a further decrease to 1.04 ± 0.31 at 6 months post-implementation (P < 0.01). The mean plaque score in Group II decreased from 1.24 ± 0.47 at baseline to 1.15 ± 0.15 at 3 months (P = 0.12), and further to 1.10 ± 0.17 at 6 months (P < 0.01) post-implementation of the educational programme. At baseline, 87.8% of the children in Group I had moderate gingivitis, whereas 52.7% of the children in Group II belonged to the mild category. At the end of 6 months, 52.7% of the children in Group I were in the mild category, and 62.2% children in Group II were in the moderate category. Conclusion: Tactile and auditory measures were found to be effective in educating and motivating visually impaired children regarding maintenance of oral hygiene.Key words: Visually impaired persons, dental health education, tactile sense, education of visually disabled, oral hygiene     

系统口腔健康教育对自锁托槽周围牙茵斑的影响

目的通过对自锁托槽矫治错袷患者定期的牙菌斑染色情况进行比较,探讨系统口腔健康教育对自锁托槽周围牙菌斑的影响。方法将70例即将使用自锁托槽固定矫治器的中学生正畸患者随机分为两组,试验组35例进行系统口腔健康教育并使用牙间隙刷,对照组35例仅进行常规刷牙宣教。在崮定正畸前、治疗6个月、保持期第1个月复诊时对两组正畸患者进行牙菌斑染色,检测菌斑指数并比较结果。结果两组患者治疗前牙菌斑染色指数差异无统计学意义（P〉0．05）,但在治疗6个月及保持期1个月全部指标牙位的牙菌斑染色指数差异均有统计学意义（P〈0．05）。结论系统口腔健康宣教并使用牙问隙刷,能提高患者的认知和配合意识,有利于改善自锁托槽矫治错耠患者的口腔卫生状况。     

An argument for dental hygiene to develop as a discipline

Abstract:  The practice of dental hygiene was developed to provide oral health education and preventive oral health care, originally for children. It has grown to provide oral health services valued by a broad spectrum of society, but has not attained the desired respect and status accorded to other professional groups. Objective:  Professional disciplines link actions of practitioners with the science that is the foundation of practice. The purpose of this paper is to examine whether dental hygiene practice could benefit from pursuit of development as a discipline. Methods:  Literature on professionalization and disciplines, related to dental hygiene in general and the North American context specifically, was retrieved from databases and grey sources, such as organizational reports. Dental hygiene's current characteristics relative to a discipline were examined. Results:  Dental hygiene has developed some characteristics of a discipline, such as identifying a metaparadigm that includes concepts of the client, the environment, health/oral health and dental hygiene actions, with a perspective that includes a focus on disease prevention and oral health promotion. However, research production by dental hygienists has been limited, and often not situated within theoretical or conceptual frameworks. Conclusion:  Dental hygiene draws its knowledge for practice from a variety of sources. Dental hygiene could strengthen its value to society by prioritizing development of highly skilled researchers to study interventions leading to improved oral outcomes, and transferring that knowledge to practitioners, strengthening links between practice and science. Intentional pursuit of knowledge for practice would lead to dental hygiene's eventual emergence as a professional discipline.